The Evolution and Development of Insomnia Pharmacotherapies

摘要: The National Institutes of Health (NIH) 2005 State the Science Conference on Manifestations and Management Chronic Insomnia in Adults panel report concluded that insomnia is a problem, at least occasionally, for approximately 30% adults general population, chronic problem about 10% adults, clinical settings prevalence roughly 50%.1 reinforced view should be appreciated as more than just nighttime nuisance, but rather condition also affects daytime functioning, quality life, other mental physical health outcomes.2 Insomnia sometimes described contemporary resulting from modern-day societal stressors. However, it hard to imagine famine, warfare, pestilence, concerns have not contributed throughout history mankind. No doubt, processes psychological conditioning perpetuated human history. People likely sought relief with wide assortment substances. Fermented beverages been available millennia alcohol remains popular, though problematic, choice attempt achieve improved sleep. Likewise, sedative properties opium were noted ancient writings. With Industrial Revolution came variety compounds packaged marketed sleep aids. While effects known thousands years, became patent medicine product 1800s when was combined sold laudanum. Although an efficacious hypnotic, there serious safety problems, including dependency respiratory depression. Label prescribing guidelines included doses infants young children, many deaths associated its use. Chloral hydrate, another abusable sedating employed induce sleep, widely used beginning mid-19th century. Barbiturates developed early 20th century remained primary prescribed hypnotic medications until 1960s. Other past hypnotics glutethimide, ethchlorvynol, paraldehyde bromide preparations. All these substances had reasonable efficacy promoting each medication. evolution treatment pharmaceutical approaches recent decades primarily has manifest major improvements safety. This review will focus pharmacological characteristics value related currently are intention helping difficulty falling asleep or remaining asleep. ranges negligible well established, several significant issues. Compounds recommended include unregulated over-the-counter (OTC) medications, prescription medicines either off-label US Food Drug Administration (FDA) approved indication insomnia. Currently only benzodiazepine receptor agonist selective melatonin agonist.