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CHAPTER 22 Sedative-Hypnotic Drugs 395

REFERENCES Jacobson LH et al: Suvorexant for the treatment of insomnia. Exp Rev Clin Pharmacol
2014;7:711.
Ancoli-Israel S et al: Long-term use of sedative hypnotics in older patients with Kato K et al: Neurochemical properties of ramelteon, a selective MT1/MT2
insomnia. Sleep Med 2005;6:107. receptor agonist. Neuropharmacology 2005;48:301.
Bateson AN: The benzodiazepine site of the GABA A receptor: An old target with Kralic JE et al: GABA(A) receptor alpha-1 subunit deletion alters receptor subtype
new potential? Sleep Med 2004;5(Suppl 1):S9. assembly, pharmacological and behavioral responses to benzodiazepines and
Chouinard G: Issues in the clinical use of benzodiazepines: Potency, withdrawal, zolpidem. Neuropharmacology 2002;43:685.
and rebound. J Clin Psychiatry 2004;65(Suppl 5):7. Krystal AD: The changing perspective of chronic insomnia management. J Clin
Clayton T et al: An updated unified pharmacophore model of the benzodiazepine Psychiatry 2004;65(Suppl 8):20.
binding site on gamma-aminobutyric acid(a) receptors: Correlation with Lader M, Tylee A, Donoghue J: Withdrawing benzodiazepines in primary care.
comparative models. Curr Med Chem 2007;14:2755. CNS Drugs 2009;23:2319.
Cloos JM, Ferreira V: Current use of benzodiazepines in anxiety disorders. Curr McKernan RM et al: Anxiolytic-like action of diazepam: Which GABA(A)
Opin Psychiatry 2009;22:90. receptor subtype is involved? Trends Pharmacol Sci 2001;22:402.
Da Settimo F et al: GABA A/Bz receptor subtypes as targets for selective drugs. Morairty SR, et al: The hypocretin/orexin antagonist almorexant promotes sleep
Curr Med Chem 2007;14:2680. without impairment of performance in rats. Front Neurosci 2014;8:3.
Davidson JR et al: A psychopharmacological treatment algorithm for generalized Neubauer DN: New directions in the pharmacologic treatment of insomnia.
anxiety disorder. J Psychopharmacol 2010;24:3. Primary Psychiatry 2006;13:51.
Drover DR: Comparative pharmacokinetics and pharmacodynamics of short-acting Rapaport MJ et al: Benzodiazepine use and driving: A meta analysis. J Clin Psy-
hypnosedatives: Zaleplon, zolpidem and zopiclone. Clin Pharmacokinet chiatry 2009;70:663.
2004;43:227.
Drugs for Insomnia. Treatment Guidelines 2012;10:57. Rosenberg R et al: An assessment of the efficacy and safety of eszopiclone in the
treatment of transient insomnia in healthy adults. Sleep Med 2005;6:15.
Dubey AK et al: Suvorexant: The first orexin receptor antagonist to treat insomnia. Sanger DJ: The pharmacology and mechanism of action of new generation, non-
J Pharmacol Pharmacother 2015;6:118. benzodiazepine hypnotic agents. CNS Drugs 2004;18(Suppl 1):9.
Erman M et al: An efficacy, safety, and dose-response study of ramelteon in Silber MH: Chronic insomnia. N Engl J Med 2005;353:803.
patients with chronic primary insomnia. Sleep Med 2006;7:17.
Gottesmann C: GABA mechanisms and sleep. Neuroscience 2002;111:231. Walsh JK: Pharmacologic management of insomnia. J Clin Psychiatry
2004;65(Suppl 16):41.
Hanson SM, Czajkowski C: Structural mechanisms underlying benzodiazepine Winkelman JW: Insomnia disorder. N Engl J Med 2015;373:1437.
modulation of the GABA(A) receptor. J Neurosci 2008;28:3490.
Hesse LM et al: Clinically important drug interactions with zopiclone, zolpidem Wurtman R: Ramelteon: A novel treatment for the treatment of insomnia. Expert
Rev Neurother 2006;6:957.
and zaleplon. CNS Drugs 2003;17:513.

C ASE STUD Y ANSWER

As described in this chapter, nonpharmacologic factors colas reported by the patient should be reduced, especially
are very important in the management of sleep problems: in the latter half of the day. If problems persist after these
proper diet (and avoidance of snacks before bedtime), measures are implemented, one of the newer hypnotics
exercise, and a regular time and place for sleep. Avoidance (eszopiclone, zaleplon, or zolpidem) may be tried on a
of stimulants is very important, and the large intake of diet short-term basis.