Clobazam in combination with nomifensine (HOE 8476): Effects on mood, sleep, and psychomotor performance relating to car-driving ability

Subjective assessment of the effects of CNS-active drugs on sleep by the Leeds sleep evaluation questionnaire: a review

The Leeds sleep evaluation questionnaire (LSEQ) comprises ten self-rating 100 mm line analogue questions concerned with sleep and early morning behaviour. A literature search identified 83 studies in peer-reviewed journals that reported the use of the LSEQ for psychopharmacological investigations of drug effects on self-reported aspects of sleep. High internal consistency and reliability of the questionnaire have been demonstrated. Findings from studies involving a variety of psychoactive agents indicated that the LSEQ was able to quantify subjective impressions of sleep and waking and the effects of drugs in healthy volunteers, depressed and insomnia patients. In accordance with their known activity profile nocturnal administration of sedative hypnotic agents and antihistamines induced dose-related improvements in self-reported ease of getting to sleep, and quality of sleep but a decrease in alertness and behavioural integrity the following morning. Psychostimulants, on the other hand, impaired subjective ratings of sleep and increased early morning alertness. Antidepressants and certain anxiolytic agents improved both self-reported sleep aspects and early morning alertness. Treatment effects measured by the LSEQ corresponded to those measured for the same drugs by other assessment methods. These data indicate that the LSEQ is a robust and reliable instrument for psychopharmacological evaluations. Self-evaluations of sleep, as obtained by the LSEQ, can therefore provide consistent and meaningful measures for estimating the effectiveness of sleep modulators and sedative-hypnotic drugs.

Nomifensine, clobazam and HOE 8476: effects on aspects of psychomotor performance and cognitive ability

The effects of a combination of nomifensine and clobazam (HOE 8476) were compared, on a variety of psychometric measures, with those of its separate monosubstances in a placebo controlled double-blind study with twelve normal volunteers. Assessments comprised a range of psychomotor performance tests, measures of cognitive processing ability and visual analogue rating scales - previously shown to be sensitive to the effects of psychotropic drugs. Subjects acted as their own control and were tested in the morning and afternoon following subchronic pre-dosing with each of the four treatments. When compared with placebo, nomifensine showed no significant change on any of the performance measures. HOE 8476 produced no significant changes in performance but significantly reduced self-rated anxiety. Clobazam significantly improved subjective ratings of the ease of getting to sleep and impaired choice reaction time and concept identification performance in the morning. No significant changes in the test measures were found in the afternoon following any treatment. The findings were in broad agreement with those of previous studies and demonstrated that clobazam and nomifensine, both alone and in combination, tended not to impair performance on a wide range of psychological test assessments.