Effects of Flurazepam and Zopiclone on the Performance of Chronic Insomniac Patients: A Study of Ethanol-Drug Interaction

Mamelak, Mortimer; Buck, Leslie T.; Csima, Adele; Price, Victoria; Smiley, Alison

doi:10.1093/sleep/10.suppl_1.79

Cited by 17 publications

(12 citation statements)

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“…Morning impairment of psychomotor performance after night-time zopiclone 7.5mg administration is similar to that observed after administration of nitrazepam 5 to 10mg (Goa & Heel 1986), but less than that occurring after flurazepam 15 to 30mg (Goa-& Heel 1986;Mamelak et al 1987;Singh & Bourgouin 1990).…”

Section: Effects On Psychomotor Function and Memorysupporting

confidence: 60%

“…Psychomotor function was not impaired the morning after night-time administration of zopiclone 7.5mg in middle-aged patients (mean age 50 years) with insomnia (Mamelak et al 1987) or in elderly patients (aged 68 to 94 years) with insomnia given up to 10mg on retiring (Dehlin et al 1983). Psychomotor function was not impaired the morning after night-time administration of zopiclone 7.5mg in middle-aged patients (mean age 50 years) with insomnia (Mamelak et al 1987) or in elderly patients (aged 68 to 94 years) with insomnia given up to 10mg on retiring (Dehlin et al 1983).…”

Section: Effects On Psychomotor Function and Memorymentioning

confidence: 99%

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Zopiclone

Wadworth¹,

McTavish²

1993

Drugs & Aging

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Zopiclone is a cyclopyrrolone which is chemically unrelated to the benzodiazepines and is thought to act on the GABAA receptor complex at a site distinct from, but closely related to, the benzodiazepine binding site. The hypnotic efficacy of zopiclone administered as single oral doses has been demonstrated in patients undergoing next-day surgery and in patients with insomnia, and these studies have established an optimal dose of 7.5mg for elderly patients. Using this dose, clinical studies have shown that zopiclone improved sleep in elderly patients to a similar extent as triazolam 0.125 to 0.5mg, flurazepam 15mg, and nitrazepam 5mg. Studies that also included younger patients have shown that zopiclone 7.5mg is at least as effective as triazolam 0.25 or 0.5mg, and on most sleep parameters is comparable to temazepam 20mg, nitrazepam 5mg, flunitrazepam 2mg, and flurazepam 20mg. Zopiclone causes minimal impairment to psychomotor performance and mental alertness the morning after night-time administration. The drug is generally well tolerated by patients of all ages; the most frequently reported adverse effects being bitter taste and dry mouth. Treatment withdrawal due to adverse effects is seldom required and reports of rebound insomnia after zopiclone withdrawal are rare. While symptoms of physical dependence have not been observed in clinical studies, there have been isolated reports of physical dependence in patients with a history of substance abuse. Although the latter finding should be kept in mind, it appears that zopiclone has a low dependence liability. Thus, with its short duration of action and good tolerability profile, zopiclone is a well established alternative to the benzodiazepine hypnotics and may be particularly beneficial in those patients unable or unwilling to tolerate the residual effects associated with many other hypnotic agents.

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Section: Effects On Psychomotor Function and Memorysupporting

confidence: 60%

Section: Effects On Psychomotor Function and Memorymentioning

confidence: 99%

Zopiclone

Wadworth¹,

McTavish²

1993

Drugs & Aging

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“…In 4 out of the 44 experimental studies, ethanol was used as a comparator drug for zopiclone impairment [23,71,77,78,84,85]. (The 4 studies were reported in 6 manuscripts.)…”

Section: Current Knowledge On Zopiclone and Traffic Accident Riskmentioning

confidence: 99%

Road traffic accident risk related to prescriptions of the hypnotics zopiclone, zolpidem, flunitrazepam and nitrazepam

et al. 2008

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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%

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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Effects of Flurazepam and Zopiclone on the Performance of Chronic Insomniac Patients: A Study of Ethanol-Drug Interaction

Cited by 17 publications

References 0 publications

Zopiclone

Zopiclone

Road traffic accident risk related to prescriptions of the hypnotics zopiclone, zolpidem, flunitrazepam and nitrazepam

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

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