Treatment regimen and hypnotic self-administration.
OBJECTIVE
Previous studies have shown that insomniacs self-administer hypnotics at high nightly rates. This study determined whether prior experience with different treatment regimens (i.e., instructions and capsule availability) would alter the previously observed high hypnotic self-administration rates.


METHODS
Sixty-four healthy men and women with (n = 32) and without (n = 32) insomnia, 21-55 years, self administered placebo or triazolam (0.25 mg) after different prior treatment regimens. They received one of three different treatment regimens enforced for 11 nights: a capsule each night, a capsule as needed, or a capsule every third night. On 14 subsequent nights they choose to self-administer a capsule or not, placebo during 1 week and triazolam (0.25 mg) the other (counterbalanced in order).


RESULTS
Insomniacs self-administered more capsules than normals and triazolam was self-administered more than placebo. For both groups, treatment regimen had a minimal effect on capsule self-administration. During the treatment phase, triazolam improved self-ratings of sleep relative to placebo. During the choice phase, nightly variations in self-rated sleep predicted self-administration of a capsule on the following night, regardless of whether the capsule was active drug or placebo.


CONCLUSIONS
The data of this study are consistent with the view that hypnotic self-administration by insomniacs is therapy-seeking behavior and not drug abuse.
Roehrs
T
T
Henry Ford Hospital, Sleep Disorders and Research Center, 2799 West Grand Blvd, Detroit, MI 48202, USA.
Bonahoom
A
A
Pedrosi
B
B
Rosenthal
L
L
Roth
T
T
D000328:Adult; D000704:Analysis of Variance; D014151:Anti-Anxiety Agents / Q000008:administration & dosage*; D002214:Capsules; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012646:Self Administration / Q000523:psychology* / Q000706:statistics & numerical data; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000523:psychology; D014229:Triazolam / Q000008:administration & dosage*
D014151:Anti-Anxiety Agents; D002214:Capsules; D006993:Hypnotics and Sedatives; D014229:Triazolam