Newer hypnotic drugs for the short-term management of insomnia: a systematic review and economic evaluation

Abstract

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Valerian for Sleep: A Systematic Review and Meta-Analysis

“…Many of these studies incompletely report results 35 and use a variety of different outcome measures, making it difficult to compare the efficacy of different agents. 36 It is possible that the methodologic flaws in the studies included in this systematic review led to invalid results in individual studies, and the only way to address this concern is to conduct new, high-quality clinical trials.…”

Magic bullets for insomnia? Patients' use and experiences of newer (Z drugs) versus older (benzodiazepine) hypnotics for sleep problems in primary care

“…4 Over the past decade, a gradual reduction has occurred in the prescribing of older benzodiazepine hypnotics, while the use and cost of hypnotic drugs continues to rise overall. 5 This has been due to fears over benzodiazepine use and abuse and an increase in prescribing of Z drugs, which were marketed as safer and less liable to dependence compared with benzodiazepines. 6 Zopiclone is now the most frequently prescribed hypnotic in the UK at 4 million items (39% of items) costing £10m (43% of total…”

Hypnotic hazards: adverse effects of zolpidem and other z-drugs

“…However, adverse events occurring in less than 1% of patients would not be expected to be revealed in trials. 20 Systematic reviews do show that in older people adverse cognitive and psychomotor effects are common with all sedatives, but they are not obviously more common with z-drugs. 21 Motor vehicle accidents are increased by use of z-drugs (relative risk 2.3), but somewhat less than by use of benzodiazepines (relative risk for nitrazepam 2.7 and for flunitrazepam 4.0).…”

“…They cause sedation and increase the risk of motor vehicle accidents, and are not a safe alternative to benzodiazepines in patients who need to drive. Z-drugs do cause dependency 20 , and are not a safe alternative for patients who have had problems with dependence on benzodiazepines.…”