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At least 19 recordsLinked to original sources
PubMed1996

Hypnotic drug use in Spain: a cross-sectional study based on a network of community pharmacies. Spanish Group for the Study of Hypnotic Drug Utilization.

OBJECTIVE: To investigate how hypnotic drugs are used in Spain, specifically, (1) to characterize the user population in some simple demographic (e.g., sex, age) and clinical (e.g., type of insomnia, type of physician who prescribed the drug) variables; (2) to estimate the proportion of long-term users (> 3 mo); (3) to determine the frequency of different administration schedules; (4) to determine whether the kind of hypnotic drug prescribed according to the duration of its effect correlates with the type of sleep disorder or patient age; and (5) to compare the dosage used by the elderly with that used by adults. DESIGN: Cross-sectional pharmacy-based study. SETTING: A network of 318 community pharmacies throughout Spain. SUBJECTS: Patients (n = 5324) requesting a hypnotic drug for insomnia who agreed to take part in the study. MAIN OUTCOME MEASURES: Distribution of the use of hypnotic drugs by age, sex, type of insomnia, type of physician, specific hypnotic drug, daily dosage, treatment schedule, and duration of treatment. RESULTS: Women (67%) and the elderly (58%) constituted the largest subgroups in the sample. Difficulties in sleep onset and in sleep maintenance as single disorders were reported by 38% and 37% of users, respectively. Prescriptions were written by general practitioners in 80% of cases. Daily use was reported by 88% and long-term use (> 3 mo) by 72% of the users. Long-term treatment was two- to threefold more frequent in the elderly than in middle-aged subjects. Intermediate-action hypnotic drugs were used by 59% of subjects, short-action drug by 24%, and long-action drugs by 17%. The type of hypnotic drug prescribed was not related to the kind of sleep disorder or the age of patients. Specialists prescribed long-action hypnotic drugs more often than did general practitioners. No relevant differences were observed between dosages used by the elderly and those used by adults. In both groups the dosage taken by most patients, regardless of the drug, corresponded to the available strength. Substitution drugs for triazolam belonged to the intermediate-action class in 53% of the cases. CONCLUSIONS: Recommendations on hypnotic drug use are largely not followed in Spain. Most patients are taking hypnotic drugs daily, over long time periods, and without an adequate dosage titration according to age. Measures should be taken to correct this situation.

Administration, Oral↗
PubMed1993

EEG spectral analysis during hypnotic induction, hypnotic dream and age regression.

EEG was recorded monopolarly at frontal (F3, F4), central (C3, C4) and posterior (in the middle of O1-P3-T5 and O2-P4-T6 triangles) derivations during the hypnotic induction of the Stanford Hypnotic Clinical Scale (SHCS) and during performance following suggestions of hypnotic dream and age-regression as expressed in the before-mentioned scale. 10 low-hypnotizable and 9 highly-hypnotizable and right-handed female students participated in one experimental session. Evaluations were Fast-Fourier spectral analyses during the following conditions: waking-rest in eyes-open and eyes-closed condition; early, middle, and late phases of hypnotic induction; rest-hypnosis in eyes closed condition; hypnotic dream and age regression. After spectral analysis of 0 to 44 Hz, the mean spectral amplitude estimates across seven Hz bands (theta 1, 4-6 Hz, theta 2, 6-8 Hz; alpha 1, 8-10 Hz; alpha 2, 10-13 Hz; beta 1, 13-16 Hz; beta 2, 16-20 Hz; beta 3, 20-36 Hz) and the 40-Hz EEG band (36-44 Hz) for each experimental condition were extracted. In eyes-open and -closed conditions in waking and hypnosis highly-hypnotizable subjects produced a greater 40-Hz EEG amplitude than did low hypnotizable subjects at all frontal, central and posterior locations. In the early and middle hypnotic induction highly-hypnotizables displayed a greater amount of beta 3 than did low hypnotizables and this difference was even more pronounced in the left hemisphere. With posterior scalp recordings, during hypnotic dream and age regression, high hypnotizables displayed, as compared with the rest-hypnosis condition, a decrease in alpha 1 and alpha 2 amplitudes. This effect was absent for low hypnotizables. Beta 1, beta 2 and beta 3 amplitudes increased in the left hemisphere during age regression for high hypnotizables; low hypnotizables, in contrast, displayed hemispheric balance across imaginative tasks. High hypnotizables during the hypnotic dream also displayed in the right hemisphere a greater 40-Hz EEG amplitude as compared with the left hemisphere. This difference was even more evident for posterior recording sites. This hemispheric trend was not evidenced for low hypnotizable subjects. Theta power was never a predictor of hypnotic susceptibility, 40-Hz EEG amplitude displayed a very high main effect (p < 0.004) for hypnotizability in hypnotic conditions by displaying a greater 40-Hz EEG amplitude in high hypnotizables with respect to lows.

