Zopicloneʼs Residual Effect Upon Actual Driving Performance Versus Those of Nitrazepam and Flunitrazepam

Volkerts, Edmund R.; Louwerens, Jw; Gloerich, A.B.M.; Brookhuis, Karel; O’Hanlon, John

doi:10.1097/00002826-198406001-00306

Cited by 5 publications

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“…Ten studies were conducted in healthy volunteers (including a group of self-defined good sleepers who did not meet any of the study criteria for insomnia and did not use hypnotics in Leufkens 2014 [ 24 ]) ( Table 1 ). Five studies reported data in subjects with insomnia: two studies were in female subjects who had previously used hypnotic drugs [ 19 , 28 ]; one enrolled subjects with acute insomnia treated with BZD in the previous 3–6 months [ 29 ]; one included subjects with chronic insomnia previously treated with a BZD, but who were hypnotic free for at least 2 weeks [ 31 ]; and one included subjects with insomnia for more than one month who were still using hypnotics frequently (chronic users) or infrequently (infrequent users) [ 24 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies investigated a single dose of insomnia treatment, [ 24–27 , 31–33 ] two studies investigated BZDs and zopiclone over two consecutive nights [ 19 , 28 ], and three studies investigated a DORA (lemborexant or suvorexant) over eight nights versus placebo, with zopiclone as an active control on the first and last night only [ 21 , 34 , 35 ]. The driving tests were conducted the morning after the first evening of study drug (Day 2) in 10 studies [ 21 , 24–27 , 31–35 ], or on the morning after the second evening of study drug (Day 3) in two studies [ 19 , 28 ]. The 8-day studies also included a driving test on the morning following the eighth evening of study drug (Day 9).…”

Section: Resultsmentioning

confidence: 99%

“…The studies published before 1998 [ 19 , 28 , 29 , 31 ] enrolled only female subjects ( Table 1 ), while the more recent studies included men and women.…”

Section: Resultsmentioning

confidence: 99%

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Comparison of the effect of lemborexant and other insomnia treatments on driving performance: a systematic review and meta-analysis

McElroy¹,

O'Leary²,

Adena³

et al. 2021

SLEEP Advances

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Study Objectives This systematic literature review and meta-analysis explored the impact of lemborexant and other insomnia treatments on next-day driving performance. Methods Searches were conducted in MEDLINE ® and Embase ® on 16 May 2019, supplemented by clinical trial registries. Randomized controlled trials in healthy volunteers or people with insomnia were included if they reported a standardized on-road driving test, were published in English and included ≥1 group receiving a recommended dose of flunitrazepam, estazolam, triazolam, temazepam, brotizolam, etizolam, alprazolam, lorazepam, zolpidem, eszopiclone, zaleplon, zopiclone, trazodone, ramelteon, lemborexant, or suvorexant. Pairwise random-effects meta-analyses used the difference between each active treatment and placebo in standard deviation of lateral position (ΔSDLP). ΔSDLP of +2.4 cm, established as equivalent to a blood alcohol concentration of 0.05%, was considered clinically significant. Results Fourteen studies were included. Clinically significant differences in ΔSDLP were shown in healthy volunteers for zopiclone (10/10 studies) and ramelteon (1/1 study), and in people with insomnia for flunitrazepam (2/3 studies). Premature test termination was reported most frequently for zopiclone (5/10 studies) and was reported in two subjects for suvorexant (1/2 studies), one for flunitrazepam (1/3 studies) and one for placebo (1/12 studies). Lemborexant had no statistically or clinically significant ΔSDLP, and no premature driving test terminations. Conclusions Zopiclone, flunitrazepam and ramelteon were associated with impaired driving performance, similar to driving under the influence of alcohol. Premature test termination was reported most frequently for zopiclone, and also for suvorexant, flunitrazepam and placebo. Lemborexant had no statistically or clinically significant effect on driving performance.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the effect of lemborexant and other insomnia treatments on driving performance: a systematic review and meta-analysis

McElroy¹,

O'Leary²,

Adena³

et al. 2021

SLEEP Advances

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Evaluating possible ‘next day’ impairment in insomnia patients administered an oral medicinal cannabis product by night: a pilot randomized controlled trial

Suraev,

McCartney,

Marshall

et al. 2024

Psychopharmacology

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Cannabis and its major constituents, Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are being widely used to treat sleep disturbances. However, THC can cause acute cognitive and psychomotor impairment and there are concerns that driving and workplace safety might be compromised the day after evening use. Here, we examined possible ‘next day’ impairment following evening administration of a typical medicinal cannabis oil in adults with insomnia disorder, compared to matched placebo. This paper describes the secondary outcomes of a larger study investigating the effects of THC/CBD on insomnia disorder. Twenty adults [16 female; mean (SD) age, 46.1 (8.6) y] with physician-diagnosed insomnia who infrequently use cannabis completed two 24 h in-laboratory visits involving acute oral administration of combined 10 mg THC and 200 mg CBD (‘THC/CBD’) or placebo in a randomised, double-blind, crossover trial design. Outcome measures included ‘next day’ (≥9 h post-treatment) performance on cognitive and psychomotor function tasks, simulated driving performance, subjective drug effects, and mood. We found no differences in ‘next day’ performance on 27 out of 28 tests of cognitive and psychomotor function and simulated driving performance relative to placebo. THC/CBD produced a small decrease (-1.4%, p=.016, d=-0.6) in accuracy on the Stroop-Colour Task (easy/congruent) but not the Stroop-Word Task (hard/incongruent). THC/CBD also produced a small increase (+8.6, p=.042, d=0.3) in self-ratings of Sedated at 10 h post-treatment, but with no accompanying changes in subjective ratings of Alert or Sleepy (p’s>0.05). In conclusion, we found a lack of notable ‘next day’ impairment to cognitive and psychomotor function and simulated driving performance following evening use of 10 mg oral THC, in combination with 200 mg CBD, in an insomnia population who infrequently use cannabis.

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Residual effects of zolpidem, zopiclone and flunitrazepam on the processing of visual information in driving context

Berthelon¹,

Longcamp

Coquerel

et al. 2008

European Review of Applied Psychology

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Zopicloneʼs Residual Effect Upon Actual Driving Performance Versus Those of Nitrazepam and Flunitrazepam

Cited by 5 publications

References 0 publications

Comparison of the effect of lemborexant and other insomnia treatments on driving performance: a systematic review and meta-analysis

Comparison of the effect of lemborexant and other insomnia treatments on driving performance: a systematic review and meta-analysis

Evaluating possible ‘next day’ impairment in insomnia patients administered an oral medicinal cannabis product by night: a pilot randomized controlled trial

Residual effects of zolpidem, zopiclone and flunitrazepam on the processing of visual information in driving context

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