Lormetazepam
LormetazepamLormetazepam
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Lormetazepam 1 INN, or methyl-lorazepam, is a drug which is a short to intermediate acting 3-hydroxy2 benzodiazepine derivative It possesses hypnotic, anxiolytic, anticonvulsant, sedative, and skeletal muscle relaxant properties. The Dutch, British, and French system called the System of Objectified Judgement Analysis for assessing whether drugs should be included in drug formularies based on clinical efficacy, adverse effects, pharmacokinetic properties, toxicity, and drug interactions was used to assess lormetazepam A Dutch analysis using the system found that lormetazepam could be suitable to be included in drug prescribing formularies, although zolpidem, zopiclone, and temazepam had higher scores and thus can be seen as relatively favorable3. Lormetazepam is considered a hypnotic benzodiazepine and is officially indicated for moderate to severe insomnia Lormetazepam is a short-acting benzodiazepine and is sometimes used in patients who have difficulty in maintaining sleep or falling asleep Hypnotics should only be used on a short-term basis or, in those with chronic insomnia, on an occasional basis4. Side effects of lormetazepam are similar to those of other hypnotic benzodiazepines and can for the most part be regarded as a class effect5 In a sleep study, 1 mg lormetazepam increased total sleep time, reduced wakefulness, but did not alter REM sleep However, at 2 mg doses, there were significant increases in stage 3 sleep and reductions in REM sleep Rebound effects have been reported after chronic use including rebound REM6 In one clinical trial with patients who had prior experience with older hypnotics temazepam and nitrazepam, most preferred lormetazepam due to less heavy sedation, amnesia, and residual effects7 Some side effects, including drowsiness, amnesia, and respiratory depression, are increased when lormetazepam is combined with other drugs with similar effects, eg alcohol and nonbenzodiazepine drugs. Residual 'hangover' effects after nighttime administration of lormetazepam such as sleepiness, impaired psychomotor and cognitive functions may persist into the next day which may impair the ability of users to drive safely and increase risks of falls and hip fractures Benzodiazepines require special precaution if used during pregnancy, in children, in alcohol- or drug-dependent individuals and individuals with comorbid psychiatric disorders11 Lormetazepam may be unsuitable for the elderly due to residual effects on memory and body sway which may result in falls12 Lormetazepam causes impaired driving skills, thus caution is required in individuals who drive or operate machinery It should be noted that the risks of tolerance, dependence, and withdrawal are very low when the drug is used for 2—4 weeks only and that lormetazepam is generally a safe and effective drug when used for no longer than 2—4 weeks Some sleep disturbance in the form of rebound insomnia can, however, occur even after short-term usage of 7 days14 Those with a history of addiction may be at increased risk of problems of tolerance and dependence especially those with a past history of dependency on sedative hypnotic drugs. Lormetazepam as with other benzodiazepines is generally only recommended for short-term use 2—4 weeks due to tolerance and loss of efficacy Tolerance to and loss of the sedative effects of benzodiazepine hypnotics occurs within 14 days of regular use Withdrawal symptoms which can occur from stopping benzodiazepines such as lormetazepam can include: Lormetazepam has a short to intermediate biological half-life half-life of approximately 10—12 hours Shorter acting benzodiazepine compounds are generally associated with a more intense and immediate withdrawal reaction compared to longer acting benzodiazepines For this reason it is generally recommended to cross from lormetazepam to an equivalent dose of diazepam to gradually taper the dosage Lormetazepam and other benzodiazepine drugs act as positive modulators at the GABAA benzodiazepine receptor complex Lormetazepam binds to the benzodiazepine receptor which in turn enhances the effect of the GABAA receptor producing its therapeutic effects as well as adverse effects When lormetazepam binds to the benzodiazepine receptor sites in sufficient quantities it produces sedation which is used clinically as a therapeutic treatment for insomnia Lormetazepam alters the brain electrical activity which has been studied via EEG readings22 Lormetazepam appears to be more selective in the type of benzodiazepine receptor it binds to showing a higher affinity for the omega 1 receptor which is responsible for sedation23 Changes in EEG can therefore be used to measure the sedative sleep promoting properties of lormetazepam. There are excerpts from wikipedia on this article and video. Cloxazolam Flutazolam Haloxazolam Mexazolam Oxazolam. Razobazam Ripazepam Zolazepam Zomebazam Zometapine. Glutethimide Methyprylon Pyrithyldione Piperidione. Tricyclic antidepressants Amitriptyline Doxepin Trimipramine, etc Tetracyclic antidepressants Mianserin Mirtazapine, etc. Typical antipsychotics Chlorpromazine Thioridazine, etc Atypical antipsychotics Olanzapine Quetiapine Risperidone, etc. Agomelatine Melatonin Ramelteon Tasimelteon. Glutethimide Methyprylon Piperidione Pyrithyldione.
Lormetazepam
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Lormetazepam: Wikis
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Lormetazepam
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