The mechanism of zolpidem and ramelteon to treat insomnia
DOI:
https://doi.org/10.61173/0qqype23Keywords:
Insomnia, Zolpidem, Ramelteon, GABA-A receptor, MelatoninAbstract
Insomnia, characterized by difficulty in getting or keeping sleep, has a serious impact on daytime performance and health. Zolpidem, a GABA-A receptor modulator, reduces sleep latency and increases sleep duration, making it suitable for short-term use. Ramelteon, a melatonin receptor agonist, regulates circadian rhythms and is effective for chronic insomnia, but is not addictive. The choice between zolpidem and ramelteon depends on the type of insomnia, and non-pharmacological treatments such as cognitive-behavioral therapy are recommended as a first choice. It is hoped that future treatments for insomnia will become safer and more personalized, combining medication with behavioral therapy to supplement treatment.
References
[1] Patel AK, Reddy V, Shumway KR, et al. (2024 Jan 26). Physiology, Sleep Stages. In: Stat Pearls [Internet]. Treasure Island (FL).
[2] Edin off, A. N., Wu, N., Ghaffar, Y. T., Prejean, R., Gremillion, R., Cogburn, M., Chami, A. A., Kaye, A. M., & Kaye, A. D. (2021). Zolpidem: Efficacy and Side Effects for Insomnia. Health psychology research, 9(1), 24927.
[3] Jennifer Robinson, MD (2023) Insomnia Medically Reviewed https://www.webmd.com/sleep-disorders/insomniasymptoms-and-causes.
[4] https://go.drugbank.com/drugs/DB01065.
[5] Sanghoon Kim, Jeong-wook Park, Chapter 19 - Sleep deprivation, headache, and Fos immunohistochemistry, (2022) The Neurobiology, Physiology, and Psychology of Pain, Academic Press, Pages 203-215.
[6] https://go.drugbank.com/drugs/DB00425.
[7] Zhang Binjia, Qiu Ziliang & Zhang Jie. (2020). A brief history of sleep medication development. World Journal of Sleep Medicine (07), 1169-1173.
[8] Akyuz, E., Celik, B. R., Aslan, F. S., Sahin, H., & Angelopoulou, E. (2023). Exploring the Role of Neurotransmitters in Multiple Sclerosis: An Expanded Review. ACS chemical neuroscience, 14(4), 527–553.
[9] Fernandes Gomes, F Isaac & Brito, Maria Gerusa & Bezerra, Mirna & Chaves, Hellíada. (2019). GABAergic transmission and modulation of anxiety: A review on molecular aspects. Brazilian Journal of Biological Sciences. 6. 9-16.
[10] Castro, L. S., Otuyama, L. J., Fumo-Dos-Santos, C., Tufik, S., & Poyares, D. (2020). Sublingual and oral zolpidem for insomnia disorder: a 3-month randomized trial. Revista brasileira de psiquiatria (Sao Paulo, Brazil: 1999), 42(2), 175–184.
[11] https://go.drugbank.com/drugs/DB00980.
[12] Wang, Q., Lu, Q., Guo, Q. et al. (2022) Structural basis of the ligand binding and signaling mechanism of melatonin receptors. Nat Commun 13, 454.
[13] Pandi-Perumal, S. R., Spence, D. W., Verster, J. C., Srinivasan, V., Brown, G. M., Cardinali, D. P., & Hardeland, R. (2011). Pharmacotherapy of insomnia with ramelteon: safety, efficacy and clinical applications. Journal of central nervous system disease, 3, 51–65.
[14] Yuping Wang (2024) Chinese Guidelines for the Diagnosis and Treatment of Insomnia in Adults, Chin J Neurol 57(06),560- 584.
[15] Franco De Crescenzo, Gian Loreto D’Alò, Edoardo G Ostinelli, Marco Ciabattini, Valeria Di Franco, Norio Watanabe, Ayse Kurtulmus, Anneka Tomlinson, Zuzana Mitrova, Francesca Foti, Cinzia Del Giovane, Digby J Quested, Phil J Cowen, Corrado Barbui, Laura Amato, Orestis Efthimiou, Andrea Cipriani,(2022)Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis, The Lancet, Volume 400, Issue 10347, Pages 170- 184.
[16] Chun, W., Chao, D., Qi, H., Dongliang, Z., Zhenmei, L., & Jia, L. (2021). Pharmacological and non-pharmacological treatments for insomnia: A protocol for a systematic review and network meta-analysis. Medicine, 100(31), e26678.
[17] Enomoto, M., Kitamura, S., Tachimori, H., Takeshima, M., & Mishima, K. (2020). Long-term use of hypnotics: Analysis of trends and risk factors. General hospital psychiatry, 62, 49–55.
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