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PubMed1999

Psychophysiological correlates of hypnosis and hypnotic susceptibility.

This article reviews and summarizes electroencephalographic (EEG)-based research on physiological and cognitive indicators of hypnotic responding and hypnotic susceptibility, with special attention to the author's programmatic research in this area. Evidence that differences in attention levels may account for hypnotic depth and individual differences in hypnotizability is provided with traditional EEG rhythms, event-related potentials, and 40-Hz EEG activity. The alteration of stimulus perception may be a secondary effect with respect to allocation of attentional resources. In both nonhypnosis and hypnosis conditions, high hypnotizables appeared to show greater task-related EEG hemispheric shifts than did low hypnotizables. Findings concerning cognitive and physiological correlates of hypnotic analgesia are discussed with respect to hemispheric functioning in the apparent control of focused and sustained attention. The conclusion is that although a definitive EEG-based signature for hypnosis and hypnotizability is not yet established, there are a number of promising leads.

Attention↗
PubMed1982

Aspects of short-term use of two benzodiazepine hypnotics in the elderly.

There are frequent reports of impairment of psychomotor performance on the morning after taking hypnotics. Possible ways of avoiding these problems include a reduction of the dose or using a hypnotic with a short half-life. This study used nitrazepam 2.5 mg and triazolam 0.125 mg in a group of hospitalized elderly patients. Both drugs were effective hypnotic agents but they are different in their residual effects. Patients reported difficulty in waking after nitrazepam but not after triazolam. These difficulties were confirmed by nurse observation. Nitrazepam significantly impairs (after repeated doses) psychomotor performance after five days therapy and this effect was not seen after triazolam. If a benzodiazepine hypnotic is used in the elderly, a drug with a short elimination half-life is an advantage.

Aged↗
PubMedDate not supplied

Hypnotic relaxation in the treatment of premature labor.

Hypnotic relaxation was used as an adjunct to pharmacologic treatment with 39 women hospitalized for premature contractions in pregnancy. The control group received medication alone and consisted of 70 women. Treatment was started at the time of hospitalization and lasted for 3 hr on the average. Patients were also given cassettes with a hypnotic-relaxation exercise for daily practice. The rate of pregnancy prolongation was significantly higher for the hypnotic-relaxation than for the medication-alone group. Infant weight also showed the advantage of the hypnotic-relaxation treatment. Background variables of the two groups were compared and it was shown that they could not have explained the treatment effect obtained.

Adult↗
PubMedDate not supplied

Reduction in skin reactions to histamine after a hypnotic procedure.

This study sought to test whether a cognitive-hypnotic intervention could be used to decrease skin reactivity to histamine and whether hypnotizability, physiological variables, attitudes, and mood would influence the size of the skin weals. Thirty eight subjects undertook three individual laboratory sessions; a pretest session to determine sensitivity to histamine, a control session, and an intervention session during which the subject experienced a cognitive-hypnotic procedure involving imagination and visualization. Compared with the control session, most subjects (32 of 38) decreased the size of their weals measured during the intervention session, and the differences between the weal sizes produced in the two sessions were highly significant (N = 38; t = 4.90; p < .0001). Mood and physiological variables but not hypnotizability scores proved to be effective in explaining the skin test variance and in predicting weal size change. Feelings of irritability and tension and higher blood pressure readings were associated with less change in weal size (i.e., a continuation of reactivity similar to that found in the control session without the cognitive-hypnotic intervention), and peacefulness and a lower blood pressure were associated with less skin reactivity during the intervention. This study has shown highly significant results in reducing skin sensitivity to histamine using a cognitive-hypnotic technique, which indicates some promise for extending this work into the clinical area.

Adolescent↗
PubMed1995

Hypnotics and caffeine as countermeasures for shiftwork-related sleepiness and sleep disturbance.

