Acute insomnia: experience of treatment with doxylamine
https://doi.org/10.21518/2079-701X-2020-21-267-273
Abstract
Insomnia is a common clinical condition characterized by difficulty initiating and/or maintaining sleep. According to most epidemiological studies, about a third of adults (30–36%) report at least one symptom of insomnia, such as having difficulty falling asleep or maintaining sleep. Insomnia interferes with the full-fledged social and professional functioning of patients, forcing them to visit doctors more often, take sick leave. While therapeutic approaches are actively developed and discussed in chronic insomnia, acute insomnia due to the transient state and the tendency (in some cases) to spontaneous resolution often remains the subject of underdiagnosis and undrtreatment. Antihistamines that are non-addictive and have a narrower side-effect profile and are nonprescription drugs are an alternative in the pharmacological treatment of insomnia, especially secondary and transient insomnia, which is widespread in the population. Donormil (doxylamine succinate) is a blocker of H1-histamine receptors from the ethanolamine group. Donormil (doxylamine succinate) is a blocker of H1-histamine receptors from the ethanolamine group. Doxylamine is successfully used in both psychiatric and general medical practice, including dermatology, allergology, and gynecology.This article presents the clinical observation of a patient with acute insomnia arising in adjustment disorder and was accompanied by anxiety and mild conversion symptoms.. Donormil therapy during two weeks allowed to reduce acute insomnia: the time to fall asleep and the number of night awakenings decreased, cognitive impairment, distraction, and asthenia associated with insomnia reduced. No significant side effects were observed.
About the Authors
D. V. Romanov
Sechenov First Moscow State Medical University (Sechenov University);
Mental Health Research Center
Russian Federation
Russian Federation
Doct. Med. Sci., Рrofessor of Department of Psychiatry and Psychosomatics, 8, Bldg. 2, Trubetskaya St., Moscow, 119991;
leading research fellow of the Department of Boundary Mental Conditions and Psychosomatic Disorders, 34a, Kashirskoe Shosse, Moscow, 115522
P. G. Iuzbashian
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Research Assistant of Department of Psychiatry and Psychosomatics,
8, Bldg. 2, Trubetskaya St., Moscow, 119991
References
1. Summers M.O., Crisostomo M.I., Stepanski E.J. Recent developments in the classification, evaluation, and treatment of insomnia. Chest. 2006;130(1):276–286. doi: 10.1378/chest.130.1.276.
2. Wickwire E.M., Shaya F.T., Scharf S.M. Health economics of insomnia treatments: The return on investment for a good night’s sleep. Sleep Med Rev. 2016;30:72–82. doi: 10.1016/j.smrv.2015.11.004.
3. Morin C.M., Jarrin D.C. Epidemiology of insomnia: prevalence, course, risk factors, and public health burden. Sleep Med Clin. 2013;8(3):281–297. doi: 10.1016/j.jsmc.2013.05.002.
4. Ohayon M.M. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6(2):97–111. doi: 10.1053/smrv.2002.0186.
5. Roth T., Ancoli-Israel S. Daytime consequences and correlates of insomnia in the United States: results of the 1991 National Sleep Foundation Survey II. Sleep. 1999;22(2 Suppl.):354–358. Available at: https://pubmed.ncbi.nlm.nih.gov/10394607.
6. Kuppermann M., Lubeck D.P., Mazonson P.D., Patrick D.L., Stewart A.L., Buesching D.P., Fifer S.K. Sleep problems and their correlates in a working population. J Gen Int Med. 1995;10(1):25–32. doi: 10.1007/bf02599573.
7. Daley M., Morin C.M., LeBlanc M., Grégoire J.P., Savard J. The economic burden of insomnia: direct and indirect costs for individuals with insomnia syndrome, insomnia symptoms, and good sleepers. Sleep. 2009;32(1):55–64. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625324.
8. Katz D.A., McHorney C.A. The relationship between insomnia and health related quality of life in patients with chronic illness. J Fam Pract. 2002;51(3):229–235. Available at: https://pubmed.ncbi.nlm.nih.gov/11978233.
9. Dolsen M.R., Asarnow L.D., Harvey A.G. Insomnia as a transdiagnostic process in psychiatric disorders. Curr Psychiatry Rep. 2014;16(9):471. doi: 10.1007/s11920-014-0471-y.
