ReviewCNS drugs2007
Use of non-benzodiazepine hypnotics in the elderly: are all agents the same?
Review in CNS drugs, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Benzodiazepines and Related Drugs as a Risk Factor in Alzheimer's Disease Dementia.Frontiers in aging neuroscience · 2019Pooled it
- Eszopiclone for insomnia.The Cochrane database of systematic reviews · 2018Pooled it
- Zolpidem and zopiclone impair similarly monotonous driving performance after a single nighttime intake in aged subjects.Psychopharmacology · 2011Trial
- Trial
- Beyond traditional sleeping pills: safety, efficacy and multidisease potential of three approved orexin receptor antagonists.Frontiers in psychiatry · 2026Review
- Sleep Disorders in Children with Autism Spectrum Disorder: Developmental Impact and Intervention Strategies.Brain sciences · 2025Review
- Pharmacogenomics of Dementia: Personalizing the Treatment of Cognitive and Neuropsychiatric Symptoms.Genes · 2023Review
- Observational
- Reversal of a Suspected Paradoxical Reaction to Zopiclone with Flumazenil.Case reports in critical care · 2016Article
- The clinical and forensic toxicology of Z-drugs.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2013Review
- Melatonin prolonged release: in the treatment of insomnia in patients aged ≥55 years.Drugs & aging · 2012Review
- [Insomnia in the elderly. An under-diagnosed and over-treated syndrome].Der Internist · 2010Article
- Anticoagulation and psychotropic medications.Current psychiatry reports · 2010Review
- Tackling sleeplessness: psychological treatment options for insomnia in older adults.Nature and science of sleep · 2010Article
- Management of insomnia in elderly patients using eszopiclone.Nature and science of sleep · 2010Article
- Treatment of Late-life Insomnia.Sleep medicine clinics · 2009Article
- Starting insomnia treatment: the use of benzodiazepines versus z-hypnotics. A prescription database study of predictors.European journal of clinical pharmacology · 2009Article
- Review
- Ramelteon: a review of its use in insomnia.Drugs · 2008Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sleep disorders, especially insomnia, are common in older adults. These disorders are frequently treated using non-benzodiazepine hypnotics. Nonetheless, there is a relative lack of data regarding the use of these agents in the elderly, and whether any of these medications is superior to any other in the class when used in the elderly is also unclear. In this article, we review, by way of the published literature, the pharmacodynamics, pharmacokinetics, drug interactions, efficacy and safety of zolpidem, zaleplon, zopiclone, eszopiclone and ramelteon in the elderly. Special emphasis is placed on identifying relevant differences between these medications when used in older adults with insomnia. Based primarily on data from placebo-controlled trials, the non-benzodiazepines reviewed were found to be most effective at improving sleep latency and sleep quality, and least effective at enhancing total sleep time. The efficacy of ramelteon was limited to improving sleep latency, while all other agents, especially at higher doses, were found to produce improvement in both sleep latency and some improvement in total sleep time. All of the medications were found to be well tolerated in the elderly. From pharmacokinetic and drug-drug interaction perspectives, zaleplon and ramelteon offer the advantage of not being primarily metabolised via the cytochrome P450 3A4 isoenzyme. In conclusion, based on relatively limited data, zopiclone, zolpidem, zaleplon, eszopiclone and ramelteon represent modestly effective and generally well tolerated treatments for insomnia in older adults. While some actual and potential differences exist among these medications, more comparative trials are needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.