Hypnotic medication reliably improves sleep during the day, in terms of increasing total sleep time (TST) and reducing awakenings and light sleep. Middle-aged individuals may benefit more than young adults. In addition, the time of day during which sleep is attempted may influence the efficacious dose of short-acting drugs. Available data suggest that improving sleep during the day may improve alertness/performance at night to a mild degree, but significant circadian-related sleepiness remains. Hypnotic medication may help minimize the cumulative effects of sleep loss associated with daytime sleep. Use for more than one week has not been adequately studied; however, as most night and rotating workers' schedules allow for night-time sleep for two or more nights per week, available evidence indicates that hypnotics can be used effectively on an intermittent basis, e.g. for the first 2-4 day-sleep periods of night shifts. Caffeine has been shown to increase alertness and improve psychomotor performance during usual night-shift hours when taken between 22.30 and 01.20 hours. Available data indicate that at approximate dosages of 250-400 mg, the beneficial effects persist until at least 05.30 hours. For most subjects, caffeine taken at the start of the night-shift does not interfere significantly with daytime sleep beginning at 09.00 hours. There is also some evidence that single doses of caffeine at the beginning of a night shift may be more alerting than divided doses. If caffeine is to be used therapeutically, avoidance of social use may be required to avoid tolerance to CNS stimulant effects. Despite the positive results of laboratory research examining hypnotics or caffeine as shiftwork countermeasures, field trials have not been conducted.

Journal Article↗
PubMed1986

Pharmacokinetics of temazepam compared with other benzodiazepine hypnotics--some clinical consequences.

When the various benzodiazepine hypnotics are studied, large differences are seen with regard to their pharmacokinetic properties and metabolism in man. Some are eliminated from the body at a relatively slow rate (e.g. nitrazepam), others are metabolized rather rapidly (temazepam, triazolam). Some benzodiazepine hypnotics have major active metabolites that are slowly eliminated (flurazepam, quazepam), while others have non-active metabolites (temazepam, lormetazepam). In hypnotic treatment, the duration of drug action should be restricted to the duration of the night, hence a compound with a relatively short elimination half-life may represent a more rational choice. An overview is given of the pharmacokinetics of the currently available benzodiazepine hypnotics with emphasis on temazepam and other hydroxylated benzodiazepines.

Anti-Anxiety Agents↗
PubMed1986

Hypnotics and transient insomnia.

An hypnotic should be used only when there is evidence of sleep disturbance. The wide range of sleep disorders (e.g. delayed sleep onset or problems of sleep maintenance) and the added complication that the patient may be involved subsequently in skilled work demand that the pharmacokinetics of various hypnotics must be understood before the correct hypnotic can be chosen. Impaired performance is more severe and persists far longer with compounds that are slowly eliminated and with the use of higher doses. The particular situations of aircrew and mountaineers have been studied in detail. Caution must be exercised in the management of aircrew coping with irregularity of rest and work. Temazepam has been used for aircrew for over 10 years and the absence of adverse effects ensures that it remains the recommended hypnotic in this area of medical practice. The relationship of insomnia with the hypoxic environment is undetermined. To investigate this, sleep was studied in six individuals during an expedition to the Himalayas. At altitude, temazepam led to less wakefulness and to drowsy sleep--there were no prolonged sleep latencies.

Altitude↗
PubMed1991

Temazepam 'Planpak': a multicentre general practice trial in planned benzodiazepine hypnotic withdrawal.

A trial was carried out in 44 patients to demonstrate the efficacy of planned withdrawal of benzodiazepine hypnotics in general practice using Temazepam 'Planpak'. The withdrawal period was 6 weeks during which time the dose of temazepam was reduced every 2 weeks from 10 mg to 5 mg to 2 mg. Patients were followed up for between 3 and 6 months after withdrawal. Four patients failed to complete the withdrawal phase due to sleep disturbance. Adverse events reported were minor. Twenty-six (59%) patients were able to sleep without a hypnotic after the withdrawal phase. Patients on 10 mg temazepam on entry into the trial had a higher success rate than those on 15 mg or 20 mg nightly (p = 0.002). At follow-up 12 to 35 weeks after completion of the trial, 52% of the patients who entered were sleeping without the use of a hypnotic. A patient management plan for hypnotic withdrawal is proposed.

Adult↗
PubMed1990

Sedative and hypnotic midazolam-morphine interactions in rats.

