title: The effects of acute treatment with ramelteon, triazolam, and placebo on driving performance, cognitive function, and equilibrium function in healthy volunteers.
abstract: BACKGROUND
  Hypnotics are widely used to treat insomnia but adverse effects of different hypnotics, especially benzodiazepine receptor agonists, are getting more attention lately. The effects of novel hypnotics have not been fully examined.
  
  
  OBJECTIVE
  This study aims to assess the effects of two hypnotics, ramelteon and triazolam, on driving performance, cognitive function, and equilibrium function.
  
  
  METHODS
  In this double-blinded, three-way crossover trial, 17 healthy males received acute doses of 8 mg ramelteon, 0.125 mg triazolam, and placebo. The subjects were administered three driving tasks-road-tracking, car-following, and harsh-braking-using a driving simulator and three cognitive tasks-Continuous Performance Test, N-back Test, and Trail-Making Test-at baseline and at 1 and 4 h post-dosing. The Stanford Sleepiness Scale scores and computerized posturography were also assessed.
  
  
  RESULTS
  In the driving simulations, ramelteon and triazolam increased the number of subjects who slid off the road. Triazolam increased the standard deviation of lateral position compared to ramelteon and placebo at 1 h post-dosing. Ramelteon and triazolam significantly increased the time to complete of Trail-Making Test part A and the environmental area in posturography compared to placebo at 1 and 4 h post-dosing. Ramelteon and triazolam significantly increased subjective sleepiness compared to placebo at 1 h post-dosing.
  
  
  CONCLUSIONS
  Ramelteon may affect road-tracking performance, visual attention and/or psychomotor speed measured by Trail-Making Test part A, and body balance in acute dosing. Lower dose of triazolam also impaired performance worse than ramelteon. Physicians should consider risks and benefits when prescribing both drugs, especially in the initial period of administration.
authors.affiliation: Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Miyata
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Iwamoto
authors.forename: Naoko
authors.initials: N
authors.lastname: Kawano
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Kohmura
authors.forename: Maeri
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Branko
authors.initials: B
authors.lastname: Aleksic
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Ebe
authors.forename: Akiko
authors.initials: A
authors.lastname: Noda
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Noda
authors.forename: Shuji
authors.initials: S
authors.lastname: Iritani
authors.forename: Norio
authors.initials: N
authors.lastname: Ozaki
mesh_terms: D000328:Adult; D001334:Automobile Driving / Q000523:psychology*; D003071:Cognition / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D064368:Healthy Volunteers; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D007192:Indenes / Q000494:pharmacology*; D008297:Male; D004856:Postural Balance / Q000187:drug effects*; D011597:Psychomotor Performance / Q000187:drug effects; D012894:Sleep Stages / Q000187:drug effects; D014229:Triazolam / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D007192:Indenes; D014229:Triazolam; C495910:ramelteon