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==Recreational use==
==Recreational use==
Zaleplon (Sonata) has a relatively high potential to be abused. Often this use involves a different delivery method ([[Insufflation (medicine)|insufflating]]) to induce effects faster.<ref>{{cite journal |author=Paparrigopoulos T, Tzavellas E, Karaiskos D, Ioannis L |title=Intranasal Zaleplon Abuse |journal=Am J Psychiatry |volume=165 |issue=11 |pages=1489-1490 |year=2008 |pmid=18981079
Zaleplon (Sonata) has a relatively high potential to be abused. Often this use involves a different delivery method ([[Insufflation (medicine)|insufflating]]) to induce effects faster.<ref>{{cite journal |author=Paparrigopoulos T, Tzavellas E, Karaiskos D, Liappas I. |title=Intranasal Zaleplon Abuse |journal=Am J Psychiatry |volume=165 |issue=11 |pages=1489-1490 |year=2008 |pmid=18981079
|doi=10.1176/appi.ajp.2008.08030452 |url=http://ajp.psychiatryonline.org/cgi/content/full/165/11/1489-a}}</ref> [[Image:Sonata10mg.JPG|thumb|right|180px|A one month's supply of Sonata 10mg capsules.]]
|doi=10.1176/appi.ajp.2008.08030452 |url=http://ajp.psychiatryonline.org/cgi/content/full/165/11/1489-a}}</ref> [[Image:Sonata10mg.JPG|thumb|right|180px|A one month's supply of Sonata 10mg capsules.]]


Revision as of 02:41, 6 April 2011

Zaleplon
Clinical data
Routes of
administration		Oral
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability30% (oral)
MetabolismHepatic
Elimination half-life1 hour
ExcretionRenal
Identifiers
  • N-(3-(3-cyanopyrazolo[1,5-a] pyrimidin-7-yl)phenyl)-N- ethylacetamide
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.126.674 Edit this at Wikidata
Chemical and physical data
FormulaC17H15N5O
Molar mass305.34 g·mol−1
3D model (JSmol)
  • O=C(N(c3cccc(c1ccnc2c(C#N)cnn12)c3)CC)C
  • InChI=1S/C17H15N5O/c1-3-21(12(2)23)15-6-4-5-13(9-15)16-7-8-19-17-14(10-18)11-20-22(16)17/h4-9,11H,3H2,1-2H3 checkY
  • Key:HUNXMJYCHXQEGX-UHFFFAOYSA-N checkY
  (verify)

Zaleplon (marketed under the brand names Sonata and Starnoc) is a sedative/hypnotic, mainly used for insomnia. It is a nonbenzodiazepine hypnotic from the pyrazolopyrimidine class.[2] In terms of adverse effects zaleplon appears to offer little improvement compared to both benzodiazepines and other non-benzodiazepine Z-drugs.[3][4]

Sonata (US) is manufactured by King Pharm. of Bristol, TN; Starnoc has been discontinued in Canada. It usually prescribed privately (rarely) in the United Kingdom; with Zopiclone being the preferred Z-Drug by the NHS.

Clinical uses

Zaleplon is effective in the treatment of insomnia where difficulty in falling asleep is the primary complaint. Zaleplon, unlike many other hypnotic drugs, does not interfere with sleep architecture and can be administered for up to long term without the risk of dependence or addiction upon discontinuation.[5]

Zaleplon is also effective in the treatment of middle of the night insomnia without causing residual hangover effects.[6][7]

Zaleplon has advantages over benzodiazepines in that it does not disrupt sleep architecture unlike benzodiazepines which whilst inducing sleep actually worsen the quality of it.[8]

Side-effects

The side effects of zaleplon are similar to the side effects of benzodiazepines, although with less next-day sedation,[3] and in two studies Zaleplon use was found to not cause an increase in road traffic accidents as compared to other hypnotics currently on the market.[9][10]

Zaleplon may cause day-time drowsiness, dizziness, headache.

Zaleplon is not addictive,and does not cause addiction and drug dependence is unlikely. Stopping this medication suddenly after prolonged or frequent use usually does not cause withdrawal effects such as mood changes, anxiety, restlessness, or rebound insomnia unlike other drugs such as Ambien.[11]

Some evidence suggests that Zaleplon tolerance and rebound effects may be less frequent than with other nonbenzodiazepine Z-drugs in its class.[12]

Special precautions

The elderly are more sensitive to the adverse effects of zaleplon such as cognitive side effects. Zaleplon may increase the risk of falls in the elderly. It should not be used in pregnancy and lactation, in patients with a history of alcohol or drug abuse, psychotic illness or depression.[13]

