Comparative efficacy of newer hypnotic drugs for the short‐term management of insomnia: a systematic review and meta‐analysis

  title={Comparative efficacy of newer hypnotic drugs for the short‐term management of insomnia: a systematic review and meta‐analysis},
  author={Yenal D{\"u}ndar and Susanna Dodd and Judith Strobl and Angela Boland and Rumona Dickson and Thomas J Walley},
  journal={Human Psychopharmacology: Clinical and Experimental},
  • Y. DündarS. Dodd T. Walley
  • Published 1 July 2004
  • Psychology, Medicine
  • Human Psychopharmacology: Clinical and Experimental
To compare the clinical effectiveness of zaleplon, zolpidem or zopiclone (Z‐drugs) with either benzodiazepines licensed and approved for use in the UK for the short‐term management of insomnia (diazepam, loprazolam, lorazepam, lormetazepam, nitrazepam, temazepam) or with each other. 

Suvorexant for insomnia: a systematic review of the efficacy and safety profile for this newly approved hypnotic – what is the number needed to treat, number needed to harm and likelihood to be helped or harmed?

  • L. Citrome
  • Psychology
    International journal of clinical practice
  • 2014
The efficacy and safety of suvorexant for the treatment of insomnia are described and the drug is described as safe and effective.

Management of insomnia: treatments and mechanisms

Current treatments of insomnia are described, both evidence-based and common practice, and some emerging approaches are described.

Comparative efficacy and acceptability of pharmacological treatments for insomnia in adults: A systematic review and network meta-analysis

This work aims to generate a clinically-useful hierarchy of available pharmacological treatments for insomnia in adults, according to their efficacy and acceptability, and to compare individual medications in terms of efficacy and acceptance.

Effectiveness of non-benzodiazepine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration

Compared with placebo, Z drugs produce slight improvements in subjective and polysomnographic sleep latency, especially with larger doses and regardless of type of drug.

Pharmacologic treatment of insomnia

The Efficacy and Safety of Drug Treatments for Chronic Insomnia in Adults: A Meta-analysis of RCTs

Benzodiazepines and non-benzodiazepine treatments for chronic insomnia are effective treatments in the management of chronic insomnia, although they pose a risk of harm.

A double-blind, randomized, comparative study to evaluate the efficacy and safety of zaleplon versus zolpidem in shortening sleep latency in primary insomnia.

There was no significant difference between zaleplon and zolpidem in the efficacy of reducing sleep latency or adverse effects in primary insomnia, and a large pharmacovigilance study is needed before concluding that either zalpidem or zalplon is free from next-day residual effects.

[Insomnias. II. Pharmacological and psychotherapeutic treatment options].

Cognitive behavioural therapy for insomnia (including psycho-education, relaxation, stimulus control, sleep restriction, cognitive therapy) is supported by an extensive database that indicates that cognitive behavioural methods are effective in the long term, thus emphasizing the importance of these strategies in the treatment of insomnia.

Clinical pharmacology, efficacy, and safety of orexin receptor antagonists for the treatment of insomnia disorders

ORAs have the potential to revolutionize the pharmacological treatment of insomnia because they not only improve sleep, but, in addition, appear to have no dependence – and tolerance-inducing effects, which makes them suitable for long-term-treatment.



Comparison of nitrazepam and zopiclone in psychiatric patients.

The results indicate that zopiclone is an active hypnotic compound, comparable in its effects to those of nitrazepam, the higher dosage being best adapted to the type of patients included in the study.

Zopiclone versus nitrazepam: a double-blind comparative study of efficacy and tolerance in elderly patients with chronic insomnia.

A randomized, double-blind, comparative trial of zopiclone versus nitrazepam was conducted in 74 geriatric chronic insomniac patients, finding that zopicLone was devoid of effect on neurological function and the condition on awakening was better with zopic lone.

Sleep latency is shortened during 4 weeks of treatment with zaleplon, a novel nonbenzodiazepine hypnotic. Zaleplon Clinical Study Group.

Zaleplon appears to provide a favorable safety profile, as indicated by the absence of rebound insomnia and withdrawal symptoms once treatment was discontinued, and was effective in the treatment of insomnia in outpatients with DSM-III-R insomnia.

Double-blind study on the hypnotic and antianxiety effects of zopiclone compared with nitrazepam in the treatment of insomnia.

The effectiveness of zopiclone in the treatment of insomnia with effects similar to nitrazepam on the quality and duration of sleep and number of nocturnal arousals, but with an improvement in all the other parameters is confirmed.

Zaleplon, A Novel Nonbenzodiazepine Hypnotic, Effectively Treats Insomnia in Elderly Patients Without Causing Rebound Effects.

Zaleplon is effective in reducing latency to sleep without evidence of undesired effects in elderly patients with insomnia, and the frequency of any central nervous system adverse events is unchanged.

Preference of insomniac patients between a single dose of zolpidem 10 mg versus zaleplon 10 mg

Insomniac patients tended to prefer zolpidem to zaleplon on both nocturnal and diurnal assessments, and these results provide additional information for the physician's choice, based on the patient's preference for a given drug.

Double‐blind, placebo‐controlled study comparing effects of zopiclone and temazepam on cognitive functioning of insomniacs

It is concluded that at the doses administered over the 3 weeks, the two hypnotic drugs in question are relatively safe and efficacious in the treatment of insomnia and enable patients to enjoy a good quality of life.

Chronic administration of zopiclone and nitrazepam in the treatment of insomnia.

A significant improvement in the working ability of patients was noted with both drugs, and some significant differences were observed in the mood rating scale and the somatic complaint check list, probably related to differences in pharmacokinetics of the two drugs.

Zopiclone: A Non-Benzodiazepine Hypnotic

  • D. Wheatley
  • Psychology, Medicine
    British Journal of Psychiatry
  • 1985
Zopiclone, a non-benzodiazepine hypnotic, was compared with temazepam in the treatment of 36 patients suffering from insomnia and there were highly significant improvements with both drugs, as compared to the control period in respect of sleep latency, number of times waking during the night, and quality and duration of sleep.

Zopiclone and nitrazepam: a multicenter placebo controlled comparative study of efficacy and tolerance in insomniac patients in general practice.

Sleep assessments by the patients showed that, compared with placebo, zopiclone and nitrazepam improved all sleep measures of efficacy from the first night and that effectiveness was maintained throughout treatment.