A clinical and psychometric evaluation of flurazepam.

Salkind,; Silverstone, Trevor

doi:10.1111/j.1365-2125.1975.tb01579.x

Cited by 43 publications

(26 citation statements)

References 5 publications

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“…It is possible that 2 mg of flunitrazepam is slightly superior to 7.5 mg of zopiclone in hypnotic potency [29], Our results confirm the findings of earlier studies in which motor impairment and EEG changes characteristic of benzodiazepines have been measurable up to 12-18 h after 1 and 2 mg of flunitrazepam orally [3,8,15]. Similar results have been obtained for other benzodiazepines, especially for those with long elimination half-life or with long-acting active metabolites [3,[22][23][24], and even for those with rapid elimination rate, e.g.. triazo lam and temazepam [15][16][17], provided that fairly high doses are used. There is some evi dence that glutethimide and methaqualone, unless otherwise more harmful, could be safer in this respect [22], As to zopiclone, it had not residual effects in the present study at a dose of 7.5 mg. We think that this lack of hangover, although shown in healthy volunteers, is advanta geous, as residual effects can be serious for ambulant insomniacs who are active in skilled mental or physical work despite sug gestions that in practice the residual effects of hypnotics have no major importance and that chronic insomniacs suffer from hang over similarly after nights on placebo or longacting hypnotics [6], At least results concern ing late adverse effects of hypnotics on per formance of healthy volunteers may well be generalized to a majority of patients receiving hypnotics who may not suffer from severe insomnia [10].…”

Section: Discussionsupporting

confidence: 81%

Drug-Alcohol Interactions on Psychomotor Skills: Zopiclone and Flunitrazepam

Seppαlä¹,

Nuotto²,

Dreyfus³

1983

Pharmacology

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Interaction between alcohol and zopiclone or flunitrazepam as well as the residual effects of both these hypnotics were studied in 20 normal male volunteers who received each 3 of 6 different drug and drink combinations according to a balanced incomplete block design as follows: placebo, zopiclone (7.5 mg), or flunitrazepam (2 mg) was administered double-blind in identical capsules at 23.00 h, and 0.5 g/kg body weight of alcohol or placebo alcohol was given at 08.30 h the following morning. Psychomotor skills of the volunteers were measured before drinking and 30 min, 1.5 h and 2.5 h after it. As compared with placebo, zopiclone had no residual effects, while flunitrazepam had some effects on standing steadiness, tracking, and flicker recognition. Alcohol alone had a non-significant effect on skills, and the combination zopiclone plus alcohol behaved as alcohol alone. Flunitrazepam plus alcohol impaired significantly standing steadiness, tracking, and reactive skills when compared with all other treatments. Time anticipation and hand and foot proprioception were not affected by any treatment. The results suggest that flunitrazepam, unlike zopiclone, has residual effects and interacts with alcohol in the morning following overnight ingestion of the drug.

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Section: Discussionsupporting

confidence: 81%

Drug-Alcohol Interactions on Psychomotor Skills: Zopiclone and Flunitrazepam

Seppαlä¹,

Nuotto²,

Dreyfus³

1983

Pharmacology

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“…98,100,101,105,109,149,[152][153][154][161][162][163][164][165][166][167] No studies contained data adequate for meta-analysis. No meta-analysis of harms was possible.…”

Section: Discussionmentioning

confidence: 99%

“…Reeves 98 noted that 6 of 13 flurazepam subjects reported somnolence (versus 4/14 in the placebo group). Salkind 167 described impaired motor performance in the flurazepam 30 mg group (although not in the 15 mg group) and a significantly higher rate of "hangover effect" at the higher dosage. In the cross-over design, 11 of 30 flurazepam group experienced morning drowsiness/hangover, which was reported by only 3 of 30 subjects during the flurazepam 15 mg period and 2 of 30 while taking placebo.…”

Section: Cohnmentioning

confidence: 93%

0395 Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline

Sateia

Buysse

Krystal

et al. 2017

Sleep

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Introduction:The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated. Unlike previous meta-analyses, which focused on broad classes of drugs, this guideline focuses on individual drugs commonly used to treat insomnia. It includes drugs that are FDA-approved for the treatment of insomnia, as well as several drugs commonly used to treat insomnia without an FDA indication for this condition. This guideline should be used in conjunction with other AASM guidelines on the evaluation and treatment of chronic insomnia in adults. Methods: The American Academy of Sleep Medicine commissioned a task force of four experts in sleep medicine. A systematic review was conducted to identify randomized controlled trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, and patient values and preferences. Literature reviews are provided for those pharmacologic agents for which sufficient evidence was available to establish recommendations. The AASM Board of Directors approved the final recommendations. Recommendations:The following recommendations are intended as a guideline for clinicians in choosing a specific pharmacological agent for treatment of chronic insomnia in adults, when such treatment is indicated. Under GRADE, a STRONG recommendation is one that clinicians should, under most circumstances, follow. A WEAK recommendation reflects a lower degree of certainty in the outcome and appropriateness of the patient-care strategy for all patients, but should not be construed as an indication of ineffectiveness. GRADE recommendation strengths do not refer to the magnitude of treatment effects in a particular patient, but rather, to the strength of evidence in published data. Downgrading the quality of evidence for these treatments is predictable in GRADE, due to the funding source for most pharmacological clinical trials and the attendant risk of publication bias; the relatively small number of eligible trials for each individual agent; and the observed heterogeneity in the data. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources.1. We suggest that clinicians use suvorexant as a treatment for sleep maintenance insomnia (versus no treatment) in adults. (WEAK) 2. We suggest that clinicians use eszopiclone as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK) 3. We suggest that clinicians use zaleplon as a treatment for sleep onset insomnia (versus no treatment) in adults. (WEAK) 4. We suggest that clinicians use zolpidem as a treatment for sleep onset and sleep maintenance in...

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“…Performance on these tasks is subject to practice effects which must be carefully controlled and personality has been shown to determine pursuit rotor scores (Eysenck, 1972). None of the 10 studies reviewed by Vogel (1979) showed any change in pursuit rotor performance following chlordiazepoxide 10-15 mg, diazepam 5-10 mg, meprobamate 200-800 mg, prazepam 10 mg and medazepam 10 mg. Salkind, Hanks & Silverstone (1979) found that pursuit rotor performance was significantly improved by placebo in a group of anxious patients showing the clear effects of practice but Salkind & Silverstone (1975) found impairment of tracking following 30 mg flurazepam. In a three way comparison of hexobarbital 250 mg, caffeine 200 mg and pemoline 40 mg against placebo, Busch et al (1979) found no significant changes in pursuit rotor performance although there were drug effects observable on other tests of concentration and memory.…”

Section: Gross Body Movementmentioning

confidence: 99%

“…The inconsistencies between some of the results from different studies on digit span assessments are due to different methodologies and test conditions for Andersson (1975) Most studies have used the technique described by Frith (1967) and tapping performance has been shown to be impaired following nitrazepam 10 mg (Peck et al, 1977), diazepam 10 mg ('ern' et al, 1973;Ghoneim et al, 1975), butobarbitone 200 mg (Walters & Lader, 1971), flurazepam 30 mg (Salkind & Silverstone, 1975), oxazepam 10 mg (Di Mascio & Barrett, 1965) and nitrazepam 5 and 10 mg (Bond & Lader, 1972 …”

Section: Memory and Learningmentioning

confidence: 99%