10. Baglioni C., Nanovska S., Regen W., Spiegelhalder K., Feige B., Nissen C. et al. Sleep and mental disorders: a meta-analysis of polysomnographic research. Psychol Bull. 2016;142(9):969–990. doi: 10.1037/bul0000053.
11. Volel B.A., Petelin D.S., Poluektov M.G. Modern concepts about insomnia in mental disorders: clinical aspects. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = Journal of Neurology and Psychiatry. 2019;119(4-2):63–68. (In Russ.) doi: 10.17116/jnevro201911904263.
12. Sateia M.J. International Classification of Sleep Disorders – Third Edition: highlights and modifications. Chest. 2014;146(5):1387–1394. doi: 10.1378/chest.14-0970.
13. Riemann D., Baglioni C., Bassetti C., Bjorvatn B., Dolenc Groselj L., Ellis J.G. et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26(6):675–700. doi: 10.1111/jsr.12594.
14. Sateia M.J., Buysse D.J., Krystal A.D., Neubauer D.N., Heald J.L. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017;13(2):307–349. doi: 10.5664/jcsm.6470.
15. Ellis J.G., Perlis M.L., Neale L.F., Espie C.A., Bastien C.H. The natural history of insomnia: focus on prevalence and incidence of acute insomnia. J Psychiatr Res. 2012;46(10):1278–1285. doi: 10.1016/j.jpsychires.2012.07.001.
16. Ellis J.G., Cushing T., Germain A. Treating acute insomnia: a randomized controlled trial of a “single-shot” of cognitive behavioural therapy for insomnia. Sleep. 2015;38(6):971–978. doi: 10.5665/sleep.4752.
17. Melnikov A.Y. Acute insomnia: natural course and correction modalities. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2019;119(4-2):28–35. (In Russ.) doi: 10.17116/jnevro201911904228.
18. Crowe S.F., Stranks E.K. The Residual Medium and Long-term Cognitive Effects of Benzodiazepine Use: An Updated Meta-analysis. Arch Clin Neuropsychol. 2018;33(7):901–911. doi: 10.1093/arclin/acx120.
19. Soldatos C.R., Dikeos D.G., Whitehead A. Tolerance and rebound insomnia with rapidly eliminated hypnotics: a meta-analysis of sleep laboratory studies. Int Clin Psychopharmacol. 1999;14(5):287–303. Avaialable at: https://pubmed.ncbi.nlm.nih.gov/10529072.
20. Vande Griend J.P., Anderson S.L. Histamine-1 receptor antagonism for treatment of insomnia. J Am Pharm Assoc (2003). 2012;52(6):e210–e219. doi: 10.1331/japha.2012.12051.
21. Ramesh V., Thakkar M.M., Strecker R.E., Basheer R., McCarley R.W. Wakefulnessinducing effects of histamine in the basal forebrain of freely moving rats. Behav Brain Res. 2004;152(2):271–278. doi: 10.1016/j.bbr.2003.10.031.
22. Zant J.C., Rozov S., Wigren H.K., Panula P., Porkka-Heiskanen T. Histamine release in the basal forebrain mediates cortical activation through cholinergic neurons. J Neurosci. 2012;32(38):13244–13254. doi: 10.1523/jneurosci.5933-11.2012.
23. Stahl S.M. Stahl’s essential psychopharmacology. 4rd ed. Cambridge; 2013. 628 p. Available at: https://www.cambridge.org/9781107025981.
24. Brown E.A., Weiss L.R., Maher J.P. The clinical evaluation of a new histamine antagonist, decapryn. Ann Allergy. 1948;6(1):1–6. Available at: https://pubmed.ncbi.nlm.nih.gov/18910150.
25. Wolfromm R., Liacopoulus P. Clinical and therapeutic study of doxylamine succinate, a new synthetic antihistamine. Gaz Med Fr. 1959;66:1733–1736. (In French). Available at: https://pubmed.ncbi.nlm.nih.gov/13845742.
26. Strygin K.N., Poluektov M.G. Insomnia. Meditsinskiy sovet = Medical Council. 2017;(1S)52–58. (In Russ.) doi: 10.21518/2079-701X-2017-0-52-58.
27. Jewell D., Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev. 2002;(1):CD000145. doi: 10.1002/14651858.cd000145.
