CNS Drugs
Synopsis The semisynthetic ergotine dopamine agonist pergolide has demonstrated activity at pre- and postsynaptic dopamine D2 receptors in vitro and in vivo animal studies. However, unlike other dopamine agonists such as bromocriptine, pergolide also has agonist activity at dopamine D1 receptors. Certain other pharmacological effects of pergolide, such as reduction of dopamine turnover and effects...
The original online version for this chapter can be found at http://dx.doi.org/10.2165/00023210-199707060-00005
Summary ▴ Ziprasidone is a novel antipsychotic drug. It has high affinity for serotonin 5-HT2 and dopamine D2 receptors in vitro, with an 11-fold higher affinity for 5-HT2 than for D2 receptors, suggestive of a low potential for inducing motor disturbance [including extrapyramidal symptoms (EPS)]. ▴ The effects of ziprasidone in receptor binding studies reflected its in vitro pharmacology, with more...
The original online version for this chapter can be found at http://dx.doi.org/10.2165/00023210-199707020-00002
Summary Synopsis Modafinil promotes wakefulness through an as yet unknown mechanism of action. It significantly increases daytime sleep latency and reduces excessive daytime sleepiness (EDS) compared with placebo in patients with narcolepsy. However, the drug does not suppress cataplexy. Although direct comparative data are lacking, modafinil offers advantages over amphetamines and methylphenidate...
The original online version for this chapter can be found at http://dx.doi.org/10.2165/00023210-199707040-00005
The original online version for this chapter can be found at http://dx.doi.org/10.2165/00023210-199809020-00006
The original online version for this chapter can be found at http://dx.doi.org/10.2165/00023210-199708020-00006
The original online version for this chapter can be found at http://dx.doi.org/10.2165/00023210-199809040-00006
Benzodiazepine hypnotic agents were the mainstream pharmacotherapy for insomnia from the 1960s to the 1980s, but their safety profile proved to be not quite as perfect as originally expected with regard to daytime performance and cognition, and above all the risk of dependence. These risks are substantially diminished in the non-benzodiazepine hypnotic agents developed and marketed during the past...
‘As needed’ non-nightly intake of hypnotic agents by patients suffering from chronic insomnia is likely to offer benefits such as maintained efficacy while preventing unnecessary long-term nightly use associated with the risk of tolerance and dependence. To date, three studies have proven the ‘as needed’ approach with zolpidem in patients with primary insomnia treated in outpatient practice. In total,...
This article introduces ‘as needed’ hypnotic treatment as a possible option in the psychopharmacological treatment for chronic but non-daily occurring insomnia complaints. This treatment option is a well-structured regimen designed by both patient and treating physician. It aims at providing symptomatic relief for sleepless nights and preventing the development of possible dependence on the hypnotic...
The new generation hypnotic drugs, zolpidem, zopiclone and zaleplon, are at least as efficacious in the clinic as benzodiazepines and may offer advantages in terms of safety. These drugs act through the BZ binding sites associated with GABAA receptors, but show some differences from benzodiazepines in pharmacological effects and mechanisms of action. Of particular interest is the finding that zolpidem...
Introduction: A survey of 2121 insomniac patients was conducted in France, Germany, Italy and the United Kingdom. Design: The survey collected data on the sociodemographic and clinical features of the subjects by interview, as well as on healthcare resource utilization. A complementary analysis of physician attitudes to insomnia provided insights into the types of treatment prescribed and expectations...
Buprenorphine/naloxone (Suboxone®) comprises the partial μ-opioid receptor agonist buprenorphine in combination with the opioid antagonist naloxone in a 4: 1 ratio. When buprenorphine/naloxone is taken sublingually as prescribed, the naloxone exerts no clinically significant effect, leaving the opioid agonist effects of buprenorphine to predominate. However, when buprenorphine/naloxone is parenterally...
Background: Antidepressant use in US adults increased 3-fold from 2.5% in 1988–94 to 8.1% in 1999–2002, based on National Health and Nutrition Examination Surveys. As the use of antidepressants increases, a comprehensive understanding of the potential health risks that may be associated with their use becomes increasingly important. Objective: This study evaluated the effects of paroxetine and sertraline...