New developments in the treatment of primary insomnia in elderly patients: focus on prolonged-release melatonin

摘要: A temporal relationship between the nocturnal rise in melatonin secretion and increase sleep propensity at beginning of night, coupled with sleep-promoting effects exogenous melatonin, indicate that is involved regulation sleep. This action attributed to MT 1 2 receptors present hypothalamic suprachiasmatic nucleus other brain areas. The actions which are demonstrable healthy humans, have been found be useful subjects suffering from circadian rhythm disorders elderly patients, who had low production secretion. effectiveness treating disturbances these patients relevant because compounds usually prescribed, such as benzodiazepines related drugs, many adverse effects, next-day hangover, dependence, impairment memory. Melatonin has used for improving insomnia mainly it does not cause any hangover or show addictive potential. However, there a lack consistency concerning its therapeutic value (partly short half-life small quantities used). Thus, attention focused either on development more potent analogs prolonged design slow-release preparations. prolonged-release preparation mela- tonin mg (Circadin ® ) approved treatment primary aged $55 years European Union. no effect psychomotor functions, memory recall, driving skills during night next morning relative placebo, was associated significantly less tasks zolpidem alone combination melatonin. In 3-week 6-month randomized, double-blind, clinical trials years, improvements placebo daytime parameters, including quality latency, alertness, life. Prolonged-release very well tolerated older tolerability profile similar placebo. Short-term longer- term tolerance, rebound insomnia, withdrawal symptoms.