Adult↗
PubMed1995

Hypnotic analgesia reduces R-III nociceptive reflex: further evidence concerning the multifactorial nature of hypnotic analgesia.

Mechanisms of hypnotic analgesia were investigated by examining changes in the R-III, a nociceptive spinal reflex, during hypnotic reduction of pain sensation and unpleasantness. The R-III was measured in 15 healthy volunteers who gave VAS-sensory and VAS-affective ratings of an electrical stimulus during conditions of resting wakefulness, suggestions for hypnotic analgesia, and attempted suppression of the reflex during non-hypnotic conditions. The H-reflex was also measured to monitor and control for general changes in alpha-motoneuron excitability. Hypnotic sensory analgesia was related to reduction in the R-III after controlling for changes in the H-reflex (R2 = 0.51, P < 0.003), suggesting that hypnotic sensory analgesia is at least in part mediated by descending antinociceptive mechanisms that exert control at spinal levels in response to hypnotic suggestion. The relationship between hypnotic affective analgesia and reduction in R-III approached significance (R2 = 0.26; P = 0.053). Reduction in R-III was 67% as great and accounted for 51% of the variance in reduction of pain sensation. In turn, reduction in pain sensation was 75% as great and accounted for 77% of the variance in reduction of unpleasantness. The results suggest that 3 general mechanisms may be involved in hypnotic analgesia. The first, implicated by reductions in R-III, is related to spinal cord antinociceptive mechanisms. The second, implicated by reductions in pain sensation over and beyond reductions in R-III, may be related to brain mechanisms that serve to prevent awareness of pain once nociception has reached higher centers, as suggested by Hilgard.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Hypnotic responsivity of the deaf: the development of the University of Tennessee Hypnotic Susceptibility Scale for the Deaf.

The purpose of these two studies was to develop and test a measure that assesses the hypnotic responsivity of deaf individuals. The University of Tennessee Hypnotic Susceptibility Scale for the Deaf (UTHSS:D) is a signed, videotaped version of a standard hypnotic induction with 12 standard suggestions. Experiment 1 compared the behavioral and subjective hypnotic responsivity of deaf and hearing individuals using the UTHSS:D and the Field Depth Inventory (FDI), respectively. As compared to hearing subjects, deaf participants were found to be less responsive to hypnosis when assessed behaviorally (UTHSS:D) and equally responsive to hypnosis when assessed subjectively (FDI). Experiment 2 undertook a more comprehensive examination of the hypnotic responsivity of deaf individuals, using hearing individuals as controls. Three dimensions of hypnosis responsivity were assessed: behavioral (UTHSS:D), subjective (FDI), and interpersonal (Archaic Involvement Measure). Additionally, correlates of hypnotic responsivity (absorption, attitudes, expectations) were examined for the two groups. In Experiment 2, no significant differences were found between the deaf and hearing participant groups on any measures of hypnotic responsivity or on any measure of the correlates of hypnotic responsivity.

Adult↗
PubMed1978

An investigation of the role of 'hypnosis', hypnotic susceptibility and hypnotic induction in the production of age regression.

