The efficacy of add-on ramelteon and subsequent dose reduction in benzodiazepine derivatives/Z-drugs for the treatment of sleep-related eating disorder and night eating syndrome: a retrospective analysis of consecutive patients.


Journal

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
ISSN: 1550-9397
Titre abrégé: J Clin Sleep Med
Pays: United States
ID NLM: 101231977

Informations de publication

Date de publication:
01 07 2021
Historique:
pubmed: 12 3 2021
medline: 6 8 2021
entrez: 11 3 2021
Statut: ppublish

Résumé

The objective of this study was to determine the efficacy of ramelteon in treating abnormal eating behavior in patients with sleep-related eating disorder and/or night eating syndrome. We retrospectively reviewed the medical records of patients with sleep-related eating disorder/night eating syndrome at the Yoyogi Sleep Disorder Center from November 2013 to November 2018. We categorized patients as ramelteon treatment responders when the frequency of nighttime eating per week decreased to less than half of that before treatment. Forty-nine patients were included in the analysis. The mean frequency of eating behavior (per week) (standard deviation) at baseline and post-ramelteon treatment was significantly different, at 5.3 (2.2) and 3.2 (3.0), respectively (P < .001). Twenty-one patients (42.9%) were classified as responders. Adverse events, all of which were mild daytime somnolence, were observed in 5 patients. There were significantly more individuals using benzodiazepine derivatives and Z-drugs before treatment and those with coexisting delayed sleep-wake phase disorder in the responder group than in the nonresponder group (P < .001 and P < .05, respectively). The mean benzodiazepine derivatives and Z-drugs dose significantly decreased from baseline to post-ramelteon treatment within the responder group (P < .05). This trend was not observed in the nonresponder group. Meanwhile, the sleep midpoint of patients with sleep-related eating disorder/night eating syndrome and delayed sleep-wake phase disorder did not significantly change after treatment. Our results indicate that ramelteon is a candidate treatment for sleep-related eating disorder/night eating syndrome. The effects of ramelteon might have occurred primarily through the reduction in benzodiazepine derivatives and Z-drugs rather than through the improvement in sleep-wake rhythm dysregulation.

Identifiants

pubmed: 33704048
doi: 10.5664/jcsm.9236
pmc: PMC8314616
doi:

Substances chimiques

Indenes 0
Pharmaceutical Preparations 0
Benzodiazepines 12794-10-4
ramelteon 901AS54I69

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1475-1483

Informations de copyright

© 2021 American Academy of Sleep Medicine.

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Auteurs

Kentaro Matsui (K)

Department of Clinical Laboratory, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.

Kenichi Kuriyama (K)

Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Mina Kobayashi (M)

Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
Department of Somnology, Tokyo Medical University, Tokyo, Japan.

Ken Inada (K)

Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.

Katsuji Nishimura (K)

Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.

Yuichi Inoue (Y)

Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
Department of Somnology, Tokyo Medical University, Tokyo, Japan.

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