佐匹克隆对驾驶的影响

目的 探讨佐匹克隆对驾驶的影响,为药物驾驶立法提供参考。方法 参考国内外关于佐匹克隆的研究,从药理学特征、驾驶能力、驾驶安全、药物相互作用4个方面分析佐匹克隆对驾驶的影响,并分析佐匹克隆的检测方法和我国药物驾驶现状。结果 佐匹克隆会影响使用者的驾驶能力,但是否会升高驾驶事故发生率还存在争议。结论 人们驾驶时需提高对佐匹克隆的警惕,同时加大我国药物驾驶方面的研究,加快药物驾驶立法的进程。     

佐匹克隆的滥用和成瘾倾向

关于佐匹克隆(zopiclone)的滥用和成瘾倾向一直以来都有许多的争论,本回顾性研究的目的在于:探讨过去9a在我们诊疗所就诊病例中佐匹克隆滥用的普遍程度及其成瘾倾向。回顾病案记录,发现共有87例确诊为佐匹克隆滥用的病人。在过去的4a中,滥用病例增长迅猛。这是到2004年为止关于佐匹克隆滥用的病例数目最多的研究报告。     

国产艾司佐匹克隆治疗失眠症的对照研究

目的:评价国产艾司佐匹克隆治疗失眠症的有效性和安全性。方法:采用多中心随机双盲双模拟、阳性药物平行对照的研究方法。入选228例,其中试验组113例,对照组115例。分别口服艾司佐匹克隆3～6 mg·d-1和佐匹克隆7．5～15 mg·d-1,疗程均为14 d。结果:睡眠障碍量表(SDRS)评分在治疗结束时两组较基线均显著降低(P<0．05);试验组和对照组的有效率分别为60．2％和62．6％,两组比较无显著性差异(P>0．05)。不良反应发生率分别为32．7％和33．9％,较常见的不良反应为口苦及头晕。结论:艾司佐匹克隆能改善睡眠,不良反应较少,是一种治疗睡眠障碍安全而有效的新药。     

COMPARATIVE EFFECTS OF ZOPICLONE, TRIAZOLAM AND PLACEBO ON MEMORY AND PSYCHOMOTOR PERFORMANCE IN HEALTHY VOLUNTEERS

This study evaluated the effects of acute doses of zopiclone (7.5 mg), triazolam (0.25 mg) and placebo on memory and psychomotor performance of 12 normal volunteers. The subjects received both drugs in a repeated measure, double-blind Latin square design. The tests (CFF, CRT, DSST, memory assessments) were performed before and 2 and 6 hr after treatment. Zopiclone and triazolam induced an anterograde amnesia affecting short-term and long-term memory which lasted less than 6 hr. No retrograde amnesia was observed. Two hr after drug intake of both hypnotics psychomotor performances were significantly altered compared with placebo. The subjects also felt more drowsy, dizzy, clumsy and tired, and less alert and energetic 2 hr after zopiclone and triazolam compared to placebo. There was no difference between the effects of the two hypnotics at the doses studied.     

佐匹克隆与阿普唑仑治疗伴睡眠障碍老年期痴呆患者的多导睡眠图观察

目的:观察佐匹克隆与阿普唑仑对照治疗伴睡眠障碍的老年期痴呆患者的临床疗效与不良反应。方法:将72例老年期痴呆睡眠障碍的患者以随机数字表法分为2组,研究组39例,每晚睡前15 min口服佐匹克隆片7.5 mg/d;对照组33例,每晚睡前15 min口服阿普唑仑片0.4 mg/d,两组疗程均为3周;采用多导睡眠图评价疗效,不良反应量表(TESS)评价不良反应。结果:研究组与对照组治疗后各睡眠参数较治疗前均有好转(P0.01);两组间比较差异无统计学意义(P0.05)。治疗过程中佐匹克隆组除口腔苦味感外的不良反应发生率(20.51%)低于对照组(60.61%,χ2=11.39,P0.01),佐匹克隆组口腔苦味感发生率(100%)高于阿普唑伦组(3.03%,P0.01)。结论:佐匹克隆与阿普唑仑能够缩短伴睡眠障碍的老年期痴呆患者入睡时间,提高睡眠的质量,疗效相当。但佐匹克隆除口腔苦味感明显外,其他不良反应较少。     