In response to criticisms of the methodology of Barber's(1969)experiments, a 2x2 factorial design, varying hypnotic susceptibility and hypnotic treatment, was used to study the role of 'hypnosis' in the production of age regression by suggestion. Twenty subjects of high hypnotic susceptibility and 20 subjects of low hypnotic susceptibility were randomly allocated to one of two treatment conditions:hypnotic induction procedure or motivational instructions. Both treatments were followed by suggestions to regress to the age of seven years. Two measures of age regression were taken:the Draw-A-Man-Test and a subjective rating of the reality of the experience. The results showed significant effects of both variables, with high suceptibility and induction treatment producing better regression on both measures than low susceptibility and motivation treatment. Hypnotic susceptibility was the stronger of the two variables. The ranking of the four conditions corresponded with predictions of hypnotic depth from the state theory of hypnosis, but the findings were not inconsistent with the non-state theory. The drawings of all regressed groups were more mature than the norms for the age of seven and the drawings of a group of seven year old children.

Adult↗
PubMed1992

Lipid solubility of sedative-hypnotic drugs influences hypothermic and hypnotic responses of long-sleep and short-sleep mice.

The anesthetic potency of many agents, including alcohols, barbiturates and other sedative-hypnotic drugs, is influenced by lipid solubility. Previous studies from our laboratory, however, have demonstrated that genetic factors influence this relationship. We have reported that mouse lines selectively bred for differences in duration of ethanol-induced anesthesia, the long-sleep (LS) and short-sleep (SS) mice, differ in sleep-time response to water-soluble, but not lipid-soluble, sedative-hypnotic drugs. The studies described here sought to determine whether this same relationship exists for the hypothermic response produced by 17 sedative-hypnotic drugs in the LS and SS mice. Dose-response and time course relationships for hypothermic actions were determined and were compared with the dose-related anesthetic effects of the drugs. Hypothermic potencies increased along with lipid solubility for both the LS and SS mouse lines, but the rate of change differed for the two mouse lines. LS mice were more responsive to ethanol and other water-soluble drugs whereas the SS were more responsive to lipid-soluble drugs; significant correlations were obtained between lipid solubility (log P-octanol-water partition coefficient) and relative LS-SS responsiveness to both the hypothermic and hypnotic actions of the 17 test drugs. Thus, both hypnotic and hypothermic actions of sedative-hypnotic drugs are correlated with lipid solubility. Possible explanation for these correlations include greater LS central nervous system sensitivity to water-soluble drugs and LS-SS differences in distribution of lipid-soluble drugs.

Animals↗
PubMed1986

The clinical use of hypnotics: indications for use and the need for a variety of hypnotics.

Insomnia may be categorized as difficulty falling asleep, frequent awakening, early awakenings or a combination of each. The ideal hypnotic must promote rapid sleep onset and maintain sleep throughout the night while allowing the patient to awake refreshed the following day. Several benzodiazepines, with differing pharmacokinetic and pharmacodynamic profiles are presently available. All are clinically effective and not only elimination half-life but also dosage prescribed and pattern of distribution are important factors for determining treatment response. Hypnotics have been divided into those with long elimination half-lives (e.g. nitrazepam, flunitrazepam, flurazepam), those with intermediately long half-lives (brotizolam, loprazolam, lormetazepam, temazepam) and those with short half-lives (midazolam and triazolam). Carry-over effects into the morning such as excessive daytime sleepiness or drowsiness are related to drug half-life, dosage and pattern of distribution. In equipotent dosages most controlled clinical trials have found no significant differences between the various benzodiazepine hypnotics. Nevertheless, clinicians in general tend to use long half-life benzodiazepines in patients who have difficulties maintaining sleep and short half-life benzodiazepines for treating sleep onset insomnia. Intermediately long half-life, benzodiazepines are used for both indications and most clinicians feel that the choice of hypnotic should not only be influenced by elimination half-life or the dosage used, but by individual patient preference. Hypnotics should be used for only short periods of time and in those patients for whom a more chronic use is indicated, they should be used only on an intermittent basis.

Anti-Anxiety Agents↗
PubMed1982

The sedative-hypnotic properties of quazepam, a new hypnotic agent.

