Neuropsychobiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Nonorganic insomnia in generalized anxiety disorder. 2. Comparative studies on sleep, awakening, daytime vigilance and anxiety under lorazepam plus diphenhydramine (Somnium) versus lorazepam alone, utilizing clinical, polysomnographic and EEG mapping methods.
Previous human pharmacological and toxicological studies demonstrated advantages of the combination drug Somnium [SOM, lorazepam (LOR) 1 mg plus diphenhydramine 25 mg] over 1 mg LOR alone, as it showed synergistic effects in hypnotic properties and antagonistic effects in regard to toxicity. In the present double-blind, parallel-group study, hypnotic and anxiolytic effects of SOM were studied in 44 patients with non-organic insomnia related to mild generalized anxiety disorder (GAD), as compared with LOR alone. After a placebo run-in phase of 1 week, they received active treatment (1 tablet SOM or LOR 1 mg) for 4 weeks and thereafter placebo again for 1 week. ⋯ In objective awakening quality, psychometry revealed an improvement of reaction time under SOM and a decrease of attention variability and an increase in fine-motor activity under LOR, with an interdrug comparison showing a significant superiority of SOM over LOR in regard to reaction time, reaction time variability and reaction time performance. After placebo substitution, rebound phenomena were seen in polysomnography and subjective sleep and awakening in the 1st night of the SOM group only, which were gone in the 7th placebo night, however. Noopsychic performance remained improved in both groups, with a superiority of SOM to LOR in regard to reaction time and reaction time variability. (ABSTRACT TRUNCATED)
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Randomized Controlled Trial Clinical Trial
Comparison of the EEG effects of midazolam, thiopental, and propofol: the role of underlying oscillatory systems.
The EEG effects of 3 intravenous sedative drugs from different chemical families were studied during conscious sedation in 47 normal volunteers. The drugs studied were midazolam (a benzodiazepine), propofol (an alkylphenol) and thiopental (a barbiturate). Though these drugs cause different degrees of amnesia, they have the common EEG effects of suppressing alpha-rhythm and increasing total beta-power. ⋯ While thiopental induced beta-rhythms which were similar to those appearing during drowsiness, midazolam and propofol induced beta-rhythms with substantially different characteristics. The differences between the beta-rhythms induced by drug infusion and previously described 'sleep spindles' are discussed. We conclude that a quantitative analysis of beta-rhythms can differentiate the effects of these drugs on the EEG.