Hypnotic efficacy and clinical safety of midazolam in shift‐workers.

Scollo-Lavizzari, G

doi:10.1111/j.1365-2125.1983.tb02273.x

Cited by 8 publications

(5 citation statements)

References 5 publications

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“…In short-term studies in healthy subjects, midazolam 10-30 mg orally significantly decreased sleep latency and stage 1 sleep, increased stage 2 sleep, delayed the onset of the first rapid eye-movement (REM) period and slightly reduced REM sleep, reduced wake time and the number of awakenings after sleep onset, increased or had no effect on slowwave sleep (stages 3 and 4) and prolonged total sleep time. [61][62][63][64][65] At the lowest dose of 10 mg, midazolam exhibited a clear sedative effect in healthy volunteers,'j6 caused a very slight increase (1.6%) in total sleep time, increased REM latency by 42% and total REM time by 14% and decreased the amount of sleep stage 1 by 32%. The duration of sleep stages 3 and 4 remained ~n c h a n g e d .~~ Higher doses -20-30 mgreduced REM sleep,66 further increased REM sleep and had a more pronounced effect on latency of sleep onset and on the duration of stage 2 sleep.…”

Section: Healthy Subjectsmentioning

confidence: 99%

Midazolam: The First Water‐soluble Benzodiazepine; Pharmacology, Pharmacokinetics and Efficacy in Insomnia and Anesthesia

Kanto

1985

Pharmacotherapy

180

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Midazolam is a 1,4-benzodiazepine derivative with a unique chemical structure: depending on environmental pH, the drug can produce highly water-soluble salts (pH less than 4) or exist in lipophilic diazepine ring-closed form (pH greater than 4). This characteristic contributes to rapid onset of action and to good local tolerance after parenteral administration. After both oral and parenteral administration, midazolam has a fast absorption rate and is rapidly excreted, with a half-life of only about 2 hours. A reasonably good correlation has been found between plasma levels and clinical effects, indicating a fast but brief response. As a hypnotic, midazolam is mainly indicated in insomniac patients with difficulties in falling asleep or having a pathologic sleep pattern during the first half of the night. No marked hangover effects are present the next morning. In anesthesiology, midazolam appears to be a useful, short-acting, sedative-anxiolytic and amnesic premedicant after both oral and parenteral administration. In minor surgery, however, the slow, unpredictable onset and variable duration of action, as compared with thiopental, may inhibit its routine use as an induction agent, especially in young patients, without heavy premedication. In major surgery, midazolam is an alternative to thiopental for induction of anesthesia in spite of its slow, variable induction time. Its advantages include good cardiovascular stability, transient and mild respiratory depression, low frequency of venous irritation, production of anterograde amnesia and short duration of action in comparison with other benzodiazepines.

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Section: Healthy Subjectsmentioning

confidence: 99%

Midazolam: The First Water‐soluble Benzodiazepine; Pharmacology, Pharmacokinetics and Efficacy in Insomnia and Anesthesia

Kanto

1985

Pharmacotherapy

180

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“…The results obtained in open trials and confirmed in double-blind studies have shown midazolam to be very effective in the treatment of sleep disorders of different degree Scollo-Lavizzari, 1983; Vogel & Vogel, 1983). In comparative studies with other benzodiazepine derivatives, midazolam has frequently been shown to be superior to the reference compounds, particularly with regard to dimininishing the sleep onset latency (Helcl et al, 1981;Feldmeier & Kapp, 1983;Nicholson & Stone, 1983).…”

Section: Introductionmentioning

confidence: 66%

Efficacy and safety of midazolam and vesparax in treatment of sleep disorders.

Fischbach¹

1983

Brit J Clinical Pharma

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1 In a double-blind parallel study in which a placebo phase preceded and followed the double-blind verum phase, midazolam 15 mg and Vesparax (150 mg secobarbital, 50 mg brallobarbital, 50 mg hydroxyzine) were administered to 30 female patients aged 20-76 years, suffering from insomnia secondary to neuromuscular disease. 2 Both products were shown to be efficient hypnotics maintaining a constant level of effect.Midazolam proved to be better tolerated and, in contrast to Vesparax, did not cause hangover, nor did rebound phenomena ensue after its withdrawal.

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“…Since midazolam in a dose of 15 mg has been shown to possess no pharmacological effect in man at around 6 h after administration (Ziegler et al, 1983;Gudgeon & Hindmarch, 1983), the increase in sleep duration must be due to an indirect mechanism. In addition to fast sleep onset, midazolam results in rapid attainment of deep sleep stages (Krieger et al, 1983;Scollo-Lavizzari, 1983) and, in low doses, has scarcely any effect on sleep architecture. These conditions would appear to favour the smooth transition to spontaneous sleep.…”

Section: Discussionmentioning

confidence: 99%

“…(Ziegler et al, 1983;Gudgeon & Hindmarch, 1983), the increase in sleep duration must be due to an indirect mechanism. In addition to fast sleep onset, midazolam results in rapid attainment of deep sleep stages (Krieger et al, 1983;Scollo-Lavizzari, 1983) Midazolam would appear to be equally as well suited for hospitalized patients as for out-patient treatment of sleep disturbances in a working population. Oxazepam in a dose of 50 mg would be more appropriate for the treatment of insomnia in hospitalized patients, particularly when rapid sleep onset is not overly important, as there is strong evidence that, in such a dose, residual effects on performance will be present (Nicholson & Stone, 1978a, 1978b.…”

Section: Safetymentioning

confidence: 99%

Midazolam and oxazepam in the treatment of insomnia in hospitalized patients.

Gallais¹,

Casanova²,

Fabregat³

1983

Brit J Clinical Pharma

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Fifty‐nine hospitalized patients participated in a double‐blind study: 19 received 15 mg midazolam, 20 received 50 mg oxazepam, and 20 placebo. The three groups were comparable with regard to age, sex, height, weight, and degree and type of insomnia. The sleep‐onset latency was shorter with midazolam than with placebo or oxazepam (Mann‐ Whitney test, alpha less than 0.05). With regard to total sleep duration and the number of nocturnal awakenings, there was no difference between the midazolam and oxazepam groups, whereas there was a difference between these two groups and placebo. More subjects of the midazolam group felt calm and refreshed on awakening. Safety, assessed by clinical examination and laboratory tests, was excellent. This study confirms the usefulness of midazolam in treating ‘early’ insomnia, i.e. difficulty in falling asleep.

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Hypnotic efficacy and clinical safety of midazolam in shift‐workers.

Cited by 8 publications

References 5 publications

Midazolam: The First Water‐soluble Benzodiazepine; Pharmacology, Pharmacokinetics and Efficacy in Insomnia and Anesthesia

Midazolam: The First Water‐soluble Benzodiazepine; Pharmacology, Pharmacokinetics and Efficacy in Insomnia and Anesthesia

Efficacy and safety of midazolam and vesparax in treatment of sleep disorders.

Midazolam and oxazepam in the treatment of insomnia in hospitalized patients.

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