28. Persaud N., Chin J., Walker M. Should doxylamine-pyridoxine be used for nausea and vomiting of pregnancy? J Obstet Gynaecol Can. 2014;36(4):343–348. doi: 10.1016/s1701-2163(15)30611-3.
29. Sjoqvist F., Lasagna L. The hypnotic efficacy of doxylamine. Clin Pharmacol Ther. 1967;8(1):48–54. doi: 10.1002/cpt196781part148.
30. Schadeck S.B., Chelly M. Comparative efficacy of doxylamine and zolpidem for the treatment of common insomnia. Sep Hop Paris. 1996;72(13–14):428–439.
31. Veyn A.M. Donormil study report in patients with insomnia. Moscow: Center on Sleep Disorders Research; 1997. (In Russ.)
32. Levin Ya.I. Donormil in the therapy of insomnia. RMZh = RMJ. 2005;(9):704. (In Russ.) Available at: https://www.rmj.ru/articles/obshchie-stati/Doksilamin_Donormil_v_lechenii_insomnii.
33. Smirnov A.A., Gustov A.V., Zheltova О. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2006;106(3):56–57. (In Russ.) Available at: http://www.fesmu.ru/elib/Article.aspx?id=143391.
34. Levin Ya.I. Sleep, insomniya, doksilamin (Donormil). RMZh = RMJ. 2007;(10):850–855. (In Russ.) Available at: https://www.rmj.ru/articles/nevrologiya/Son_insomniya_doksilamin_Donormil.
35. Artyuhova M.G., Shanaeva I.A. The structure and characteristics of the treatment of sleep disorders in patients with cardiovascular diseases. RMZh = RMJ. 2010;(26):1573. (In Russ.) Available at: https://www.rmj.ru/articles/nevrologiya/Struktura_i_osobennosti_lecheniya_narusheniy_sna_u_bolynyh_serdechnososudistymi_zabolevaniyami.
36. Sadovnikova I.I. The problem of insomnia in the practice of a cardiologist. RMZh = RMJ. 2006;(10):770. (In Russ.) Available at: https://www.rmj.ru/articles/obshchie-stati/Problema_insomnii_v_praktike_kardiologa.
37. Burchakov D.I. Doxylamine and melatonin in treatment of sleep disruption in gynecological practice. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2018;118(4–2):67–72. (In Russ.) doi: 10.17116/jnevro20181184267.
38. Smulevich A.B., Zheleznova M.V., Pavlova L.K. The use of the Donormil in the treatment of sleep disorders of moderate and mild severity in the practice of a psychiatrist; Psychiatry and psychopharmacotherapy. Psihiatriya i psihofarmakoterapiya im. P.B. Gannushkina. 2006;(1):12–17. (In Russ.) Available at: https://con-med.ru/magazines/psikhiatriya_i_psikhofarmakoterapiya_im_p_b_ganushkina/psikhiatriya_i_psikhofarmakoterapiya_im_p_b_ganushkina-01-2006/primenenie_preparata_quot_donormil_quot_pri_lechenii_narusheniy_sna_sredney_i_legkoy_stepeni_vyrazhe.
39. Melnikov A.Y., Lavrik S.Yu., Bikbulatova L.F., Raginene I.G., Ivanova Ya.A., Zakharov A.V. Effectiveness of reslip (doxylamine) in short-term insomnia: multicenter comparative randomized study. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2017;117(4-2):56–59. (In Russ.) doi: 10.17116/jnevro20171174256-59.
40. Felinskaya N.I. Reactive states in a forensic psychiatric clinic. Moscow; 1968. 292 p. (In Russ.)
41. Smulevich A.B.. Personality disorders. Path in the space of mental and somatic pathology. Moscow: Meditsinskoe Informatsionnoe Agentstvo; 2012. 336 p. (in Russ.)
42. Millon T., Davis R.O. Disorders of personality: DSM-IV and Beyond. John Wiley & Sons; 1996.
43. Spielman A.J., Caruso L.S., Glovinsky P.B. A behavioural perspective on insomnia treatment. Psychiatr Clin North Am. 1987;10(4):541–553. Avaialble at: https://pubmed.ncbi.nlm.nih.gov/3332317.
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For citations:
Romanov DV, Iuzbashian PG. Acute insomnia: experience of treatment with doxylamine. Meditsinskiy sovet = Medical Council. 2020;(21):267-273. (In Russ.) https://doi.org/10.21518/2079-701X-2020-21-267-273
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