Elderly

An extensive review of the medical literature regarding the management of insomnia and the elderly found that there is considerable evidence of the effectiveness and durability of non-drug treatments for insomnia in adults of all ages and that these interventions are underutilized. Compared with the benzodiazepines, the nonbenzodiazepine (including zaleplon) sedative-hypnotics appeared to offer few, if any, significant clinical advantages in efficacy or tolerability in elderly persons. It was found that newer agents with novel mechanisms of action and improved safety profiles, such as the melatonin agonists, hold promise for the management of chronic insomnia in elderly people. Long-term use of sedative-hypnotics for insomnia lacks an evidence base and has traditionally been discouraged for reasons that include concerns about such potential adverse drug effects as cognitive impairment (anterograde amnesia), daytime sedation, motor incoordination, and increased risk of motor vehicle accidents and falls. In addition, the effectiveness and safety of long-term use of these agents remain to be determined. It was concluded that more research is needed to evaluate the long-term effects of treatment and the most appropriate management strategy for elderly persons with chronic insomnia.[4]

Pharmacology

Zaleplon selectively binds with high efficacy to the benzodiazepine site (ω1) on the α1 containing GABAA receptors which produces its therapeutic hypnotic properties. The ultra short half life gives zaleplon a unique advantage over other hypnotics because of its lack of next day residual effects on driving and other performance related skills.[14][15] Unlike non-selective benzodiazepine drugs and zopiclone which distort the sleep pattern zaleplon appears to induce sleep without disrupting the natural sleep architecture.[16]

A meta-analysis of randomised controlled clinical trials which compared benzodiazepines against Zaleplon or other Z Drugs such as zolpidem and zopiclone, has found that there are few clear and consistent differences between Zaleplon and the benzodiazepines in terms of sleep onset latency, total sleep duration, number of awakenings, quality of sleep, adverse events, tolerance, rebound insomnia and daytime alertness.[17]

Zaleplon has a pharmacological profile similar to benzodiazepines, that is characterized by an increase in SWDS with rapid onset of hypnotic action. Zaleplon is a full agonist for the benzodiazepine α1 receptor located on the GABAA receptor ionophore complex in the brain, with lower affinity for the α2 and α3 subtypes. It selectively enhances the action of GABA similar to but more selectively than benzodiazepines. Zaleplon, although not benzodiazepine-like in chemical structure induces sedative-hypnotic, anticonvulsant and anticonflict effects via its binding to the central nervous system (CNS) type benzodiazepine receptors. The elimination half life of zaleplon is 1 hour. Absorption is rapid. Zaleplon can be classed as an ultra short acting sedative hypnotic drug for the treatment of insomnia characterised by difficulty in falling asleep. Zaleplon increases EEG power density in the delta frequency band and a decrease in the energy of the theta frequency band. In tests on rabbits zaleplon shows drowsy pattern of spontaneous EEG characterized by high-voltage slow waves and desynchronization of hippocampal theta waves and an increase in the energy of the delta frequency band on the spectral analysis of the electroencephalogram.[18][19]

Chemistry

Pure zaleplon in its solid state is a white to off-white powder that has very low solubility in water as well as low solubility in alcohol and propylene glycol. It has a partition coefficient in octanol/water that is constant (log PC = 1.23) when the pH range is between 1 and 7.

Pharmacokinetics

Zaleplon is primarily metabolised by aldehyde oxidase, and its half-life can be affected by substances which inhibit or induce aldehyde oxidase. Taken orally, zaleplon reaches full concentration in approximately one hour. It is extensively metabolised, into 5-oxo-zaleplon and 5-oxo-desethylzaleplon (the latter via desethylzaleplon), with less than 1% of it excreted intact in urine.

Interactions

Cimetidine, rifampicin and thioridazine cause interactions with zaleplon.[20]

Recreational use

Zaleplon (Sonata) has a relatively high potential to be abused. Often this use involves a different delivery method (insufflating) to induce effects faster.[21]

A one month's supply of Sonata 10mg capsules.

The effects of Zaleplon are similar to those of many other benzodiazepines but the fast-acting nature and short half-life of the chemical mean that high dosages set on much more quickly and last for short periods of time (usually from 45 to 60 minutes). Insufflating the drug causes effects to happen even more quickly, and last for even shorter periods of time, with some loss of yield as Zaleplon is not entirely water soluble. Anterograde amnesia is very common, and can cause one to lose track of the amount of Zaleplon already ingested, causing them to ingest more than originally planned.[22][23]

