The role of benzodiazepines in common conditions: a narrative review focusing on lormetazepam

Abstract

This review aimed to examine the place of benzodiazepines, specifically lormetazepam, in the treatment of insomnia, including during pregnancy or in patients with psychodermatoses. PubMed was searched for the term “lormetazepam” in association with MeSH terms encompassing anxiety, insomnia/sleep disorders, pregnancy/gestation, and psychodermatoses/skin disorders. English-language articles up to 31 July 2022 were identified. Ad hoc searches for relevant literature were performed at later stages of review development. Multiple randomized, placebo-controlled studies have demonstrated that lormetazepam dose-dependently increases total sleep time, decreases wakefulness over a dosing range of 0.5–2.0 mg, and improves subjective assessments of sleep quality. Lormetazepam is as effective as other benzodiazepines in improving sleep duration and quality, but is better tolerated than the long-acting agents with minimal next-day effects. Benzodiazepines can be used as short-term monotherapy at the lowest effective dose during the second or third trimesters of pregnancy; lormetazepam is also a reasonable choice due to its limited transplacental passage. Insomnia associated with skin disorders or pregnancy can be managed by effective symptom control (especially itching), sleep hygiene, treatment of anxiety/depression, and a short course of hypnotics.

Stroke, COVID-19, and other somatic aspects of psychiatric disorders treatments

“…It is therefore important to be informed about the specificity of each compound. Lormetazepam is among the most widely used benzodiazepines for insomnia in Europe, though it is not available in North America, and in this issue, a review focuses on its specificity and features (Pallanti, 2023). Lormetazepam has been available for more than 40 years and, because of the relatively short half-life and lack of active metabolites, it is usually used for the short-term treatment of insomnia, frequently combined with other pharmacological or non-pharmacological interventions, but a specific focus is lacking in the literature.…”