The midazolam-morphine interactions in relation to the sedative effect and in relation to the hypnotic effect were studied in rats. Two series of experiments (sedative and hypnotic) were performed. In the sedative series, doses that inhibited locomotor activity to 10% or more of the control level were determined when the agents were given singly or in combination. Dose-response curves were determined with a probit procedure. The ED50 values of both agents and their combination were compared with algebraic (fractional) and isobolographic analyses in one subseries of experiments. The effect of a small fixed dose of morphine (1/10 of ED50 value for the sedative effect) on the slope of the sedative dose-response curve for midazolam was determined in the other subseries. In the hypnotic series of experiments, doses (ED50) that blocked the righting reflex with drugs given separately and in combination were determined by a probit procedure and, as in the sedative series, compared with algebraic (fractional) and isobolographic analyses. Sedative interaction between midazolam and morphine was found to have a tendency for synergism (interaction coefficient of 1.56, P greater than 0.05) with decreased individual variability in the sedative response to the combination. Hypnotic midazolam-morphine interaction was highly synergistic with the interaction coefficient of 3.70 (P less than 0.0001). A difference in the outcomes of midazolam-morphine interaction regarding sedation and hypnosis suggests that underlying mechanisms for these two effects are different; therefore, they should not be regarded as only increasing depths of the same action.

Animals↗
PubMed2007

The hypnotic, electroencephalographic, and antinociceptive properties of nonpeptide ORL1 receptor agonists after intravenous injection in rodents.

BACKGROUND: Agonists at the opioid receptor-like receptor 1 (ORL1) induce motor impairment, sedation, and loss of righting reflex (LRR) in rodents. This receptor may provide a novel target in the field of anesthesia. METHODS: We examined the hypnotic, electroencephalographic (EEG), and antinociceptive effects of two IV administered nonpeptide ORL1 agonists, (Ro 65-6570 and Org 26383), using LRR in mice and rats, percent EEG burst suppression in rats, and formalin paw test in mice. RESULTS: In mice, Ro 65-6570 and Org 26383 produced LRR (hypnotic dose 0.6 and 3.7 micromol/kg for Ro 65-6570 and Org 26383, respectively). Naloxone had no significant effect on sleep times produced by both compounds. In rats, Ro 65-6570 (0.6-2.4 micromol/kg) and Org 26383 (4-8 micromol/kg) produced LRR and burst suppression activity in the EEG. Both sleep times and burst suppression activity were significantly reduced with a selective ORL1 antagonist. In mice, dose-dependent inhibition of formalin-induced nociceptive behaviors occurred (Phase 1 ED50 0.4 and 1.8 micromol/kg and Phase 2 ED50 0.4 and 4.2 micromol/kg for Ro 65-6570 and Org 26383, respectively). CONCLUSIONS: These results show that Ro 65-6570 and Org 26383 (probably via the ORL1 receptor) behave as IV hypnotics and analgesics in mice and rats, and that the hypnotic and antinociceptive doses are similar.

Animals↗
PubMed1995

Visual field asymmetry in facial affect perception: moderating effects of hypnosis, hypnotic susceptibility level, absorption, and sustained attentional abilities.

Effects of hypnotic level, affect valence and cerebral asymmetry on reaction time (RT) in the discrimination of Ekman and Friesen's (1978) stimuli of angry and happy faces were studied in counterbalanced conditions of waking and hypnosis. Assessed previously on two hypnotic susceptibility scales [Harvard Group Scale of Hypnotic Susceptibility; Stanford Hypnotic Susceptibility Scale, Form C (SHSSC)], non-depressed subjects were 16 low (0-4 SHSSC) and 17 highly (10-12 SHSSC) hypnotizable, right-handed college students. Subjects were required to identify affects of faces, presented tachistoscopically to left (LVF) or right (RVF) visual fields, by using a forced-choice RT paradigm. Highs were significantly faster than lows in angry and happy affect recognition. Hypnosis had no significant effects. For highs only, angry emotional valence was identified faster when presented to the right hemisphere (LVF), but there were no significant hemispheric effects for happy emotional valence. For lows there were no hemispheric differences. Gender was a nonsignificant factor. Significant correlations showed that faster reaction times to angry and happy stimuli, in both LVF and RVF in waking and hypnosis, were obtained by subjects who reported more deeply absorbed and extremely focused and sustained attention on the Tellegen (1982) Absorption Scale and a subscale of the Differential Attentional Processes Inventory (Grumbles & Crawford, 1981). Vividness of Visual Imagery Questionnaire (Marks, 1973) and Affect Intensity Measure (Larsen, 1985), in general, did not correlate with RTs. The potential role of the fronto-limbic attentional system in the recognition of external visual sensory affect is discussed.

Adult↗
PubMed1961

Dangerous and Hypnotic Drug Act.

