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Up to 10% of the US adult population will experience chronic insomnia, with women and elderly individuals at particularly high risk. Cognitive behavioral therapy is the core treatment for insomnia. When cognitive behavioral therapy is not enough, medications can help patients overcome the barriers and learned behaviors that prevent a good night’s sleep.
Objectives
Through this research we aimed to investigate the effectiveness and safety of new drugs in the treatment of insomnia.
Methods
We try to do a Bibliographic Review in PubMed using keywords like “insomnia” “new hypnotic drugs” and “effectiveness”
Results
Patients receiving trazodone perceived better sleep quality than those receiving the placebo with a non-significantly moderate heterogeneity. As to secondary efficacy outcomes, we only found a significant reduction for trazodone in the number of awakenings compared to the placebo. Trazodone was effective in sleep maintenance by decreasing the number of early awakenings and it could significantly improve perceived sleep quality, although there were no significant improvements in sleep efficiency or other objective measures. Importantly, lemborexant improves latency to sleep onset and sleep maintenance and is able to help people who experience early morning awakenings. Safety data reveal that lemborexant has minimal residual effects on morning alertness or next day function.
Conclusions
Unfortunately, treatment of insomnia is not always that simple. The disorder’s complex underlying pathophysiology warrants consideration of different nonpharmacologic and pharmacologic treatment options. Indeed, recent insights gained from research into the pathophysiology of insomnia have facilitated development of newer treatment approaches with more efficacious outcomes.
As of 1960, British academic psychiatry was ‘social’. Social meant epidemiological rather than committed to the idea that mental illness was social rather than biological in origin. The designation ‘biological psychiatry’ became current in the 1990’s. In the 1960s, after an astonishing flood of new drugs, a nascent pharmaceutical industry, previously run by chemists and clinicians, brought in management consultants to ensure the breakthroughs continued but drug discovery in psychiatry has dried up. The pharmaceutical industry has colonised medical research, education and clinical practice. Evidence-based medicine (EBM) and clinical guidelines have served to extend rather than contain the influence of the industry. Antidepressants are now the second most prescribed drugs to teenage girls after contraceptives, in the face of thirty RCTs of antidepressants given to depressed minors – all negative. While they came with drawbacks, through to 1990 the psychotropic drugs introduced from the late 1950s onwards extended the range of clinical capabilities and likely did more good than harm. It is difficult to make the same claims about developments since 1990.
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