Lormetazepam 1mg tablets

This review aimed to examine the place of benzodiazepines, specifically lormetazepam, in the treatment of insomnia, including during pregnancy or in patients with psychodermatoses. PubMed was searched for the term "lormetazepam" in association with MeSH terms encompassing anxiety, insomnia/sleep disorders, pregnancy/gestation, and psychodermatoses/skin disorders. English-language articles up to 31 July 2022 were identified. Ad hoc searches for relevant literature were performed at later stages of review development. Multiple randomized, placebo-controlled studies have demonstrated that lormetazepam dose-dependently increases total sleep time, decreases wakefulness over a dosing range of 0.5-2.0 mg, and improves subjective assessments of sleep quality. Lormetazepam is as effective as other benzodiazepines in improving sleep duration and quality, but is better tolerated than the long-acting agents with minimal next-day effects. Benzodiazepines can be used as short-term monotherapy at the lowest effective dose during the second or third trimesters of pregnancy; lormetazepam is also a reasonable choice due to its limited transplacental passage. Insomnia associated with skin disorders or pregnancy can be managed by effective symptom control (especially itching), sleep hygiene, treatment of anxiety/depression, and a short course of hypnotics.

Abstract licence: CC BY-NC-ND 4.0

Chiral HPLC method development still relies heavily on trial-and-error screening. We introduce the Efficient Enantioseparation (EES) parameter─a single metric integrating resolution (Rs) and retention (k)─to move from point predictions to full mobile-phase (MP) profile modeling. Using EES as the response, we trained multiple artificial neural networks (ANNs) on 62 variables (molecular descriptors) and 76 objects (structurally diverse neutral and basic compounds chromatographed on a Lux Cellulose-1 column under aqueous-acetonitrile conditions at nine MP compositions). ANNs were optimized with a chaotic competitive-learning optimizer (CCLNNA), then ranked/selected and combined into a consensus model to enhance robustness and limit overfitting. The ANN-consensus model accurately reproduces full EES-MP profiles (R2 > 0.9) with lower error dispersion, enabling prospective feasibility checks and single-shot selection of high-EES mobile-phase compositions. External tests on fluoxetine and lormetazepam confirmed prospective utility by anticipating separability at one or more MPs (nominating the MP with maximal EES) or nonseparability across the explored MP range. To our knowledge, this work provides the first proof-of-concept for in silico prediction of full EES-MP profiles in chiral HPLC, enabling intelligent MP selection. Rather than a definitive model, this work evaluates the potential of the strategy: consensus stabilizes learning with limited data and offers greener, actionable guidance that can reduce experiments, reagent consumption, and development time. The framework is extensible to broader chemotypes and stationary and mobile phases; larger data sets could further generalize EES-profile prediction and support intelligent MP selection in sustainable chiral HPLC.

Abstract licence: CC BY

ObjectivesInsomnia and hypnotic consumption are major public health concerns, especially due to issues of dependence, side effects, and misuse. This study aims to describe the dispensing trends of reimbursed hypnotic tablets in France from 2012 to 2022, highlighting the potential impact of public policies designed to mainly reduce prescriptions of benzodiazepines and z-drugs.MethodsData were sourced from the Medic'AM database, managed by French National Health Insurance, which records quantities of all reimbursed medications provided by pharmacies. The study focused on 13 reimbursed hypnotics with specific French marketing authorization for insomnia, including z-drugs (zolpidem, zopiclone), antihistamines (alimemazine, doxylamine, chlorazépate+acepromazine, meprobamate+acepromazine), and benzodiazepines (lormetazepam, loprazolam, estazolam, nitrazepam, temazepam, triazolam, flunitrazepam).ResultsOver the 11-year period, alongside public health policies, a 25.30% decrease in reimbursed dispensed tablets was observed. Z-drugs saw a major 39.54% decrease, primarily due to a 69.15% drop in zolpidem prescriptions following the requirement for secure prescription pads. Antihistamines, mainly represented by alimemazine after the withdrawal and delisting of other antihistaminergic specialties, decreased by 5.48%. Benzodiazepines experienced a 16.98% reduction, mainly represented by lormetazepam and loprazolam, following the withdrawal or delisting of flunitrazepam, temazepam, and nitrazepam. Proportionally, the use of z-drugs decreased in favor of antihistamines, while benzodiazepines remained relatively stable. During the COVID-19 pandemic and its lockdowns, there was a smaller reduction in dispensed hypnotics.ConclusionsAnalyzing these trends provides insights into the potential impact of concurrent public health policies. While these trends are promising, continued efforts are necessary, emphasizing preventive and nonpharmacological measures, including improved sleep hygiene.

