Tsoi W F
Department of Psychological Medicine, National University of Singapore.
Ann Acad Med Singap. 1991 Mar;20(2):269-72.
This is a review and update on hypnotics. Insomnia is a symptom of many underlying conditions which have to be evaluated before resorting to medication. Hypnotics are useful for short term treatment. The benzodiazepines have replaced the barbiturates which have a low therapeutic index. The action of benzodiazepines depends on their absorption rate, lipophilicity, half-life and metabolites. They induce sleep, prolonged sleep time and reduced night wakenings. They increase stage 2 sleep, and reduce stage 1, 3, 4 and REM (Rapid Eye Movement) sleep. Flurazepam, triazolam and midaolam are described. The benzodiazepines suffer from many unwanted effects which include tolerance, dependence, withdrawal symptoms, rebound insomnia, hang over effect, alteration of memory process and synergism with ethanol. The ideal hypnotic should be free from these drawbacks. Three new generation hypnotics quazepam, zopiclone and zolpidem are described. Drugs suitable for long term hypnotic medication include antipsychotics, antidepressants and antihistamines.
这是一篇关于催眠药的综述与更新。失眠是许多潜在病症的症状，在诉诸药物治疗之前必须对这些病症进行评估。催眠药对短期治疗有用。苯二氮䓬类药物已取代了治疗指数较低的巴比妥类药物。苯二氮䓬类药物的作用取决于它们的吸收速率、亲脂性、半衰期和代谢产物。它们能诱导睡眠、延长睡眠时间并减少夜间觉醒。文中描述了氟西泮、三唑仑和咪达唑仑。苯二氮䓬类药物有许多不良作用，包括耐受性、依赖性、戒断症状、反弹性失眠、宿醉效应、记忆过程改变以及与乙醇的协同作用。理想的催眠药应没有这些缺点。文中描述了三种新一代催眠药夸西泮、佐匹克隆和唑吡坦。适用于长期催眠治疗的药物包括抗精神病药、抗抑郁药和抗组胺药。
