Sleep maintenance insomnia: strengths and weaknesses of current pharmacologic therapies

Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists
Russell Rosenberg

Abstract

Although insomnia is highly prevalent, sleep disturbances often go unrecognized and untreated. When insomnia is recognized, considerable emphasis has been placed on improving sleep onset; however, there is growing evidence that improving sleep maintenance is an equally important treatment goal. A MEDLINE literature search was performed using the search parameters "insomnia," "zolpidem," "zaleplon," "flurazepam," "estazolam," "quazepam," "triazolam," and "temazepam," as these agents are FDA-approved for the treatment of insomnia. Per reviewer comments, the search criteria was later expanded to include lorazepam. A literature search using the terms "trazodone" and "insomnia" was also performed, as this is the second-most commonly prescribed agent for treating insomnia. Sleep efficacy endpoints from randomized, placebo-controlled clinical trials in adult populations and key review articles published between 1975 and 2004 were included in this review. As only one randomized placebo-controlled trial evaluated trazodone use in primary insomnia, the trazodone search was expanded to include all clinical trials that evaluated trazodone use in insomnia. Relevant texts and other articles that evaluated side effect profiles of these agents...Continue Reading

References

Jun 1, 1975·British Journal of Clinical Pharmacology·M R Salkind, T Silverstone
Jan 1, 1976·The Journal of International Medical Research·P Lomen, O I Linet
Jan 1, 1976·The Journal of International Medical Research·L F FabreR T Harris
Jan 1, 1978·The Journal of International Medical Research·A J Bowen
Jan 1, 1978·The Journal of International Medical Research·K K Okawa, G S Allens
Jan 1, 1979·British Journal of Clinical Pharmacology·M M MitlerW C Dement
Jan 1, 1979·British Journal of Clinical Pharmacology·W A Heffron, P B Roth
Jan 1, 1979·British Journal of Clinical Pharmacology·J M Fillingim
Jan 1, 1979·The Journal of International Medical Research·Thomas RothM Kaffeman
May 1, 1975·Clinical Pharmacology and Therapeutics·A Sunshine
Jan 1, 1979·The Journal of International Medical Research·I MacPhailC R Purvis
Jan 1, 1992·Psychopharmacology·A L van BemmelR van Diest
Mar 1, 1992·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·D Wheatley
Jan 1, 1992·Acta Oncologica·P Strang
Aug 1, 1991·Journal of Clinical Pharmacology·J B CohnM Ettinger
Sep 1, 1990·Hospital Practice·A Kales
Apr 1, 1991·Clinical Pharmacology and Therapeutics·A KalesE C Fee
Oct 1, 1990·International Clinical Psychopharmacology·R ElieP Le Morvan
Oct 1, 1990·Archives of General Psychiatry·K RickelsD J Greenblatt
Oct 1, 1990·Archives of General Psychiatry·E SchweizerD J Greenblatt
Mar 1, 1985·Archives of General Psychiatry·G D MellingerE H Uhlenhuth
Mar 1, 1985·The British Journal of Psychiatry : the Journal of Mental Science·D Wheatley
Jan 1, 1988·Psychopharmacology·J MouretM Renardet
Jan 1, 1982·Current Medical Research and Opinion·D Van Steenis
Jan 1, 1984·The Journal of International Medical Research·M GringrasS I Ankier
Jan 1, 1983·The Journal of International Medical Research·J Mendels, S Stern
Jan 1, 1983·The Journal of International Medical Research·R Hernández LaraM C Ponce
Jan 1, 1983·Psychopharmacology·E HartmannC Spinweber
Aug 1, 1983·British Journal of Clinical Pharmacology·I MontgomeryK Adam
Jan 1, 1995·Psychiatric Services : a Journal of the American Psychiatric Association·W V McCall
Aug 1, 1994·The American Journal of Psychiatry·Charles M MorinS M Schwartz
Apr 1, 1997·Clinical Neuropharmacology·J C WareG W Vogel
Jun 9, 1999·The American Journal of Psychiatry·J L Levenson
Nov 26, 1999·European Psychiatry : the Journal of the Association of European Psychiatrists·P M Haffmans, M S Vos
Jun 1, 2000·Journal of Clinical Psychopharmacology·S M TroyRichard M Mangano
Jun 14, 2000·Seminars in Reproductive Endocrinology·K E Moe
Dec 16, 2000·Clinical Therapeutics·K W WeitzelJ G Strom
Jul 27, 2001·The Journal of International Medical Research·S Tsutsui, Zolipidem Study Group
Jan 5, 2002·The American Journal of Psychiatry·Michael T SmithDaniel J Buysse
Jan 31, 2002·Progress in Neuro-psychopharmacology & Biological Psychiatry·Gerda Maria Saletu-ZyhlarzB Saletu
Sep 6, 2002·Journal of Medicinal Chemistry·Osamu UchikawaShigenori Ohkawa
Aug 21, 2003·Sleep Medicine Reviews·Charles M Morin
Oct 24, 2003·Sleep·Michael LittnerStandards of Practice Committe
Feb 11, 2005·Current Medical Research and Opinion·Gary ZammitThomas Roth
Mar 3, 2005·European Journal of Pharmacology·Paul TarantinoKate Lansdell

