Efficacy Without Tolerance or Rebound Insomnia for Midazolam and Temazepam After Use for One to Three Months

@article{Allen1987EfficacyWT,
  title={Efficacy Without Tolerance or Rebound Insomnia for Midazolam and Temazepam After Use for One to Three Months},
  author={Richard P. Allen and Joseph Mendels and Donald B. Nevins and Doris A. Chernik and Eric Hoddes},
  journal={The Journal of Clinical Pharmacology},
  year={1987},
  volume={27}
}
Midazolam (15 mg) was compared with temazepam (30 mg) in a randomized, double‐blind, parallel group study. An initial screening period was followed by 3 days of placebo baseline, 4 to 12 weeks of nightly oral use of the medication and a 4‐day placebo withdrawal period. One hundred seventy‐five patients with chronic insomnia participated in this multicenter outpatient study. Because the elimination half‐life of midazolam, a new trizolobenzodiazepine hypnotic, is short (1.3‐2.2 hr) compared to… 
A STUDY COMPARING THE HYPNOTIC EFFICACIES AND RESIDUAL EFFECTS ON ACTUAL DRIVING PERFORMANCE OF MIDAZOLAM 15 MG, TRIAZOLAM 0.5 MG, TEMAZEPAM 20 MG AND PLACEBO IN SHIFTWORKERS ON NIGHT DUTY
TLDR
It was concluded that midazolam 15 mg can be recommended for use by rotating shift workers in order to cope with transient insomnia caused by poor adaptation to night-shift, and that in general no residual effects will be present 6.5 hours after ingestion.
Treatment of insomnia with two benzodiazepines: a double-blind crossover study
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Both nitrazepam and oxazepam were found to be effective in inducing sleep and increasing sleep quality and in improving sleep quality in patients with insomnia.
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Almorexant consistently and dose‐dependently improved sleep variables and may offer a new treatment approach for primary insomnia.
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Present evidence, while limited, is consistent with claims of less rebound potential than older benzodiazepine hypnotics of equivalent duration of action, but further rigorous studies are essential before these claims can be totally accepted.
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It is concluded that the sensitivity of the central nervous system to midazolam, as reflected in α activity, possibly shows a circadian variation.
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Behavioral and pharmacological approaches are effective for the short-term management of insomnia in late life; sleep improvements are better sustained over time with behavioral treatment.
Rational Use of Benzodiazepines in the Elderly
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It is essential that the practitioner develop a treatment plan when utilising these agents to treat older patients, as the acute administration of benzodiazepines is associated with impairments in cognition, memory, coordination and balance, and long term use has been associated with symptoms of withdrawal upon abrupt discontinuation.
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