Feasibility of an every-other-night regimen in insomniac patients: subjective hypnotic effectiveness of quazepam, triazolam, and placebo.
BACKGROUND
Rebound insomnia, a worsening of sleep difficulty beyond baseline levels, can complicate the physician's attempt to use regularly scheduled drug holidays in the management of insomniac patients. Quazepam, a benzodiazepine with a long half-life, has been shown to exhibit carryover effectiveness for the first night or two following withdrawal. This finding suggests a potential utility for an alternate-night drug regimen in which the withdrawal features of the compound serve as a potential benefit.


METHODS
A randomized, double-blind, three-compartment, parallel-group design of 5 weeks' duration, comparing quazepam 15 mg, triazolam 0.5 mg, and placebo, was conducted in 65 insomniac subjects. This study was a nonpolysomnographic study utilizing sleep questionnaires.


RESULTS
No differences were noted between quazepam and triazolam on treatment nights. Evidence of carryover effectiveness with quazepam and rebound effects with triazolam were noted on off-treatment nights.


CONCLUSIONS
The efficiency of alternate-night therapy with quazepam should be rigorously evaluated using polysomnographic determinations.
Scharf
M B
MB
Sleep Disorders Center, Mercy Hospital, Cincinnati, Ohio 45246.
D014151:Anti-Anxiety Agents; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects; D002940:Circadian Rhythm / Q000187:drug effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D010919:Placebos; D012890:Sleep / Q000187:drug effects; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced / Q000188:drug therapy*; D014229:Triazolam / Q000008:administration & dosage* / Q000009:adverse effects
D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D010919:Placebos; D001569:Benzodiazepines; D014229:Triazolam; C025130:quazepam