7-Chloro-1-(2,2,2-trifluoroethyl)-5-(o-fluorophenyl)-1,3-dihydro-2H-1, 4-benzodiazepine-2-thione (Sch 16134, quazepam) is a new hypnotic drug with demonstrated clinical efficacy. Quazepam has been shown in our laboratories to have potent hypnotic activity and fewer side effects at effective doses than flurazepam, which was studied concurrently. Hypnotic potency was estimated in mice via antagonism of electroshock-induced convulsions (ECS), potentiation of hexobarbital-induced sleeping time, and chlorprothixene potentiation. The respective oral ED50's (95% fiducial limits) in the 3 tests were 0.9 (0.4-2.0), 0.5 (0.3-0.8) and 0.05 (0.02-0.08) mg/kg for quazepam and 1.6 (1.1-2.3), 0.6 (0.4-1.0) and 0.11 (0.07-0.42) mg/kg for flurazepam. The duration of action of quazepam as measured by antagonism of ECS in mice was similar to that of flurazepam at equi-effective doses but quazepam had a faster onset. When potential tolerance to hypnotic efficacy was studied, quazepam did not show tolerance after dosing 20 mg/kg p.o. twice daily (b.i.d.) for 5 days, whereas tolerance was seen with flurazepam at equi-effective doses b.i.d. for 5 days. In conscious, unrestrained squirrel monkeys and cats, quazepam produced sedation with less ataxia and less evidence of CNS stimulant action than flurazepam. On the basis of the aforementioned studies, quazepam should be an effective hypnotic with less potential for ataxia, paradoxical excitation, and tolerance than flurazepam.

Animals↗
PubMed1990

EEG correlates of hypnotic susceptibility and hypnotic trance: spectral analysis and coherence.

EEG was recorded monopolarly at frontal (F3, F4), central (C3, C4) and occipital (O1, O2) derivations during A-B-A conditions of waking rest, hypnosis (rest, arm immobilization, mosquito hallucination, hypnotic dream), and waking rest. Stringently screened on several measures of hypnotic susceptibility, 12 very low hypnotizable and 12 very highly hypnotizable, right-handed undergraduate, subjects participated in one session. Evaluations were Fast-Fourier spectral analysis, EEG coherence between selected derivations and maximum spectral power within EEG bands. In eyes open and closed conditions in waking and hypnosis, highly hypnotizable subjects generated substantially more mean theta power than did low hypnotizable subjects at all occipital, central and frontal locations in almost all conditions of waking and hypnosis, with a larger difference in frontal locations. Both low and high hypnotizables showed increased mean theta power in hypnosis, suggesting an intensification of attentional processes and imagery enhancement. Mean alpha power was never a predictor of hypnotic susceptibility. Interactions with hypnotic susceptibility showed that highly susceptible subjects had more beta activity in the left than right hemispheres, while low susceptible subjects showed only weak asymmetry. No main effects for or interactions between waking/hypnosis and hypnotic level were found for coherence between derivations or maximum spectral power within theta, alpha and beta EEG bands.

Alpha Rhythm↗
PubMedDate not supplied

Conversational assessment of hypnotic ability to promote hypnotic responsiveness.

In this article, hypnotic responsiveness is conceptualized as the byproduct of hypnotic ability, which is largely unalterable, plus hypnotic participation, which is highly subject to manipulation in the therapeutic context. This framework constitutes the basis of a model for the conversational assessment of hypnotic ability and hypnotic participation, as well as the subsequent tailoring of therapeutic interventions based on that assessment. Specific clinical steps for implementing activities implied by the model are explained and then demonstrated by way of a case example.

Adolescent↗
PubMed1985

Failing to resist hypnotic test suggestions: a strategy for self-presenting as deeply hypnotized.

Traditionally, hypnosis has been associated with the idea that highly hypnotizable subjects lose voluntary control over their responses and become incapable of resisting suggestions. We contend instead that even excellent hypnotic subjects retain control over their responses. These subjects are invested in presenting themselves as "deeply hypnotized," and to this end employ relevant contextual information to guide their hypnotic enactments. Contextual demands in the hypnotic test situation usually reinforce the idea that hypnotic behavior is involuntary. Therefore, the enactments of highly hypnotizable subjects are typically designed to convey the impression that responses to suggestions are involuntary happenings that cannot be successfully resisted. This formulation implies that highly hypnotizable subjects will present themselves as unable to resist suggestions or, alternatively, as able to easily resist suggestions, depending upon which of these self-presentations they associate with "deep hypnosis." We tested this and related hypotheses by varying the demands associated with "deep hypnosis" and noting the effects on the tendencies of highly hypnotizable subjects to resist suggestions and to describe their responses as involuntary happenings over which they had lost control.

