Clinical effect and electroencephalographic oscillation changes of the repetitive transcranial magnetic stimulation and eszopiclone treatment of chronic insomnia disorder / 中华行为医学与脑科学杂志

Objective:To observe the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with eszopiclone in the treatment of chronic insomnia disorder and its influence on brain electrical activity.Methods:Ninety patients with chronic insomnia were randomly divided into rTMS group, drug group and combination group, with 30 cases each group. The rTMS group was treated with bilateral dorsolateral prefrontal lobe (left 5 Hz 400 pulse, right 1 Hz 1 200 pulse), the drug group was treated with eszopiclone (3mg/d) and the combination group was treated with rTMS + eszopiclone. Continuous treatment for 2 weeks, Pittsburgh sleep quality index (PSQI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and changes in brain electricity activity (α, β, θ, δ) and sleep parameters were evaluated before treatment, after treatment and during follow-up. The SPSS generalized linear model statistical method was used to analyze the changes of each evaluation index.Results:Compared with before treatment, the PSQI score of the combination group decreased (7.2±1.7 vs 13.2±2.9), and the improvement was better than that of the rTMS group (9.2±2.5 vs 12.1±2.8) and the drug group (7.5±2.8 vs 11.4±2.9) ( P<0.05). Multiple comparisons results showed that combination group > drug group > rTMS group; and combination group > rTMS group > drug group during follow-up. After treatment and during follow-up, the HAMA and HAMD scores of the rTMS group and the combination group decreased. There was no statistical difference in the improvement rate between the two groups, but they were all higher than the drug group ( P<0.05). After treatment and during follow-up, the β power of the rTMS group and the combination group decreased, and the α power increased, but there was no statistical difference in the δ and θ power. The β, δ and θ power in the drug group increased ( P<0.05), but the α power had no statistical difference. Multiple comparisons results showed that the power of β, δ and θ bands in the rTMS group and the combination group were lower than the drug group, α power was higher than that in the drug group ( P<0.05). Compared with before treatment During follow-up, the sleep latency of the combination group and rTMS group was shorten, and the total sleep time, sleep efficiency, deep sleep (N3) and rapid eye movement (REM) increased( P<0.05), but there was no statistical difference in the changes of sleep parameters in the drug group. Conclusions:rTMS combined with Eszopiclone can significantly improve the sleep quality of patients with chronic insomnia, which is better than that of rTMS and Eszopiclone alone, and it can reduce cortical excitability by regulating brain electrical activity. It can be an ideal treatment for patients with chronic insomnia disorder.

Eszopiclone versus zopiclone in the treatment of insomnia

OBJECTIVE: To determine the therapeutic effects of two selective GABA-A agonists, zopiclone and eszopiclone, in the treatment of insomnia. METHODS: This study comprised a phase III, single-center, randomized, double-blind, double-dummy, parallel-group, non-inferiority trial. Patients were randomized to receive zopiclone 7.5 mg or eszopiclone 3 mg, both orally, for four weeks. In total, 199 patients were evaluated during two visits and then followed for at least six weeks. The primary endpoint was the Insomnia Severity Index after four weeks of treatment. Secondary endpoints were obtained through polysomnography data, including total sleep time, sleep latency and sleep efficiency. The frequency of adverse events was also analyzed. ClinicalTrials.gov: NCT01100164. RESULTS: The primary efficacy analysis demonstrated the non-inferiority of eszopiclone over zopiclone. Analysis of objective parameters assessed by polysomnography showed that eszopiclone increased total sleep time and also improved sleep efficiency. The safety profile of both study treatments was similar and the most common events reported in both groups were dysgeusia, headache, dizziness, irritability and nausea. Adverse events were observed in 223 patients, 109 (85.2%) in the eszopiclone group and 114 (87.7%) in the zopiclone group. CONCLUSION: Based on the Insomnia Severity Index at the end of four weeks of treatment, eszopiclone demonstrated efficacy comparable to that of zopiclone in the treatment of insomnia, increasing total sleep time as well as sleep efficiency according to polysomnography.

Effect of eszopiclone combined with sertraline on serum S100βand clinical efficacy in patients with depression after cerebral infarction / 中国生化药物杂志

Objective To analyse the effect of eszopiclone combined with sertraline on serum S100βand clinical efficacy in patients with depression after cerebral infarction.Methods 58 patients who were diagnosed with depression after cerebral infarction were collected.All patients were randomly divided into experimental group and control group,29 cases in each group.Patients in the control group received sertraline treatment, patients in the experimental group were given eszopiclone treatment on the basis of control group, after the treatment, the serum levels of S100β,BDNF and clinical efficacy were detected in all patients.Results After treatment, compared with control group, the serum level of S100βwas lower in the experimental group(P<0.05); the serum level of BDNF was higher in the experimental group(P<0.05); the total efficiency was higher in the experimental group (P<0.05).Conclusion The eszopiclone combined with sertraline can significantly reduce the serum level of S100β,and improve serum level of BDNF in patients with depression after cerebral infarction,improve the therapeutic effect.

Effect of eszopiclone on pentobarbital sodium-induced sleeping time in acute hypobaric hypoxia mice / 中华行为医学与脑科学杂志

Objective To assess the effects of eszopiclone (ESZ) on the pentobarbital sodium-induced sleeping time and spontaneous activity in mice exposed to acute hypobaric hypoxia.Methods 120 mice were randomly divided into 6 groups by using two factors 2×3 levels factorial design,in which two factors were interventions (ESZ and 0.9％ sodium chloride,2 levels) and altitudes (800 m,3500 m and 6000 m,3 levels).The pentobarbital sodium-induced sleeping test and the open field test were engaged to assess the effects of ESZ on sleeping time and spontaneous activity.Results (1) The drug and altitude had no interaction in the results of both the pentobarbital sodium-induced sleeping test and the open field test(P＞0.05).(2)The time of pentobarbital sodium-induced sleeping of mice in the groups of ESZ at each altitudes were (37.77± 18.22) min,(37.02± 13.67) min,(95.67±47.68)min and in the groups of NS were(17.78± 14.10) min,(15.09± 12.46) min,(39.54±28.24) min respectively,and the sleep time in ESZ groups were significantly longer than those in the groups of NS (P＜0.05).The time of pentobarbital sodium-induced sleeping were longer in group of 6000 m than those in the other two groups,both the ESZ and NS groups (P＜0.05).(3)No significant difference was found in the open field test between the ESZ and NS groups in the same altitude(P＞0.05) ; while the mice at the altitude of 6000 m in groups of ESZ and NS decreased compared with the groups at the altitude of 800 m after the relevant drugs intra-perineally for 6 h (P＜0.05).Conclusion ESZ may prolong pentobarbital sodium-induced sleeping time especially at the altitude of 6000 m and with no influence on the spontaneous activity in mice exposed to acute hypobaric hypoxia.High altitude at 6000 m may prolong the sleep time induced by pentobarbital sodium and reduce the spontaneous activities.

Clinical Observation of Eszopiclone or Zolpidem in the Treatment of Insomnia / 中国药房

0.05). CONCLUSION: Eszopiclone has the same clinical efficacy and safety to zolpidem in the treatment of insomnia. The subjective satisfaction of treatment group is higher than control group, and with statistically significance(P