See also

References

  1. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 Oct 2023.
  2. ^ Elie R (1999). "Sleep latency is shortened during 4 weeks of treatment with zaleplon, a novel nonbenzodiazepine hypnotic. Zaleplon Clinical Study Group". J Clin Psychiatry. 60 (8): 536–44. doi:10.4088/JCP.v60n0806. PMID 10485636. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  3. ^ a b Wagner J (1998). "Beyond benzodiazepines: alternative pharmacologic agents for the treatment of insomnia". Ann Pharmacother. 32 (6): 680–91. doi:10.1345/aph.17111. PMID 9640488. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  4. ^ a b Bain KT (2006). "Management of chronic insomnia in elderly persons". Am J Geriatr Pharmacother. 4 (2): 168–92. doi:10.1016/j.amjopharm.2006.06.006. PMID 16860264. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. ^ Walsh JK (2000). "A five week, polysomnographic assessment of zaleplon 10 mg for the treatment of primary insomnia". Sleep Med. 1 (1): 41–49. doi:10.1016/S1389-9457(99)00006-4. PMID 10733619. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  6. ^ Walsh JK (2000). "Lack of residual sedation following middle-of-the-night zaleplon administration in sleep maintenance insomnia". Clin Neuropharmacol. 23 (1): 17–21. doi:10.1097/00002826-200001000-00004. PMID 10682226. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  7. ^ Verster JC, Veldhuijzen DS, Volkerts ER (2004). "Residual effects of sleep medication on driving ability". Sleep Med Rev. 8 (4): 309–25. doi:10.1016/j.smrv.2004.02.001. PMID 15233958. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ Barbera J, Shapiro C (2005). "Benefit-risk assessment of zaleplon in the treatment of insomnia". Drug Saf. 28 (4): 301–18. doi:10.2165/00002018-200528040-00003. PMID 15783240.
  9. ^ Menzin J, Lang KM, Levy P, Levy E (2001). "A general model of the effects of sleep medications on the risk and cost of motor vehicle accidents and its application to France". Pharmacoeconomics. 19 (1): 69–78. doi:10.2165/00019053-200119010-00005. PMID 11252547. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  10. ^ Vermeeren A, Riedel WJ, van Boxtel MP, Darwish M, Paty I, Patat A (2002). "Differential residual effects of zaleplon and zopiclone on actual driving: a comparison with a low dose of alcohol". Sleep. 25 (2): 224–31. PMID 11905433. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  11. ^ Kirkwood CK (1999). "Management of insomnia". J Am Pharm Assoc (Wash). 39 (5): 688–96. PMID 10533351. {{cite journal}}: Unknown parameter |month= ignored (help)
  12. ^ Lader MH (2001). "Implications of hypnotic flexibility on patterns of clinical use". Int J Clin Pract Suppl (116): 14–9. PMID 11219327. {{cite journal}}: Unknown parameter |month= ignored (help)
  13. ^ Antai-Otong D (2006). "The art of prescribing. Risks and benefits of non-benzodiazepine receptor agonists in the treatment of acute primary insomnia in older adults". Perspect Psychiatr Care. 42 (3): 196–200. doi:10.1111/j.1744-6163.2006.00070.x. PMID 16916422. {{cite journal}}: Unknown parameter |month= ignored (help)
  14. ^ Patat A, Paty I, Hindmarch I (2001). "Pharmacodynamic profile of Zaleplon, a new non-benzodiazepine hypnotic agent". Hum Psychopharmacol. 16 (5): 369–392. doi:10.1002/hup.310. PMID 12404558. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  15. ^ Rowlett JK, Spealman RD, Lelas S, Cook JM, Yin W (2003). "Discriminative stimulus effects of zolpidem in squirrel monkeys: role of GABA(A)/alpha1 receptors" (PDF). Psychopharmacology (Berl.). 165 (3): 209–15. doi:10.1007/s00213-002-1275-z. PMID 12420154. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  16. ^ Noguchi H, Kitazumi K, Mori M, Shiba T (2002). "Binding and neuropharmacological profile of zaleplon, a novel nonbenzodiazepine sedative/hypnotic". Eur. J. Pharmacol. 434 (1–2): 21–8. doi:10.1016/S0014-2999(01)01502-3. PMID 11755161. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  17. ^ Dündar, Y (2004). "Comparative efficacy of newer hypnotic drugs for the short-term management of insomnia: a systematic review and meta-analysis". Hum Psychopharmacol. 19 (5): 305–22. doi:10.1002/hup.594. PMID 15252823. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  18. ^ Noguchi H (2004). "Electroencephalographic properties of zaleplon, a non-benzodiazepine sedative/hypnotic, in rats" (pdf). J Pharmacol Sci. 94 (3): 246–51. doi:10.1254/jphs.94.246. PMID 15037809. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  19. ^ Petroski RE, Pomeroy JE, Das R; et al. (2006). "Indiplon is a high-affinity positive allosteric modulator with selectivity for alpha1 subunit-containing GABAA receptors" (PDF). J. Pharmacol. Exp. Ther. 317 (1): 369–77. doi:10.1124/jpet.105.096701. PMID 16399882. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  20. ^ Wang JS, DeVane CL (2003). "Pharmacokinetics and drug interactions of the sedative hypnotics" (PDF). Psychopharmacol Bull. 37 (1): 10–29. doi:10.1007/BF01990373. PMID 14561946.
  21. ^ Paparrigopoulos T, Tzavellas E, Karaiskos D, Liappas I. (2008). "Intranasal Zaleplon Abuse". Am J Psychiatry. 165 (11): 1489–1490. doi:10.1176/appi.ajp.2008.08030452. PMID 18981079.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  22. ^ Rush CR (1999). "Zaleplon and triazolam in humans: acute behavioral effects and abuse potential". Psychopharmacology (Berl). 145 (1): 39–51. doi:10.1007/s002130051030. PMID 10445371. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  23. ^ Ator NA (2000). "Zaleplon and triazolam: drug discrimination, plasma levels, and self-administration in baboons". Drug Alcohol Depend. 61 (1): 55–68. doi:10.1016/S0376-8716(00)00123-X. PMID 11064184.
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