頁籤選單縮合
題名 | 治療失眠的 Ramelteon=Treatment of Insomnia with Ramelteon |
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作者 | 楊璦瑜; | 書刊名 | 藥學雜誌 |
卷期 | 33:4=133 2017.12[民106.12] |
頁次 | 頁46-50 |
分類號 | 415.939 |
關鍵詞 | 失眠; 褪黑激素; Ramelteon; Melatonin; |
語文 | 中文(Chinese) |
中文摘要 | Ramelteon 是第一個選擇性褪黑激素受體活化劑,美國食品藥物管理局核准用於 治療入睡困難型的失眠。特異性地作用於 melatonin-1(MT-1) 和 melatonin-2(MT-2) 褪 黑激素受體,對 gamma-aminobutyric acid (GABA) 受體複合物沒有作用。DSM-IV 將 失眠分為入睡困難、睡眠難以持續或容易早醒,能影響病人的生活品質、社會功能。 在安慰劑對照試驗中證實 ramelteon 在慢性失眠患者的療效和安全性。研究顯示使用8 mg 的 ramelteon 可減少入睡時間,但對於睡眠效率、睡眠品質沒有改善。 建議在睡前30分鐘服用 ramelteon。由於 ramelteon 經肝臟中代謝,因此重度肝損 傷者不能使用,中度肝損傷者應謹慎使用。常見的不良事件在這些研究中包括頭痛、 疲勞、眩暈、嗜睡,但沒有發生反彈失眠或停藥的戒斷症狀。短期使用 ramelteon 可改 善入睡困難的睡眠障礙,然而仍須要長期的研究證實臨床療效。 |
英文摘要 | Ramelteon is the first selective melatonin receptor agonist and is currently approved by the Food and Drug Administration for the treatment of insomnia characterized by sleep onset difficulties. It acts specifically on MT1 and MT2 melatonin receptors, with no appreciable affinity for the gamma-aminobutyric acid receptor complex. The DSM-IV classifies insomnia as difficulty initiating sleep or maintaining sleep, or dysphylaxia that causes impairment in quality of life and social function. The efficacy and safety of ramelteon in patients with chronic insomnia was confirmed in placebo-controlled trials. The studies show evidence for reduction of sleep latency at the recommended prescribed dosage (8 mg), measures of sleep efficiency and sleep quality showed no clinically significant improvement. It is recommended to be taken 30 minutes before bedtime. As ramelteon is metabolized in the liver, the drug should not be used in patients with severe hepatic impairment and should be used with caution in patients with moderate hepatic impairment. Commonly reported adverse events in these studies included headache, fatigue , dizziness and somnolence. There was no evidence of rebound insomnia or withdrawal effects following discontinuation. Shortterm use of ramelteon improvement in sleep onset difficulties in patients with insomnia. Long-term trials are needed before solid conclusions can be established. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。