Finally, a Sleep Aide not Linked to Abuse; Loss of Brain Power

(Ivanhoe Newswire) -- Some welcomed news for patients with chronic insomnia: there may finally be a drug that helps their condition without leading to abuse or cognitive problems.

Some of the drugs usually used to treat insomnia (benzodiazepine receptor agonists) can lead to a risk for abuse especially if the patient has a history of substance abuse. They can also cause problems with thinking, learning and memory. And patients may have withdrawal symptoms -- including anxiety, irritability and even seizures -- if they stop taking the drugs.

Researchers from The Johns Hopkins School of Medicine in Baltimore looked at ramelteon (Rozerem), a drug recently approved to treat insomnia. The medication works through a different pathway in the brain that involves melatonin receptors.

Researchers compared the potential for abuse and cognitive problems between ramelteon, a placebo, and triazolam (a benzodiazepine) in 14 adults with a history of sedative abuse. Results show ramelteon's effects didn't differ from the placebo's.

Researchers say the results combined with studies that show ramelteon's effectiveness may fill an unmet need in treating insomnia.

"Although further clinical trials are warranted, ramelteon may be particularly useful for the treatment of insomnia in individuals with histories of substance abuse, in older subjects, and in persons requiring minimal interference with arousal response (e.g., on-call workers and patients with chronic obstructive pulmonary disease)," write the authors. "Furthermore, ramelteon may be a safe first-line medication even in individuals not reporting substance abuse, given that some individuals may not admit to such misuse."

The authors conclude future research on sleep medications should look at the effectiveness of other drugs that work on the same pathway as ramelteon.

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SOURCE: Archives of General Psychiatry, 2006;63:1149-1157