NDLI: Pharmacotherapy of insomnia. (Journal: Expert Opinion on Pharmacotherapy Volume: 13 Issue: 9)

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Pharmacotherapy of insomnia. (Journal: Expert Opinion on Pharmacotherapy Volume: 13 Issue: 9)

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Ioachimescu, Octavian C. El-Solh, Ali A.
Description	Country affiliation: United States Author Affiliation: Ioachimescu OC ( Emory School of Medicine, Atlanta VA Medical Center, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Atlanta, GA, USA.)
Abstract	INTRODUCTION: Insomnia is one of the most prevalent sleep disorders in developed countries, being surpassed only by chronic sleep deprivation. Patients with insomnia tend to have an altered quality of life, impaired daytime functioning and an increased risk of work accidents and motor vehicle crashes. Insomnia is commonly associated with chronic medical conditions, metabolic illnesses and mental disorders (such as depression and anxiety), with which there is a dual, reciprocal relationship. AREAS COVERED: This paper focuses on current pharmacotherapy options for the treatment of insomnia, particularly benzodiazepine receptor agonists, which nowadays represent the mainstay of hypnotic therapy. The melatonin receptor antagonist, ramelteon, is reviewed (an alternative for some patients with only sleep-onset difficulty), as are sedating antidepressants, which are commonly used 'off-label' to treat insomnia, despite limited efficacy data and potential significant safety concerns. Orexin (OX) antagonists are also discussed, especially those that block OX2 or both OX1 and OX2 receptors, as these are the most promising new agents for the treatment of insomnia, with encouraging results in preliminary clinical trials. EXPERT OPINION: Research to evaluate and formulate treatments for insomnia is often complicated by the fact that insomnia is usually of multifactorial etiology. Understanding the molecular and receptor mechanisms involved in promoting sleep in varied disorders could provide future approaches in new drug development. In the long term, more randomized controlled trials are needed to assess both short-term and long-term effects of these medications and their efficacy in comorbid diseases that affect sleep quality or quantity.
File Format	HTM / HTML
ISSN	14656566
Issue Number	9
Volume Number	13
e-ISSN	17447666
Journal	Expert Opinion on Pharmacotherapy
Language	English
Publisher	Taylor & Francis
Publisher Date	2012-06-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Antidepressive Agents Therapeutic Use Antipsychotic Agents Hypnotics And Sedatives Nonprescription Drugs Sleep Initiation And Maintenance Disorders Drug Therapy Sleep Drug Effects Animals Adverse Effects Humans Risk Factors Etiology Physiopathology Treatment Outcome Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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Pharmacotherapy of insomnia. (Journal: Expert Opinion on Pharmacotherapy Volume: 13 Issue: 9)

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Pharmacotherapy of insomnia. (Journal: Expert Opinion on Pharmacotherapy Volume: 13 Issue: 9)