Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons.
Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons.
复制标题
优化失眠的药物治疗：现状和未来前景。
DOI：
10.1016/j.jsmc.2013.06.002
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发表时间：
2013
影响因子：
2.8
通讯作者：
Krystal,AndrewD
中科院分区：
文献类型：
--
作者：
Minkel,Jared;Krystal,AndrewD
许多药物可用于治疗失眠患者。这些药物包括美国食品和药物管理局（FDA）批准的失眠治疗药物，FDA批准的用于“标签外”治疗失眠的另一种情况的药物，以及失眠患者服用的“非处方药”。这些药物在其性质、用于不同失眠患者亚型时的安全性和有效性以及关于其在这些亚型中的有效性和安全性的可用数据方面有所不同。因此，优化给定患者的失眠症的药物治疗需要临床医生选择具有使其最有可能有效且安全地解决该个体所经历的睡眠困难类型的特征的药剂来使用。本文旨在帮助临床医生和研究人员进行这种优化。它首先回顾了用于治疗失眠的药物的基本特征。其次是对失眠症患者可能不同并影响药物治疗选择的基本方式进行审查。本综述包括讨论，说明如何根据现有药物的特点，失眠患者之间的主要差异，以及现有的研究文献，最好地选择药物。最后，我们讨论了失眠症的优化药物管理的未来方向。希望本文讨论的治疗定制方法作为改善失眠的临床管理的手段，从而改善患有这种常见和损害性疾病的许多患者的生活。
A number of medications are available for treating patients with insomnia. These medications include agents approved as insomnia therapies by the U.S. Food and Drug Administration (FDA), agents approved by the FDA for another condition that are used “off-label” to treat insomnia, and agents available “over-the-counter” that are taken by individuals with insomnia. These agents differ in their properties, their safety and efficacy when used for different insomnia patient subtypes, and the available data on their efficacy and safety in these subtypes. As a result, optimizing the medication treatment of insomnia for a given patient requires that the clinician select an agent for use which has characteristics that make it most likely to effectively and safely address the type of sleep difficulty experienced by that individual. This article is intended to assist clinicians and researchers in carrying out this optimization. It begins by reviewing the basic characteristics of the medications used to treat insomnia. This is followed by a review of the fundamental ways that individuals with insomnia may differ and affect the choice of medication therapy. This review includes discussions that illustrate how to best choose a medication based on the characteristics of the available medications, the key differences among insomnia patients, and the available research literature. Lastly, we discuss future directions for the optimizing pharmacologic management of insomnia. It is hoped that the treatment tailoring methods discussed herein serve as a means of improving the clinical management of insomnia and, thus, improve the lives of the many patients who suffer from this common and impairing condition.