The identification of residual impairment Another unwanted effect is for hypnotics taken in the evening to facilitate sleep to have residual effects the next morning, ie, for the “sedative” effects

to persist such that the individual is less capable of performing the tasks of daily living. In normal volunteers, temazepam 40 mg was Inhibitors,research,lifescience,medical compared with flurazepam 30 mg in a double-blind, placebo-controlled, SKI606 crossover design.38 Next morning, volunteers were impaired on the rapid visual information processing task if they had taken flurazepam the night before rather than placebo or temazepam. There were no effects detected on two traditional measures, DSST and CFF. Interestingly, Inhibitors,research,lifescience,medical although none of the volunteers typically experienced sleep difficulties, both hypnotics produced significant improvements in a range of aspects of self-rated sleep

quality. Flurazepam produced greater benefits on sleep quality, at the cost of residual effects on performance. In a follow-up trial using the same general design, Inhibitors,research,lifescience,medical temazepam 10 and 20 mg were both found to improve sleep quality without having residual effects on performance.39 Finally, in a third trial, volunteers were kept awake all night to simulate shift -work and were administered temazepam 20 mg the morning after to facilitate daytime sleeping.39 The trial identified that the volunteers slept better with temazepam than with placebo, and again that temazepam had no residual effects on performance. Inhibitors,research,lifescience,medical Interaction trials Such trials are important and are generally conducted in volunteers, though there is no scientific reason why they could not be conducted in patient populations. The major reason for conducting them in volunteers is the ease of recruitment of the subjects and the avoidance of the

complication of concomitant medications. Alcohol interaction trials are the most, common, as all compounds carry the risk that the patient, might, consume alcohol while taking the medication. Research has established that the “everyday” perception Inhibitors,research,lifescience,medical of the effects of alcohol do appropriately describe the actions of alcohol. At very low doses, there through is the possibility that performance is enhanced.40 However, above 2 units, attention is impaired, anterograde amnesia is produced, skilled coordination is disrupted, postural stability is decreased, and sel’-ratings of alertness and clear-headedness decline.41 These are the aspects of cognitive function which underpin the everyday behavioral effects of alcohol. To properly conduct an alcohol interaction trial of the effects upon cognitive function, the following conditions must be satisfied: The dose of alcohol must be relevant. A typical dose range is 0.5 to 0.7 g/kg, which puts individuals around the legal limits for driving in Europe.