ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2016
Flumazenil for the Treatment of Refractory Hypersomnolence: Clinical Experience with 153 Patients.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Pooled it
- Medications for daytime sleepiness in individuals with idiopathic hypersomnia.The Cochrane database of systematic reviews · 2021Pooled it
- GR3027 reversal of neurosteroid-induced, GABA-A receptor-mediated inhibition of human brain function: an allopregnanolone challenge study.Psychopharmacology · 2018Trial
- Idiopathic hypersomnia is a 24-hour disorder.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Review
- Present and Future of Central Disorders of Hypersomnolence.Journal of sleep research · 2025Review
- Current knowledge on the pathophysiology of idiopathic hypersomnia and potential mechanisms of action for low-sodium oxybate treatment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Review
- Pathophysiological Models of Hypersomnolence Associated With Depression.Biological psychiatry global open science · 2025Review
- Circadian Modulation of Sleep-Wake Behavior in Patients with Narcolepsy Type 1 and Idiopathic Hypersomnia.Nature and science of sleep · 2025Article
- A scoping review of the evidence on pharmacological and nonpharmacological interventions for idiopathic hypersomnia.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Flumazenil may improve gait and mentation in dogs presenting with marijuana toxicosis.Frontiers in veterinary science · 2024Article
- Idiopathic Hypersomnia: Neurobiology, Diagnosis, and Management.CNS drugs · 2023Review
- Commonly Used Therapeutics Associated with Changes in Arousal Inhibit GABABiomolecules · 2023Article
- Stability of nocturnal wake and sleep stages defines central nervous system disorders of hypersomnolence.Sleep · 2021Article
- Idiopathic Hypersomnia and Other Hypersomnia Syndromes.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Review
- Natural Cannabinoids as Templates for Sleep Disturbances Treatments.Advances in experimental medicine and biology · 2021Article
- Central Disorders of Hypersomnolence.Continuum (Minneapolis, Minn.) · 2020Review
- Treatment of Excessive Daytime Sleepiness in Patients with Narcolepsy.Current treatment options in neurology · 2019Review
- Systemic exertion intolerance disease/chronic fatigue syndrome is common in sleep centre patients with hypersomnolence: A retrospective pilot study.Journal of sleep research · 2019Article
- Neurobiological and immunogenetic aspects of narcolepsy: Implications for pharmacotherapy.Sleep medicine reviews · 2019Review
- Clinical update on central hypersomnias.Journal of thoracic disease · 2018Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
objectivesPatients with central disorders of hypersomnolence sometimes do not achieve satisfactory symptom control with currently available wake-promoting medications. Based on the finding that the cerebrospinal fluid from some patients with hypersomnolence demonstrates potentiation of gamma-aminobutyric acid (GABA)-A receptors in excess of that of controls, a finding that reverses with flumazenil, we initiated prescribing compounded flumazenil to carefully selected, treatment-refractory hypersomnolent patients.
methodsThis retrospective chart review evaluated the first 153 consecutive patients treated with transdermal and/or sublingual flumazenil by physicians at our center from 2013 through January 2015.
resultsPatients were 35.5 y old (± 14.4) and 92 (60.1%) were women. Mean Epworth Sleepiness Scale scores prior to flumazenil were 15.1 (± 4.5) despite prior or current treatment with traditional wake-promoting therapies. Symptomatic benefit was noted by 96 patients (62.8%), with a mean reduction in Epworth Sleepiness Scale score of 4.7 points (± 4.7) among responders. Of these, 59 remained on flumazenil chronically, for a mean of 7.8 mo (± 6.9 mo). Female sex and presence of reported sleep inertia differentiated flumazenil responders from nonresponders. Adverse events were common, but often did not result in treatment discontinuation. Serious adverse events included a transient ischemic attack and a lupus vasculopathy, although whether these events occurred because of flumazenil administration is unknown.
conclusionsThis chart review demonstrates that sublingual and transdermal flumazenil provided sustained clinical benefit to 39% of patients with treatment-refractory hypersomnolence. Prospective, controlled studies of this GABA-A receptor antagonist for the treatment of hypersomnolence are needed. COMMENTARY: A commentary on this article appears in this issue on page 1321.
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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.