Adolescent↗
PubMed2001

Study on withdrawal of hypnotics: questionnaire on hypnotic use and its withdrawal.

To investigate the situation and problems contingent to hypnotic use and withdrawal, we conducted a questionnaire of outpatients. Only 41% of the patients were satisfied with their sleep and 53% of the patients took hypnotics. As regards the period, 83% of users had used them for more than 1 year and 19% had used them for more than 10 years. Although 90% of patients perceived efficacy of hypnotics, 67% felt more or less anxious about hypnotic use. Sixty-seven per cent of patients had actually withdrawn from the drugs or decreased dosage before. More than half the patients' conditions worsened after the withdrawal or reducing dosage.

Adolescent↗
PubMed2000

Metabolism of a novel hypnotic, N3-phenacyluridine, and hypnotic and sedative activities of its enantiomer metabolites in mouse.

1. The metabolism of N3-phenacyluridine (3-phenacyl-1-beta-D-ribofuranosyluracil), a potent hypnotic nucleoside derivative, was studied in mouse. 2. Of the radioactivity, 65% was excreted in urine within 48 h after intraperitoneal (i.p.) administration of [3H]N3-phenacyluridine. The urinary metabolites N3-phenacyluracil and N3-alpha-hydroxy-beta-phenethyluridine were extracted, isolated and analyzed by mass spectrometry. 3. Racemates of N3-alpha-hydroxy-beta-phenethyluridine were synthesized and both isomers were separated as N3-(S)-(+)-alpha-hydroxy-beta-phenethyluridine and N3-(R)-(-)-alpha-hydroxy-beta-phenethyluridine by hplc (CHIRALCEL-OJ column) with retentions of 13.8 and 17.9 min respectively. The reduction process took place with high stereo-selectivity, which gave an alcohol product in the urine with the same retention (17.9 min) as one of the synthetic isomers separated by hplc. 4. One of urinary metabolites was identified as N3-(S)-(+)-alpha-hydroxy-beta-phenethyluridine. N3-phenacyluridine was predominantly converted to an alcoholic metabolite of (S)-(+)-configuration. 5. N3-phenacyluracil and uridine were also identified as minor metabolites. 6. The pharmacological effects of the metabolites and related compounds were also evaluated in mouse. N3-(S)-(+)-alpha-hydroxy-beta-phenethyluridine, but not N3-(R)-(-)-alpha-hydroxy-beta-phenethyluridine, possessed hypnotic activity and potentiated pentobarbital-induced sleeping time with a similar potency to the parent compound, N3-phenacyluridine. N3-alpha-hydroxy-beta-phenethyluridine (racemate) had almost two thirds of the hypnotic activity of N3-(S)-(+)-alpha-hydroxy-beta-phenethyluridine. No other metabolites exhibited hypnotic activities. 7. The present study indicates that N3-(S)-(+)-alpha-hydroxy-beta-phenethyluridine, a major metabolite of N3-phenacyluridine, is an active metabolite and contributes a significant CNS depressant effect.

Animals↗
PubMed1992

The effect of prior knowledge of hypnotic items on hypnotic performance and depth.

First we exposed experimental subjects to either the hypnotic items they were about to experience or to those items embedded in a longer list of hypnotic items. We then asked them to give item-difficulty ratings prior to administration of a standard group susceptibility scale. Controls received no prior exposure to any hypnotic items. We obtained four dependent measures: hypnotic susceptibility score, an in-hypnosis depth report, Field (1965) Depth Inventory score, and retrospective depth reports. The three groups did not differ significantly on any of the dependent measures. Although this result differs from that of Shor, Pistole, Easton, and Kihlstrom (1984), who found that prior knowledge of items depressed susceptibility scores, this may be due to procedural differences between the two studies. Subjects' self-predictions of item difficulty were poor to modest, and accuracy of predictions was not related to any of the four dependent measures.

Adolescent↗
PubMed1994

Relationships of hypnotic susceptibility to paranormal beliefs and claimed experiences: implications for hypnotic absorption.