It is unprofessional conduct within the meaning of the Medical Practice Act to prescribe a dangerous drug without either a medical examination by a physician or other medical indications. Dangerous and hypnotic drugs are specifically defined by both state and federal law and distribution is strictly regulated.A physician may administer to his own patients such amounts of dangerous drugs as are necessary for the immediate needs of the patient. The physician may obtain such needed amounts of these drugs by an order placed with a pharmacist marked "for administration to immediate needs of patients." A licensed physician may also prescribe dangerous and hypnotic drugs for patients and such prescriptions may be refilled on the specific authorization of the physician.A physician who dispenses dangerous and hypnotic drugs to patients must obtain a hypnotic drug license; he must use specific purchase orders when purchasing; the drugs must be labeled in the manner provided by law; and all records of sale shall be open to inspection by authorized officers of the law and kept for three years. By the Principles of Medical Ethics physicians are bound to limit the source of their professional income to medical services actually rendered. Recent decisions of the Judicial Council answer questions concerning a physician's interest in a corporation which purchases, packages and sells medicines under a corporate name. Also answered are questions as to the measures that exist to prevent physicians from abusing the privilege of owning a pharmacy, and whether a physician can ethically rent space in a building owned by him to a pharmacist with a percentage of the income of the pharmacy as rental. The public welfare of California and the nation as determined by legislation strictly regulates the distribution of dangerous drugs. It is in the best interest of the medical profession and its patients that these laws be understood and carefully observed.

California↗
PubMed2003

[Prevalence and distribution of antidepressant, anxiolytic and hypnotic use in 2001.].

OBJECTIVE: To study the prevalence of the use of antidepressant, anxiolytic and hypnotic drugs, the distribution of the use according to clinical and demographic factors and to compare it with the prevalence according to official sales figures. MATERIAL AND METHODS: Data was collected in a survey by the Alcohol and Drug Prevention Committee. Four thousand individuals were selected at random from the population aged 18-75 years. Pharmaceutical use was studied according to sex, age, length of use, well-being, medical consultations, smoking, alcohol problems, education, marital status, income, occupation, and work pressure. Data on sales was supplied by the Ministry of Health and Social Security, Office of Pharmaceutical Affairs. RESULTS: The response rate was 63.6%. Almost 20% had used some of these drugs during the preceeding 12 months, slightly more women than men. There was neither significant difference in the one year prevalence of use of antidepressants and hypnotics according to sex nor according to age for antidepressants and anxiolytics. One half of the youngest age group used antidepressants for less than three months. Use of hypnotics increased by age. Estimated use of antidepressants and hypnotics is 54% and 61%, respectively, of sales figures. There was no significant difference in the relative risk of drug use for men and women seeking medical consultations. Odds ratios were higher for smokers, especially for the use of antidepressants. People with the little education and low income was most likely to have used antidepressants and anxiolytics. CONCLUSIONS: Use of these drugs is common, but not as extensive as sales figures suggest. Sex difference is smaller than in previous studies. Prevalence of use, especially longterm, increases with age. As expected the use is most common among the socio-economically disadvantaged.

English Abstract↗
PubMed1983

Lipid solubility is correlated with hypnotic and hypothermic responses of long-sleep (LS) and short-sleep (SS) mice to various depressant drugs.

The long-sleep (LS) and short-sleep (SS) lines of mice have been selected for a difference in duration of ethanol-induced sleep time. In our previous study, recent generations of the two lines were found to exhibit differential hypnotic and hypothermic responses to pentobarbital which appear to be explained by differences in elimination. Casual observation that the LS mice were fatter than the SS suggested that this discrepancy may influence the responses of these animals to sedative-hypnotic drugs which differ in lipid solubility. The present study was designed to determine whether the LS and SS mice differ in hypnotic and hypothermic responses to two barbiturates which differ in lipid solubility; to the highly lipid soluble tertiary alcohol, ethchlorvynol; and to the water soluble depressant, methyprylon. Mice of the SS line were more responsive to the lipid soluble depressants than were LS mice, and increasing the lipid solubility of the barbiturates resulted in a greater difference between the lines. LS mice were more responsive to the water soluble depressant, apparently due to differential central nervous system sensitivity rather than to differences in elimination. The whole-body lipid content of the LS mice is double that of the SS mice. The influence of body lipid content on drug disposition may accentuate the elimination differences that result in the lesser responsivity of LS mice to barbiturates and possibly ethchlorvynol. This study indicates that sedative-hypnotic drugs of varying lipid solubilities may not share common mechanisms of action.

