Estazolam - a new benzodiazepine hypnotic
Article Abstract:
Estazolam is a benzodiazepine-type drug that was recently approved for use in treating insomnia. Other benzodiazepine agents used to treat sleep problems include flurazepam and quazepam, which have long durations of action and may cause sleepiness during the day; triazolam, which has a short duration of action, does not cause day-time sedation, but may produce anxiety, rebound, or recurrent insomnia, amnesia, and confusion; and temazepam, which has an intermediate duration of action. The blood levels of estazolam reach a maximum within one and a half to two hours after taking the drug. Estazolam is metabolized in the liver and eliminated in the urine. Fifty percent of the drug at therapeutic doses is eliminated within 10 to 24 hours. The metabolism and elimination of estazolam may take longer in elderly persons, who have diminished liver function, or in patients with liver disease, and patients being treated with cimetidine, a drug that inhibits liver enzymes involved in drug metabolism. Studies show that estazolam reduces the time taken to fall asleep, increases the duration of sleep, and is as effective as flurazepam in treating insomnia. Adverse effects of estazolam include drowsiness, sedation, dizziness, diminished reaction to a stimulus, lack of coordination, decreased ability to recall events, and rebound insomnia with worsened sleep problems after discontinuation of the drug. The recommended dose and cost of estazolam are discussed. Although estazolam is effective for treating insomnia for a short duration, its toxicity may limit its use. Temazepam is less expensive and has a longer duration of action than estazolam. Furthermore, the ability of all benzodiazepines to cause tolerance, or a decreased sensitivity requiring increasing doses of a drug, and physical dependence must be considered when deciding to prescribe these agents for treatment of sleep problems. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1991
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Hypnotic drugs
Article Abstract:
Hypnotic drugs marketed for insomnia are not recommended for long-term use. Benzodiazepines or zolpidem (Ambien) are good choices for occasional treatment but alternatives to pharmacological choices may be safer. Side effects of hypnotics include dependency, nightmares, daytime anxiety or sedation. The benefits of substances not clearly labeled for insomnia, such as antihistamines, alcohol, or melatonin are not established.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1996
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Hypnotic drugs
Article Abstract:
Drugs used to treat insomnia are called hypnotics. They include two antihistamines, chloral hydrate, barbiturates, benzodiazepines, and some antidepressants. Melatonin and valerian root are two non-drug treatments.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 2000
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