Abstract licence: CC BY

Background and objectiveDuring the coronavirus disease 2019 (COVID-19) pandemic, sedative prescriptions surged, leading to shortages of midazolam. This study investigates lormetazepam as an adjunct sedative alternative to midazolam for mechanically ventilated patients with COVID-19. We aimed to determine the clinical pharmacokinetics (PK) of enterally administered lormetazepam and provide dosing recommendations.MethodsCritically ill patients with acute respiratory distress syndrome (ARDS) or COVID-19 requiring mechanical ventilation were enrolled in April 2020. Lormetazepam 2 mg every 12 h was administered enterally. Blood samples were collected to quantify lormetazepam and its glucuronide. PK analysis was conducted using a one-compartment model with the Edsim++ KinPop plugin.ResultsThe primary PK parameters (means ± coefficient of variation [CV] %) for absorption constant (Ka), volume of distribution (Vd/F), and clearance (CL/F) were 6.4 h-1, 207 L/70 kg, and 14.5 L/h/kg0.75, respectively. Vd/F and CL/F median values were 2.64 L/kg and 2.53 mL/kg/min, respectively, with a half-life of 10.7 h. Lormetazepam's median ratio to its glucuronide was 11.5. Trough-guided dosing suggested alternatives of 0.92 mg three times daily, 1.62 mg twice daily, or 5.36 mg once daily.ConclusionThis is the first study to report a validated PK model for enterally administered lormetazepam as a sedative adjunct in critically ill adults on mechanical ventilation for ARDS and COVID-19. The model was internally validated using a bootstrap procedure. Adequate lormetazepam concentrations were achieved at prescribed doses, with no significant alterations in clearance or half-life. This population model may aid in dose optimization and sedation management for future intensive care unit (ICU) patients.

Abstract licence: CC BY-NC

BackgroundSeasonal affective disorder (SAD) occurs in two main forms: winter-pattern SAD, associated with depressive symptoms during shorter, darker days; and summer-pattern SAD, linked to mood disturbances during longer, hotter days. SAD may develop into a chronic condition with recurring depressive episodes. Risk factors for SAD include geographic latitude, age, gender, genetic predisposition, and lifestyle. Sleep disturbances, such as insomnia, hypersomnia, and circadian rhythm disruptions, are common and can amplify emotional symptoms.ObjectiveThis review explores the clinical features and management strategies for insomnia associated with SAD, focusing on the potential of benzodiazepines (BZDs), in particular lormetazepam.ResultsControversies surround current nonpharmacological and pharmacological strategies for managing sleep disorders in SAD. This review emphasizes the importance of using more effective treatments for insomnia associated with SAD, currently an unmet need. In particular, clinical evidence supports the potential benefits of intermittent hypnotic BZDs to treat insomnia. Among the BZDs, short-term or intermittent use of lormetazepam is an effective treatment option in the management of insomnia.ConclusionInsomnia associated with SAD is an important symptom to monitor because it impacts the patient’s quality of life. BZDs, including lormetazepam, are a standard short-treatment option for insomnia that could improve the sleep symptoms associated with SAD. Comparative clinical trials of the efficacy and safety of lormetazepam in this patient population are required to confirm this.

Abstract licence: CC BY 4.0

Despite the increasing interest for pharmaceuticals in the marine environment, their accumulation in wild organisms and consequent environmental hazards are still poorly known. The Mediterranean Sea is highly challenged by the density of coastal populations, large consumption of pharmaceuticals and their often limited removal by Wastewater Treatment Plants (WWTPs). In this respect, the present study aims to provide the first large-scale survey on the distribution of such contaminants of emerging concern in native mussels, Mytilus galloprovincialis from Italian coasts. Organisms were collected from 14 sites representative of relatively unpolluted marine waters along the Adriatic and Tyrrhenian Sea and analysed for 9 common pharmaceuticals including Non-Steroidal Anti-Inflammatory Drugs (NSAIDs: Diclofenac DIC, Ibuprofen IBU, Ketoprofen KET and Nimesulide NIM), the analgesic Acetaminophen AMP, the antiepileptic Carbamazepine CBZ, the antihypertensive Valsartan VAL, the anxiolytic Lormetazepam LOR and the antidepressant Paroxetine PAR. Results indicated the widespread occurrence of the majority of pharmaceuticals in mussel tissues: CBZ was measured in >90% of analysed samples, followed by VAL (>50%), PAR (>40%), and DIC (>30%), while only AMP and KET were never detected. Heterogeneous tissue concentrations ranged from a few units up to hundreds of ng/g (d.w.), while seasonal and interannual variability, investigated over 4 years, did not highlight any clear temporal trend. Limited differences obtained between the Adriatic and Tyrrhenian Sea, as well as coastal versus off-shore sampling sites, suggest that analysed levels of pharmaceuticals in mussels tissues should be considered as baseline concentrations for organisms collected in unpolluted areas of the Mediterranean. This study provided the first unambiguous evidence of the widespread occurrence of pharmaceuticals in marine mussels from Italian coasts, giving novel insights on the potential ecotoxicological hazard from such compounds in marine species.

Abstract licence: CC BY-NC-ND