Study, Jul/19:Reintroduction of quazepam...comparative hynotic & adverse effects

The full title of this American study is "Reintroduction of quazepam: an update on comparative hypnotic and adverse effects".

 

https://www.ncbi.nlm.nih.gov/pubmed/31274695

 

Abstract

 

Insomnia is a prevalent disorder that affects over one-third of the U.S. population to varying degrees and is highly disruptive towards quality of life. Pharmacological treatments for insomnia include benzodiazepines (BZs) and the non-BZ 'Z-drugs' (zolpidem, zaleplon, eszopiclone, zopiclone), which are amongst the most widely prescribed medications. Yet, these agents can produce adverse effects such as tolerance to the hypnotic effect, rebound insomnia, next-day residual drowsiness, as well as amnesia and complex behaviours such as sleep-walking, sleep-eating and sleep-driving. Quazepam, one of the five BZ approved for treatment of insomnia, was recently relaunched to the U.S. market in 2016 and is distinguished amongst hypnotic BZ by unique pharmacological characteristics including selectivity for sleep-promoting α1-subunit containing γ-aminobutyric acid (GABA-A) receptors and a significantly lower relative receptor binding affinity. These features likely drive the decreased rate of adverse events seen clinically with quazepam, such as tolerance, rebound insomnia and amnesic behaviours, compared with other BZ. Given the recent reintroduction of quazepam as a pharmacotherapeutic option, and the lack of head-to-head comparative trials against newer agents, the purpose of this review is to provide an update on distinguishing features of quazepam with regard to its pharmacology, pharmacokinetics, sleep efficacy and potential adverse effects compared to other agents used for insomnia.

 

 

Um....did we need to add another benzodiazepine to the ones that were already available? Really?

???

 

 

When will these people EVER understand???

The full title of this American study is "Reintroduction of quazepam: an update on comparative hypnotic and adverse effects".

 

https://www.ncbi.nlm.nih.gov/pubmed/31274695

 

Abstract

 

Insomnia is a prevalent disorder that affects over one-third of the U.S. population to varying degrees and is highly disruptive towards quality of life. Pharmacological treatments for insomnia include benzodiazepines (BZs) and the non-BZ 'Z-drugs' (zolpidem, zaleplon, eszopiclone, zopiclone), which are amongst the most widely prescribed medications. Yet, these agents can produce adverse effects such as tolerance to the hypnotic effect, rebound insomnia, next-day residual drowsiness, as well as amnesia and complex behaviours such as sleep-walking, sleep-eating and sleep-driving. Quazepam, one of the five BZ approved for treatment of insomnia, was recently relaunched to the U.S. market in 2016 and is distinguished amongst hypnotic BZ by unique pharmacological characteristics including selectivity for sleep-promoting α1-subunit containing γ-aminobutyric acid (GABA-A) receptors and a significantly lower relative receptor binding affinity. These features likely drive the decreased rate of adverse events seen clinically with quazepam, such as tolerance, rebound insomnia and amnesic behaviours, compared with other BZ. Given the recent reintroduction of quazepam as a pharmacotherapeutic option, and the lack of head-to-head comparative trials against newer agents, the purpose of this review is to provide an update on distinguishing features of quazepam with regard to its pharmacology, pharmacokinetics, sleep efficacy and potential adverse effects compared to other agents used for insomnia.

 

 

Um....did we need to add another benzodiazepine to the ones that were already available? Really?

???

 

https://en.wikipedia.org/wiki/Quazepam

 

"Quazepam (marketed under brand names Doral, Dormalin) is a relatively long-acting benzodiazepine derivative drug developed by the Schering Corporation in the 1970s..."

Why was it taken off the market? Does anyone know? It seems, from the reviews I was reading, that people reacted better to this than the other awful drugs for insomnia.

Hi Terry,

It's still a benzo. It still has the same side effects as the others. It's still meant for short-term use only.

 

https://livertox.nih.gov/Quazepam.htm 

 

Background

 

Quazepam (quazepam) is a benzodiazepine used as a sleeping aid in the therapy of insomnia.  The antianxiety (anxiolytic) and soporific activity of the benzodiazepines is mediated by their ability to enhance gamma-aminobutyric acid (GABA) mediated inhibition of synaptic transmission through binding to the GABA A receptor.  Quazepam was approved in the United States in 2007, but is now not commonly used, having been replaced by non-benzodiazepines that bind to the benzodiazepine receptor on the GABA-A receptor complex, which have a shorter duration of action and are better tolerated.  Quazepam is available in tablets of 7.5 and 15 mg under the brand name Doral.  The recommended initial oral dose for adults is 15 mg at bedtime, which can be decreased to 7.5 mg nightly.  Quazepam is recommended only for temporary therapy of insomnia and not as chronic therapy.  The most common side effects are dose related and include daytime drowsiness, lethargy, ataxia, dysarthria and dizziness.  Tolerance develops to these side effects, but tolerance may also develop to the effects on insomnia.

 

 

I know it's a benzo. I don't know what I was thinking when I said it seems better according to what people's reviews are. Of course people are going to say good things while they're on it and haven't reached tolerance. 

Ugh. I just don't see why they needed to add another benzo back into the mix. To me, it seems just as problematic as all the rest -- especially if it's long-acting. It's likely for $$$$$.

Yes. I don't understand it either. News just hasn't come out fast enough about these double-edged swords!!