Concentrations and effects of zopiclone are greatly reduced by rifampicin

Aims The effects of rifampicin on the pharmacokinetics and pharmacodynamics of zopiclone, a non-benzodiazepine hypnotic, were studied.
Methods In a randomized, placebo-controlled cross-over study with two phases, eight young healthy volunteers took either 600  mg rifampicin or placebo once daily for 5 days. On the 6th day, 10  mg zopiclone was administered orally. Plasma zopiclone concentrations and effects of zopiclone were measured for 10  h.
Results The total area under the plasma zopiclone concentration-time curve after rifampicin was 18.0% (95% CI 13.5–22.5%) of that after placebo (86.1±34.5  ng  ml⁻¹ h vs 473±114  ng  ml⁻¹  h (mean±s.d.); P <0.001). Rifampicin decreased the peak plasma concentration of zopiclone from 76.9±27.2  ng  ml⁻¹ to 22.5±6.0  ng  ml⁻¹ ( P <0.001) and the half-life from 3.8±0.6  h to 2.3±0.9  h ( P <0.005). A significant ( P <0.02) reduction in the effects of zopiclone was seen in three of the five psychomotor tests used (digit symbol substitution test, critical flicker fusion test and Maddox wing test) after rifampicin pretreatment.
Conclusions The strong interaction of rifampicin with zopiclone is due to enhanced metabolism of zopiclone. Zopiclone may show a reduced hypnotic effect when used concomitantly with rifampicin or other potent inducers of CYP3A4 such as phenytoin and carbamazepine.     

Comparative study of zopiclone,a novel hypnotic,and three benzodiazepines

Summary The hypnotic effect and tolerance of zopiclone 7.5 mg, nitrazepam 5 mg, flurazepam 30 mg, flunitrazepam 2 mg and placebo were compared in a one-night double blind study in 414 hospitalised patients who were to undergo an operation on the following day. Zopiclone was slightly superior to nitrazepam but was inferior both to flurazepam and flunitrazepam. All the active drugs differed clearly from placebo. The results from a subset of patients, excluding those who felt anxious either before treatment on the evening prior to the operation or on the following morning, were analysed separately. All the active products differed significantly from placebo; zopiclone was slightly less effective than the three benzodiazepines. All the benzodiazepines decreased the precentage of patients feeling anxious about the operation by about 25%, zopiclone by about 10% and placebo did not change it at all.     

Effects of Zopiclone on Slow Wave Sleep and Spontaneous K-complexes for Normal Healthy Young Adults

Abstract: Benzodiazepine (BZD) hypnotics have been known to decrease, to some degree, human slow wave sleep (SWS) although they elevate the arousal threshold during sleep. Zopiclone (ZPC), a cyclopyrrolone hypnotic, has attracted the interest of sleep researchers because an increase in human SWS has been reported. Since the increase has not been fully confirmed by all of the studies, the authors investigated the effects of ZPC 10 mg on SWS and the K-complexes for 7 healthy young adults because there is evidence indicating that delta waves consisting of SWS and the spontaneous K-complexes are identical. SWS and st. 4 sleep did not decrease on any of the ZPC nights but st. 3 sleep showed a tendency to reduce on the 1st ZPC night. The frequency of the K-complexes decreased significantly on the 2nd ZPC night and tended to reduce on the 1st ZPC night. Moreover, a significant positive correlation was noted between the decrease rates of SWS and the K-complexes on both the ZPC nights. The authors, therefore, could not obtain any findings suggesting an increase in SWS with ZPC.