China
Africa
Explore chapters and articles related to this topic
Sleep–Wake Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Margaret Kay-Stacey, Eunice Torres-Rivera, Phyllis C. Zee
Ramelteon, a melatonin MT1 and MT2 receptor agonist, has shown only a modest decrease in sleep latency, occasionally relieves sleep-initiation insomnias, but may have limited benefits for treatment of most insomnias.
Sedative and Hypnotic Drugs
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Arup Kumar Misra, Pramod Kumar Sharma
Ramelteon is a melatonin receptor agonist (MT1 and MT2 receptors). It is used therapeutically to promote sleep onset and to treat sleep disorder. Somnolence, fatigue, etc., are some of the adverse effects of the drug (Masaomi, 2009). Ramelteon is specific for MT1 and MT2 only. Its side effects are less as it does not bind to any other classes of receptors, such as nicotinic ACh, neuropeptide, dopamine, and opiate receptors, or the benzodiazepine binding site on GABAA receptors (Masaomi, 2009).
Boxing
Published in Ira Glick, Danielle Kamis, Todd Stull, The ISSP Manual of Sports Psychiatry, 2018
For insomnia, one would first try sleep hygiene techniques, depending on the compliance or ability of the patient and the caregiver(s). If behavioral therapy techniques do not work, Ramelteon is an acceptable hypnotic.
Understanding the role of chronopharmacology for drug optimization: what do we know?
Published in Expert Review of Clinical Pharmacology, 2023
Akio Fujimura, Kentaro Ushijima
Disruption of the circadian clock by travel across time zones can cause jet lag, which is one of the exogenous circadian rhythm sleep-wake disorders. Melatonin agonists are available for the treatment of insomnia characterized by difficulty with sleep onset in patients with jet lag [101]. In one study, subjects with a history of jet lag-induced sleep difficulty were allocated to receive ramelteon, a MT1, MT2, and MT3 agonist, at doses of 1, 4 or 8 mg or to receive placebo [102]. Ramelteon 1 mg was found to reduce sleep latency in comparison with placebo. In another study, healthy subjects with experimentally induced jet lag were allocated to receive tasimelteon, a MT1 and MT2 agonist, at a dose of 20, 50 or 100 mg or to receive placebo [103]. All doses of the drug significantly reduced sleep latency and improved sleep efficiency. Therefore, melatonin agonists are effective for the treatment of sleep problems in subjects with jet lag.
Challenges and opportunities in insomnia disorder
Published in International Journal of Neuroscience, 2021
Meaghan Roach, Timothy Juday, Rifat Tuly, Jacquelyn W. Chou, Anupam B. Jena, Paul P. Doghramji
There are two additional classes of medications with FDA approved drugs indicated for insomnia disorder. One is melatonin receptor agonists, such as ramelteon, and the other is orexin receptor antagonists, such as suvorexant and lemborexant. The American Academy of Sleep Medicine (AASM) only offers a weak recommendation for both ramelteon and suvorexant in the treatment of insomnia disorder [40]. Ramelteon was recommended only for sleep onset and suvorexant only for sleep maintenance. In addition, the AASM deemed the quality of evidence in support of the use of ramelteon for insomnia disorder to be very low and of suvorexant to be low [40]. Lemborexant was recently approved by the FDA for insomnia disorder, but the AASM has not yet offered a recommendation on its use or a ruling on its quality of evidence.
Clinical drug development for dementia with Lewy bodies: past and present
Published in Expert Opinion on Investigational Drugs, 2019
Garam Lee, Jeffrey Cummings, Boris Decourt, James B. Leverenz, Marwan N. Sabbagh
Patients with DLB often experience sleep disturbances such as excessive daytime sleepiness and RBD. The latter is highly prevalent in DLB and was added as a core clinical feature to the revised diagnostic criteria. RBD is typically treated with clonazepam, a long-acting benzodiazepine, and melatonin, even though no specific evidence exists for their use in the DLB population [18]. Clonazepam is considered as first line therapy for RBD; however, cautious use is warranted as benzodiazepines are associated with an increased risk of falls and cognitive impairment in older patients. The lowest possible dose should be used with augmentation with melatonin; in case of severe adverse events with clonazepam, melatonin should be used alone [79]. No RCTs for RBD in DLB patients have been conducted and current treatment recommendations are based on available practice guidelines for managing RBD [80]. Per ClinicalTrials.gov, two trials of ramelteon, a selective agonist of melatonin receptors MT1 and MT2, were terminated due to low subject recruitment and enrollment (NCT00745030, NCT00907595). Ramelteon is marketed as a non-habit forming hypnotic for insomnia, and was being studied for the treatment of RBD and sleep/wake cycle disturbances in DLB.