Animals↗
PubMed1995

Hypnotically recalling dreams during analysis.

This study described the procedure, the theoretical rationale, and clinical material relating to the hypnotic recalling of dreams during periods of protracted "dreamless" analyses. Two clinical examples were used to demonstrate the efficacy of using a special hypnotic procedure close to the analytic free-association method for the remembering or recalling the dreams. Discussion of the clinical material found: 1. the main factors contributing to a "dreamless" analysis were to be found in the transference-countertransference resistances of the analysis; 2. the justification for introducing the special hypnotic procedure as a parameter in the analysis was discussed and confirmed; 3. the remembering-recalling of the first dream--following the hypnotic intervention--lead to the recovery of a critical childhood memory; and 4. the parameter of using hypnosis as a method of breaking the intractable resistance of a "dreamless" analysis did not become an alien force which intervened whenever strong resistances appeared. On the contrary, it seemed to serve as a temporary therapeutic mechanism for allowing an energy shift to occur in the all-or-none defensive state of a "dreamless" analysis.

Adult↗
PubMed1989

Zopiclone in insomniac shiftworkers. Evaluation of its hypnotic properties and its effects on mood and work performance.

Fifty adult insomniac shiftworkers (47 males and 3 females) between the ages of 22 and 55 participated in this two-week, double-blind comparative study of the hypnotic properties and effects on mood and work performance of zopiclone 7.5 mg and placebo. All subjects took inactive medication on the first night of the study and then received either zopiclone or placebo for the following 13 nights according to randomization. Pre-study variables included a demographic profile, medical history, physical examination, laboratory data, profile of insomnia and work shift pattern description. A sleep questionnaire along with mood and work performance questionnaires were filled out on Days 1, 2, 4, 9 and 12 of the study; on Days 7 and 14, adverse events were recorded. After the first placebo night, subjects assigned to receive zopiclone showed significantly improved sleep induction; from the second night on, a distinct pharmacological effect over placebo was observed and maintained since statistically significant increases in quantitative sleep induction and sleep soundness (qualitative and quantitative) were noted during the course of zopiclone treatment. Active hypnotic treatment did not interfere with morning awakening and functioning, nor did it affect mood or work performance. Zopiclone treatment produced significantly more taste disturbance and drowsiness. In summary, zopiclone was shown to be an effective, fast-acting hypnotic which maintained its efficacy over a two-week period in our sample of insomniac shiftworkers and did not produce mood changes or influence work performance.

Adult↗
PubMed1981

Prostaglandin synthetase inhibitors antagonize hypothermia induced by sedative hypnotics.

Previous studies in our laboratory have demonstrated that inhibition of prostaglandin biosynthesis through pretreatment with aspirin and other prostaglandin synthetase inhibitors (PGSI) significantly reduces CNS sensitivity to a hypnotic dose of ethanol. Indomethacin, a potent PGSI, was administered to male LS, SS, and HS/Ibg mice (65 +/- 10 days of age) 15 min prior to administration of a hypnotic dose of ethanol or pentobarbital. Doses of indomethacin used were identical to those previously reported as optimally antagonizing ethanol-induced sleep. Another group received a vehicle-control injection, while a third group also received a control injection, but were placed in a incubator maintained at 30 +/ 1 degrees C. Body temperatures were recorded periodically for several hours. Both indomethacin and incubation significantly reduced hypothermia induced by ethanol and pentobarbital. Incubation increased sleep time after ethanol, but did not affect pentobarbital sleep time. These results suggest that the hypnotic and hypothermic effects of ethanol, although possibly mediated through prostaglandins, apparently are not causally linked.

Body Temperature↗
PubMed1982

Sedative-hypnotics and human performance.

In 52 studies, performance data were obtained the next day following bedtime ingestion of a sedative-hypnotic or a placebo. Only eight of these studies used insomniac patients. Most studies used young adult males. Benzodiazepine hypnotics were most frequently administered and psychomotor performance was most often measured. Little consistent data are available on cognitive functioning and more complex behavior. Drug-related improvement in performance was not found, and, in comparing active drug to placebo, it is clear that all hypnotics, at some doses, produce decrements in performance the next day. Higher doses consistently showed a decrement, and this decrement was usually persistent over the entire day. Although long-acting drugs generally showed more performance decrement, half-life data were not consistent.

Adolescent↗