Xyrem for Treatment Refractory Insomnia Due to PTSD
Withdrawn
State University of New York - Upstate Medical University
Phase 2
2005-08-01
Xyrem (sodium oxybate) is an agent with the propensity to improve slow wave sleep and sleep
efficiency. It is FDA approved to treat cataplexy (drop attacks) associated with narcolepsy
(sleep attacks). It has been shown to be a safe and effective agent here where deep,
restorative slow wave sleep improves and next day cataplexy attacks tend not to occur.
Post Traumatic Stress Disorder (PTSD) is a psychiatric illness where a patient has witnessed
or been involved in a traumatic event. After the event is over, nightmares, flashbacks,
avoidance of people and places associated with trauma and hyperarousal occur which is
incapacitating to the patient. One major part of PTSD hyperarousal is marked insomnia with
multiple awakenings at night. This resultant poor sleep is compounded by use of SSRI
serotonergic antianxiety agents (ie Zoloft(sertraline)) as first line therapy which tend to
degrade slow wave, restorative sleep. Patients may respond to SSRI treatment but may fail to
remit as they continue to have sleep problems. PTSD patients will often fail to respond to
antihistamine (Desyrel (trazodone)) and benzodiazepine GABA hypnotic agents
(Restoril(temazepam)) and continue with poor, interrupted sleep. It is possible that Xyrem's
ability to remarkably improve slow wave sleep may greatly help treatment refractory insomnia
due to PTSD.
The author proposes an open-label study (no placebo) where 10 PTSD patients, who have failed
usual PTSD treatments and have failed usual insomnia treatments in particular will be given
Xyrem in addition to their current PTSD medication. The authors wish to determine if Xyrem is
a safe treatment optionin this difficult-to-treat patient population.
Comparison of Temazepam and Acetazolamide to Treat Difficulty Sleeping at High Altitude
Completed
Massachusetts General Hospital
N/A
2012-03-01
More than 70% of visitors to high altitude suffer poor sleep. The present study seeks to
answer the question: Which medication is associated with better sleep at high altitude:
temazepam or acetazolamide? The investigators hypothesis is that one medication will be
associated with higher subjective sleep scores than the other. The study will compare the
sleep quality of 100 subjects as they take either temazepam or acetazolamide during a visit
to high altitude.
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