RETURNYonago Acta medica 1991;34:261-274
Effect of Butoctamide Hydrogen Succinate on Sleep during Long-term Use and after Discontinuation of Triazolam
Ryuzo Kawahara, Yuzo Tanaka, Toru Kuwai, Susumu Takada, Yoshiharu Kobayashi, Hidebumi Hazama, Katsuhiko Sugihara* and Shinichiro Matsumoto
Department of Neuro-Psychiatry, Faculty of Medicine, Tottori University, Yonago 683 and *Yasugi Daiichi Hospital, Yasugi 692, Japan
The studies were designed to examine the effect on human sleep when butoctamide hydrogen succinate (BAHS) is administered together with triazolam (TZL) and after discontinuation of TZL. Six schizophrenics who had been taking TZL for a long time because of insomnia were chosen as subjects. The nocturnal sleep polysomnographs (NSPGs) were recorded over 3 consecutive nights of TZL administration, on the 1st and 3rd nights after withdrawing TZL, on the 3rd and 4th nights of combined administration of TZL and BAHS, and on the 1st and 3rd nights after discontinuation of TZL during BAHS administration. After the last NSPG recording, BAHS was gradually reduced. The obtained results were as follows: (i) By administering TZL with BAHS, the number of awakenings and percentage of sleep stage 4 increased significantly. However, there was no obvious increase of rapid eye movement sleep. (ii) After discontinuing TZL, total sleep time, sleep efficiency index, number of awakenings and percentage of waking state increased significantly. Sleep stage 2 decreased significantly. On the other hand, discontinuing TZL during BAHS administration caused no significant change in any of the sleep parameters. (iii) There was no difference in the score of self-estimate of sleep between TZL administration and combined TZL and BAHS administration. After TZL withdrawal, however, the patients reported worse sleep compared with after TZL withdrawal during BAHS administration. (iv) For half of the subjects it was possible to stop using hypnotics. These results led us to the conclusion that BAHS relieves rebound insomnia after TZL withdrawal and improves sleep during the long-term administration of TZL.
Key words: butoctamide hydrogen succinate; combined effects of butoctamide hydrogen succinate and triazolam; triazolam withdrawal