ramelteon (Rozerem)
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Introduction
Not a controlled substance.
Indications
- insomnia
- prevention of delirium in hospitalized elderly[3]
- case reports of treatment of delirium with ramelteon[5]
Dosage
8 mg QHS
Pharmacokinetics
- metabolized by cyt P450
- elimination 1/2life 1.5 hours, 2.6 hours in older adults
Laboratory
Mechanism of action
- melatonin receptor agonist
- agonist for melatonin receptor-1 & melatonin receptor-2[3]
More general terms
References
- ↑ Prescriber's Letter 12(9): 2005 Comparison of Insomnia Treatments Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210901&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Johnson MW, Suess PE, Griffiths RR. Ramelteon: a novel hypnotic lacking abuse liability and sedative adverse effects. Arch Gen Psychiatry. 2006 Oct;63(10):1149-57. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17015817
Roth T, Seiden D, Sainati S, Wang-Weigand S, Zhang J, Zee P. Effects of ramelteon on patient-reported sleep latency in older adults with chronic insomnia. Sleep Med. 2006 Jun;7(4):312-8. Epub 2006 May 18. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16709464
Erman M, Seiden D, Zammit G, Sainati S, Zhang J. An efficacy, safety, and dose-response study of Ramelteon in patients with chronic primary insomnia. Sleep Med. 2006 Jan;7(1):17-24. Epub 2005 Nov 23. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16309958 - ↑ 3.0 3.1 3.2 Hatta K et al. Preventive effects of ramelteon on delirium: A randomized placebo-controlled trial. JAMA Psychiatry 2014 Feb 19 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24554232 <Internet> http://archpsyc.jamanetwork.com/article.aspx?articleid=1831407
- ↑ 4.0 4.1 Gooneratne NS, Gehrman P, Gurubhagavatula I et al Effectiveness of ramelteon for insomnia symptoms in older adults with obstructive sleep apnea: a randomized placebo- controlled pilot study. J Clin Sleep Med. 2010 Dec 15;6(6):572-80. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21206546
- ↑ 5.0 5.1 Tsuda A, Nishimura K, Naganawa E, Otsubo T, Ishigooka J. Successfully treated delirium in an extremely elderly patient by switching from risperidone to ramelteon. Psychiatry Clin Neurosci. 2013 Feb;67(2):130. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23438172
Furuya M, Miyaoka T, Yasuda H et al Marked improvement in delirium with ramelteon: five case reports. Psychogeriatrics. 2012 Dec;12(4):259-62. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23279149
Tsuda A, Nishimura K, Naganawa E, Otsubo T, Ishigooka J. Ramelteon for the treatment of delirium in elderly patients: a consecutive case series study. Int J Psychiatry Med. 2014;47(2):97-104. doi:http://dx.doi.org/ 10.2190/PM.47.2.a. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25084796