Citations

Nov 28, 2012·Wiener medizinische Wochenschrift·Inga TrompetterGabriele Weiss
Nov 30, 2012·CNS Drugs·Andrea FagioliniSiegfried Kasper
Sep 21, 2011·Experimental and Clinical Psychopharmacology·Bethea A KleykampM Z Mintzer
Aug 18, 2012·BMC Complementary and Alternative Medicine·Wilfried DimpfelBernd Seilheimer
Jul 19, 2012·PloS One·Vladimira JakubcakovaMayumi Kimura
May 21, 2010·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Kaveh MonshatPeter Bosanac
Jul 16, 2013·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Thomas RothRonald C Kessler
Dec 19, 2012·Annual Review of Clinical Psychology·David H BarlowAmantia A Ametaj
Dec 25, 2009·Chronobiology International·Kimberly Burkhart, James R Phelps
Jun 12, 2012·Expert Opinion on Emerging Drugs·Nava Zisapel
Sep 10, 2009·Human & Experimental Toxicology·Mathias B Forrester
Nov 11, 2011·The Cochrane Database of Systematic Reviews·Sohil KhanBruce Charles
Dec 6, 2008·Journal of Psychiatric Practice·Lara Kierlin
Jan 14, 2009·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Julie S YoungKimberly A Hardin
Jan 20, 2007·The Journal of Head Trauma Rehabilitation·Steven R FlanaganStasia Wieber
Sep 29, 2011·Journal of Pineal Research·Daniel P CardinaliGregory M Brown
May 3, 2012·Clinical Pharmacology and Therapeutics·P HoeverJ Dingemanse
Sep 21, 2013·Indian Journal of Psychological Medicine·Gurvinder Pal Singh, Neeraj Loona
May 27, 2015·Human Psychopharmacology·Rowan P OgeilJillian H Broadbear
Aug 16, 2015·Sports Medicine·Mathieu NédélecGregory Dupont
Feb 14, 2017·Current Sleep Medicine Reports·Sheila N GarlandNicole Rodriguez
Nov 26, 2011·Expert Review of Clinical Pharmacology·Aravind Mittur
Jun 5, 2013·Journal of Biomolecular Structure & Dynamics·Hsin-Yi ChenCalvin Yu-Chian Chen
Aug 22, 2014·Biomolecules & Therapeutics·Vikash Kumar ShahKi-Wan Oh
Feb 6, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Patricia MurphyMargaret Moline
Aug 7, 2019·Harvard Review of Psychiatry·Vinícius Dokkedal-SilvaMonica Levy Andersen
Aug 29, 2017·The Breast Journal·Oxana PaleshLidia Schapira
Sep 22, 2017·Current Neurology and Neuroscience Reports·Surendra Barshikar, Kathleen R Bell
Nov 6, 2018·Neuroscience and Biobehavioral Reviews·John A CaldwellHarris R Lieberman

Related Concepts

Zolpidem AbZ
Starnoc
Acetamides
Vigilance, Cortical
Benzodiazepines
Sedatives
Transient Insomnia
Pyridines
Pyrimidines
Sleep, Slow-Wave

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Lipidomics & Rhinovirus Infection

Lipidomics can be used to examine the lipid species involved with pathogenic conditions, such as viral associated inflammation. Discovered the latest research on Lipidomics & Rhinovirus Infection.

Spatio-Temporal Regulation of DNA Repair

DNA repair is a complex process regulated by several different classes of enzymes, including ligases, endonucleases, and polymerases. This feed focuses on the spatial and temporal regulation that accompanies DNA damage signaling and repair enzymes and processes.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Torsion Dystonia

Torsion dystonia is a movement disorder characterized by loss of control of voluntary movements appearing as sustained muscle contractions and/or abnormal postures. Here is the latest research.

Archaeal RNA Polymerase

Archaeal RNA polymerases are most similar to eukaryotic RNA polymerase II but require the support of only two archaeal general transcription factors, TBP (TATA-box binding protein) and TFB (archaeal homologue of the eukaryotic general transcription factor TFIIB) to initiate basal transcription. Here is the latest research on archaeal RNA polymerases.

Alzheimer's Disease: MS4A

Variants within the membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease in genome-wide association studies. Here is the latest research on Alzheimer's disease and MS4A.

Central Pontine Myelinolysis

Central Pontine Myelinolysis is a neurologic disorder caused most frequently by rapid correction of hyponatremia and is characterized by demyelination that affects the central portion of the base of the pons. Here is the latest research on this disease.