This study examined the relationships of hypnotic susceptibility level to belief in and claimed experience with paranormal phenomena. The Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) and the Inventory of Paranormal Beliefs and Experiences were administered on consecutive days to 43 undergraduate students (14 men, 29 women) at a midwestern university. A significant multiple correlation was obtained (r = .55, p < .001). A partial correlation between hypnotic susceptibility and belief in paranormal phenomena was also significant (r = .53, p < .001), while hypnotic susceptibility was not found to be significantly related to claimed paranormal experiences. Implications of these relationships for the role of absorption in hypnosis are discussed.

Female↗
PubMed1990

40-Hz EEG activity during hypnotic induction and hypnotic testing.

The present study evaluates changes in left and right 40-Hz EEG production for 19 high and 20 low hypnotizable female Ss during the hypnotic induction and the administration of the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) of the Weitzenhoffer and Hilgard (1962). Scalp recorded 40-Hz EEG density was obtained from the middle of the O1-P3-T5 and O2-P4-T6 triangles. As the hypnotic induction proceeded, high hypnotizable Ss exhibited a shift to greater right-hemisphere activity as compared to a waking-state rest condition. In contrast, low hypnotizable Ss, showed a reduction in left- and right-hemisphere activity. No differences between groups for SHSS:C ideomotor items were observed. A main effect for Hypnotizability among SHSS:C imaginative items was found. A Hypnotizability x Hemisphere x Trial interaction was found for both sensory distortion and imaginative SHSS:C items. A comparison was made between low versus high hypnotizable Ss of 40-Hz EEG activity while they passed the same item. The results of these comparisons indicate that differences in brain activity might be partially related to the differences between experiencing a hypnotic suggestion or failing to do so. Significant relationships between 40-Hz EEG production and hypnotizability and 40-Hz EEG production and level of amnesia were also found.

Adult↗
PubMed1981

Was I hypnotized?: a social psychological analysis of hypnotic depth reports.

We will here review experimental work on subjects' reports of being hypnotized, using an attribution theory framework. Subjective experiences accompanying a hypnotic induction procedure and test suggestions are ambiguous, and, therefore, subjects rely on contextual information in order to label these experiences. Thus, subjects are most likely to define themselves as hypnotized when the situation is convincingly defined as hypnosis and when they observe that their responses are consistent with their conception of hypnosis. Other variables which influence subjects' reports include expert opinion and the wording of the scales used to assess subjective experiences. Rather than accurately reflecting a unique state of the person, reports of being hypnotized appear to represent the outcome of a complex interaction involving contextual information, self-observation, and pre-conceptions concerning hypnosis.

Amnesia, Retrograde↗
PubMed1993

[Abrupt shift to zolpidem, a new imidazopyridine hypnotic, in insomniac patients previously treated with benzodiazepine hypnotics].

Zolpidem is a new imidazopyridine hypnotic with a pharmacological profile substantially different from benzodiazepines. In this observational multicenter study the possibility of shifting to zolpidem (10 mg at N1, 15 or 20 after N1) insomniac patients previously taking (for at least 15 days and not longer than 3 months) standard posology of triazolam (0.125-0.25 mg), lorazepam (1 mg) or lormetazepam (1 mg) was assessed. For ethical reasons the patients were mandatorily to be insomniacs despite their taking hypnotics or not tolerating them. Patients enrolled were 299 of whom 276 evaluable (139 males and 136 females; mean age 48.67 +/- 14.64, range 18-83). Study duration was 7 nights with visits at N0 (baseline), N1 (after 1st night), N3 (after 3rd night) and N7 (final evaluation); on each visit the Saint Mary Hospital Sleep Questionnaire and the benzodiazepine withdrawal symptom's rating scale were administered; moreover, after N7, investigators were asked a judgement of feasibility of such a shift. In 229 (83.5%) out of 274 patients such a shift to zolpidem was considered successfully (no occurrence of symptoms and/or signs of previously taken hypnotic withdrawal); in the remaining 45 patients, just 17 (6.2%) seemed to be real unsuccessful cases (reactions mild and transient, anyhow). In conclusion abrupt shift to zolpidem appeared to be largely feasible in the patients studied.

Adolescent↗