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AuthorMendelson, Wallace B. author
TitleThe Use and Misuse of Sleeping Pills [electronic resource] : A Clinical Guide / by Wallace B. Mendelson
ImprintBoston, MA : Springer US : Imprint: Springer, 1980
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Descript XII, 220 p. online resource


Hypnos (the Greek god of sleep) and Thanatos (death) were the twin sons of Nyx, the goddess of night (Fox, 1964). Hypnos lived in a dusky valley in the land of the Cimerians, watered by Lethe, the river of forgetfulness. He brought sleep to both men and gods, and sometimes sent his sons Morpheus, Icelus, and Phantasus to appear in dreams. At the door of his abode grew poppies and other herbs which induce sleep (Hamilton, 1961). This book deals with these herbs and their subsequent imitations. Before launching into an examination of hypnotics, it might be well to comment briefly on the manner in which this was written, and to acknowledge the help of a number of individuals. My intention was that this be useful not only for the physician or scientist, but also for the student. Thus each chapter contains an introductory section which proยญ vides background material. Chapter 3, for instance, describes the general principles of drug absorption, distribution, and metabolism before disยญ cussing the pharmacologic properties of each hypnotic. In addition, each chapter concludes with a section which summarizes the main issues


1 Basic Concepts about Sleep and Insomnia -- History -- The Sleep Stages -- Influences on the Appearance of Sleep Stages -- Physiologic Regulation of Sleep -- Hypnotics and Sleep Regulation -- Sleep Deprivation -- The Need for Sleep -- Insomnia -- Summary and Conclusions -- 2 The Prevalence of Sleep Disturbance and Hypnotic Use -- Surveys of Reported Sleep Disturbance -- Types of Sleep Complaints -- Surveys of Hypnotic Use -- Patient-Physician Interaction -- Prescriptions for Outpatients -- Prescribing Hypnotics in Hospital Practice -- Summary and Conclusions -- 3 Pharmacology of Prescription Hypnotics -- Pharmacologic Considerations -- Barbiturates -- Benzodiazepines -- Nonbarbiturate, Nonbenzodiazepine Hypnotics -- Summary and Conclusions -- 4 The Efficacy of Hypnotics -- Methodologic Considerations -- Efficacy Studies in Specific Disorders -- Reference Section: Efficacy Studies in Normal Volunteers and โ{128}{156}Insomniacsโ{128}{157} -- Nonbarbiturate, Nonbenzodiazepine Hypnotics -- Summary and Conclusions -- 5 Suicide and Hypnotics -- Incidence -- Traits of the Victim -- Clinical Toxicity -- Treatment -- Prevention -- Summary and Conclusions -- 6 Residual Daytime Effects of Hypnotics -- Electrophysiologic Residual Effects -- Psychomotor Measures of Residual Effects -- Subjective Evaluation of Daytime Performance -- Hypnotics and Driving -- Summary and Conclusions -- 7 Interactions with Ethanol -- General Considerations -- Barbiturates -- Benzodiazepines -- Nonbarbiturate, Nonbenzodiazepine Hypnotics -- Summary and Conclusions -- 8 Hypnotic Dependence -- Classical Drug Abuse -- Dependence in Medical Practice -- Summary and Conclusions -- 9 Hypnotics and the Elderly -- Pharmacology in the Elderly -- Efficacy Studies -- Toxicity -- Summary and Conclusions -- 10 Other Pharmacologic Approaches -- Over-the-Counter Hypnotics -- l-Tryptophan -- Ethanol -- Summary and Conclusions -- 11 Nonpharmacologic Treatment of Insomnia -- Counseling and Psychotherapy -- Behavioral Therapies -- Summary and Conclusions -- 12 Conclusion: Implications for Medical Practice -- Summary -- Approach to the Insomniac Patient -- References

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