China
Africa
Explore chapters and articles related to this topic
Ailments and Diseases
Published in James Sherifi, General Practice Under the NHS, 2023
By the first decade of the 21st century, of the benzodiazepine class of drugs, only chlordiazepoxide (for short-course management of withdrawal symptoms in alcoholics), midazolam (for seizures), and the old warhorse, diazepam (mainly as a muscle relaxant), were still in widespread circulation. The hypnotic benzodiazepines were replaced by the nonbenzodiazepine ‘Z-drugs’ (zopiclone, zolpidem), marketed as being non-addictive. In due course, as their use became more widespread, they were found to have no advantages over their predecessors.19 The dictum that ‘where there is a need and a means to effectively meet that need, then dependence almost inevitably follows’ remained extant.
Postconcussive syndrome
Published in Brian Sindelar, Julian E. Bailes, Sports-Related Concussion, 2017
Brian Sindelar, Julian E. Bailes
Conservative measures can be instituted acutely and continued with chronically symptomatic athletes, but persistent symptoms warrant escalation to pharmacological agents. Due to the limited research on pharmaceutical interventions specifically for concussive injury, these are only recommendations based on the limited data from concussion and moderate to severe TBI literature. Medications that have been suggested for use in cognition and arousal following a concussion/TBI are neurostimulants (i.e. amantadine, dextroamphetamine, modafinal, methylphenidate, atomoxetine), selective serotonin reuptake inhibitors (i.e sertraline, fluoxetine), and acetylcholinesterase inhibitors (i.e donepezil, rivastigmine, galantamine)175,184,186,215,217–227 (refer to Table 5.3).175 In patients whose complaints appear to be more sleep-related, the use of both nonbenzodiazepine sedatives and herbal remedies are advocated (Table 5.4).175 Benzodiazepines, such as lorazepam, clonazepam, and diazepam, are highly addictive and alter the normal sleep architecture and therefore are not recommended for routine use.184,186,228 Nonbenzodiazepine derivatives, such as zolpidem, are good short-term, first line agents to aid those with sleep difficulties because they decrease sleep latency and nocturnal awakenings.11,175,184,228 Caution should be exercised when used in the elderly due to potential side effects of confusion and altered mental status.228
Sleep Disorders in Older Adults
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Armando Miciano, David Berbrayer
The benzodiazepines are psychoactive drugs with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant, and amnestic properties. Nonbenzodiazepines, also called benzodiazepine receptor agonists, are comparatively new drugs whose actions are similar to those of the benzodiazepines, although they are structurally unrelated. The one approved melatonin receptor agonist has a different mechanism of action. Melatonin receptors, acted upon by endogenous melatonin, are thought to be involved in the maintenance of the circadian rhythm underlying the normal sleep–wake cycle.
Sleep-promoting activity of lotus (Nelumbo nucifera) rhizome water extract via GABAA receptors
Published in Pharmaceutical Biology, 2022
Yejin Ahn, Singeun Kim, Chunwoong Park, Jung Eun Kim, Hyung Joo Suh, Kyungae Jo
Humans spend one third of their lives sleeping. Sleep is crucial in human life; during sleep, the brain relieves mental and physical fatigue acquired during work and processes information to strengthen cognitive functions such as memory (Berkley 2021). However, 30%–35% of the world’s population has temporary sleep disorders, and the ratio is particularly high among women and older adults (Ohayon 2011). Sleep disorders are caused by various factors, such as stress, tension, fear and anxiety, and among these, people in modern society tend to experience stress-induced sleep disorders. In fact, 78% of insomnia patients reported that the insomnia was caused by stress (Bastien et al. 2004). Benzodiazepine-based drugs, nonbenzodiazepine-based drugs, benzodiazepine receptor agonists and antidepressants with sedative action have been used as therapeutic drugs (Madari et al. 2021). However, prolonged use of these drugs has side effects, which include resistance and dependence. Therefore, use of alternative drugs that can treat anxiety and insomnia and have fewer side effects is warranted.
“Sign Me Up, I’m Ready!”: Helping Patients Prescribed Sleeping Medication Engage with Cognitive Behavioral Therapy for Insomnia (CBT-I)
Published in Behavioral Sleep Medicine, 2021
Erin Koffel, Mariah Branson, Erin Amundson, Jennifer P. Wisdom
Participants were 29 Veterans (59% female) with insomnia who had been prescribed sleeping medication in the last year and had no history of CBT-I treatment. A pool of potential participants was first identified by searching the electronic medical record for insomnia diagnoses and prescriptions, including nonbenzodiazepines (e.g., z-drugs) and benzodiazepines, antidepressants and melatonin agonists. The study coordinator sent invitation letters to potentially eligible patients and if patients were interested, screened for eligibility over the phone. All participants met criteria for insomnia as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) using the insomnia module from a validated semi-structured interview, the Structured Clinical Interview for DSM-5 Sleep Disorders (SCISD) (Taylor et al., 2018). Participants were also asked to confirm that they had been given a sleeping medication in the last year and had no history of CBT-I treatments. The most common medications prescribed for sleep were zolpidem and trazodone.
Efficacy and safety of mirogabalin for the treatment of fibromyalgia: results from three 13-week randomized, double-blind, placebo- and active-controlled, parallel-group studies and a 52-week open-label extension study
Published in Current Medical Research and Opinion, 2019
Lesley M. Arnold, Susan Whitaker, Ching Hsu, David Jacobs, Domenico Merante
Use of concomitant medications – particularly analgesics and/or other medications or therapies that might be intended specifically as treatments for FM – that might have confounded assessments of efficacy and/or safety was not permitted during the study. Excluded treatments included anticonvulsants, opioids, benzodiazepines, dopamine agonists, tricyclic antidepressants, serotonin–norepinephrine reuptake inhibitors, and other antidepressants with the exception of allowed selective serotonin reuptake inhibitors, nonbenzodiazepine hypnotics, muscle relaxants, topical capsaicin, topical or injected local anesthetics, tender point injections, fatty acid supplements, and memantine. Aspirin up to 160 mg/day was allowed for cardiovascular disease prophylaxis and acetaminophen/paracetamol (up to 2 g/day in divided doses) was permitted for breakthrough FM pain. Nonsteroidal anti-inflammatory drugs were allowed for any pain indication (e.g. headache) except for breakthrough FM. Stable nonpharmacologic therapies (e.g. massage, psychological therapies) were allowed.