Benzodiazepines can impair thinking, learning and memory and cause motor impairments that can make driving dangerous or cause older adults to fall. Long-term users can have unpleasant withdrawal symptoms when they stop taking the drug, like anxiety, irritability and even seizures.
The reason ramelteon (brand name Rozerem) seemingly does not create such side effects is because it works through a different pathway in the brain - one that involves melatonin receptors - than benzodiazepines do.
In a study carried out by researchers at Johns Hopkins University School of Medicine, 14 patients with histories of sedative abuse were given ramelteon, the benzodiazepine receptor agonist triazolam/Halcion or placebo for about 18 days.
The patients were then assessed in several areas, including cognition and motor function, and asked how they responded to the drugs or placebo. The study found there was no difference in terms of side effects between the patients who had taken ramelteon and those who had taken placebo.
The benzodiazepine group demonstrated the expected response.
The study authors wrote, "In contrast, triazolam showed dose-related effects on a wide range of subject-rated, observer-rated and motor and cognitive measures, consistent with its profile as a sedative drug and abuse liability."
The researchers wrote that although more trials need to be done, the findings suggest that ramelteon "may fill an unmet need in the treatment of insomnia."
The study appears in the October issue of the journal Archives of General Psychiatry.
