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Vinckenbosch F, Lammers GJ, Overeem S, Chen D, Wang G, Carter LP, Zhou K, Ramaekers JG, Vermeeren A. Effects of solriamfetol on on-the-road driving in participants with narcolepsy: A randomised crossover trial. Hum Psychopharmacol 2023; 38:e2858. [PMID: 36420633 PMCID: PMC10078175 DOI: 10.1002/hup.2858] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 08/24/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of solriamfetol, a dopamine and norepinephrine reuptake inhibitor, on on-the-road driving performance in participants with narcolepsy. METHODS In this randomised, double-blind, placebo-controlled, crossover study, driving performance during a 1 h on-road driving test was assessed at 2 and 6 h post-dose following 7 days of treatment with solriamfetol (150 mg/day for 3 days, followed by 300 mg/day for 4 days) or placebo. The primary endpoint was standard deviation of lateral position (SDLP) at 2 h post-dose. RESULTS The study included 24 participants (54% male; mean age, 40 years); 22 had evaluable SDLP data. At 2 h post-dose, median SDLP was significantly lower (improved) with solriamfetol compared with placebo (19.08 vs. 20.46 cm [median difference, -1.9 cm], p = 0.002). Four participants on solriamfetol and 7 on placebo had incomplete driving tests. At 6 h post-dose, median SDLP was not statistically significantly different with solriamfetol compared with placebo (19.59 vs. 19.78 cm [median difference, -1.1 cm], p = 0.125). Three participants on solriamfetol and 10 on placebo had incomplete driving tests. Common adverse events (≥5%) included headache, decreased appetite, and somnolence. CONCLUSIONS Solriamfetol 300 mg/day improved on-the-road driving performance, at 2 h post-administration in participants with narcolepsy.
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Affiliation(s)
- Frederick Vinckenbosch
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Gert Jan Lammers
- Sleep-Wake Centre SEIN, Leiden, The Netherlands.,Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sebastiaan Overeem
- Sleep Medicine Center Kempenhaeghe, Heeze, The Netherlands.,Department of Electrical Engineering, Biomedical Diagnostics Group, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Dan Chen
- Jazz Pharmaceuticals, Palo Alto, California, USA
| | - Grace Wang
- Jazz Pharmaceuticals, Palo Alto, California, USA
| | - Lawrence P Carter
- Alector Inc, South San Francisco, California, USA.,University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kefei Zhou
- Jazz Pharmaceuticals, Palo Alto, California, USA
| | - Johannes G Ramaekers
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Annemiek Vermeeren
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Vinckenbosch F, Asin J, de Vries N, Vonk PE, Donjacour CEHM, Lammers GJ, Overeem S, Janssen H, Wang G, Chen D, Carter LP, Zhou K, Vermeeren A, Ramaekers JG. Effects of solriamfetol on on-the-road driving performance in participants with excessive daytime sleepiness associated with obstructive sleep apnoea. Hum Psychopharmacol 2022; 37:e2845. [PMID: 35633275 PMCID: PMC9788130 DOI: 10.1002/hup.2845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/08/2022] [Accepted: 04/28/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate the impact of solriamfetol, a dopamine and norepinephrine reuptake inhibitor, on on-the-road driving in participants with excessive daytime sleepiness (EDS) associated with obstructive sleep apnoea (OSA). METHODS Eligible participants were aged 21-75 years with OSA and EDS (Maintenance of Wakefulness Test mean sleep latency <30 minutes and Epworth Sleepiness Scale score ≥10). Participants were randomised 1:1 to solriamfetol (150 mg/day [3 days], then 300 mg/day [4 days]) or placebo for 7 days, before crossover to the other treatment paradigm. On Day 7 of each period, standardised on-road driving tests occurred (2 and 6 hours postdose). Standard deviation of lateral position (SDLP) was the primary endpoint. RESULTS Solriamfetol significantly reduced SDLP at 2 (n = 34; least squares mean difference, -1.1 cm; 95% CI, -1.85, -0.32; p = 0.006) and 6 hours postdose (n = 32; least squares mean difference, -0.8 cm; 95% CI, -1.58, -0.03; p = 0.043). Two hours postdose, 4 placebo-treated and 1 solriamfetol-treated participants had incomplete driving tests; 6 hours postdose, 7 and 3 participants, respectively, had incomplete tests. Common treatment-emergent adverse events included headache, nausea, and insomnia. CONCLUSIONS Solriamfetol 300 mg/day significantly improved on-the-road driving performance in participants with EDS associated with OSA.
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Affiliation(s)
| | - Jerryll Asin
- Center for Sleep Medicine AmphiaBredaNetherlands
| | - Nicolaas de Vries
- Faculty of Medicine and Health SciencesDepartment of OtorhinolaryngologyHead and Neck SurgeryAntwerp University HospitalAntwerpBelgium,OLVGAmsterdamNetherlands
| | | | | | - Gert Jan Lammers
- Sleep–Wake Centre SEINNetherlands,Department of NeurologyLeiden University Medical CenterLeidenNetherlands
| | - Sebastiaan Overeem
- Sleep Medicine Center KempenhaegheHeezeNetherlands,Department of Electrical EngineeringBiomedical Diagnostics GroupEindhoven University of TechnologyEindhovenNetherlands
| | | | - Grace Wang
- Jazz PharmaceuticalsPalo AltoCaliforniaUSA
| | - Dan Chen
- Jazz PharmaceuticalsPalo AltoCaliforniaUSA
| | - Lawrence P. Carter
- Alexza PharmaceuticalsIncMountain ViewCaliforniaUSA,University of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Kefei Zhou
- Jazz PharmaceuticalsPalo AltoCaliforniaUSA
| | - Annemiek Vermeeren
- Faculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtNetherlands
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Vermeeren A, Jongen S, Murphy P, Moline M, Filippov G, Pinner K, Perdomo C, Landry I, Majid O, Van Oers ACM, Van Leeuwen CJ, Ramaekers JG, Vuurman EFPM. On-the-road driving performance the morning after bedtime administration of lemborexant in healthy adult and elderly volunteers. Sleep 2020; 42:5267834. [PMID: 30597112 PMCID: PMC6448281 DOI: 10.1093/sleep/zsy260] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/16/2018] [Indexed: 01/03/2023] Open
Abstract
Study Objectives To assess potential effects of lemborexant on next-morning driving performance in adult and elderly healthy volunteers. Methods Randomized, double-blind, double-dummy, placebo and active-controlled, four period incomplete crossover study in 48 healthy volunteers (22 females), 23–78 years old. Participants were treated at bedtime for eight consecutive nights with two of three dose levels of lemborexant (2.5, 5, or 10 mg), zopiclone 7.5 mg (on the first and last night with placebo on intervening nights), or placebo. Driving performance was assessed in the morning on days 2 and 9 using a standardized highway driving test in normal traffic, measuring standard deviation of lateral position (SDLP). Drug–placebo differences in SDLP >2.4 cm were considered to reflect clinically meaningful driving impairment. Results Mean drug–placebo differences in SDLP following lemborexant 2.5, 5, and 10 mg on days 2 and 9 were 0.74 cm or less. The upper bound of the 95% confidence intervals (CIs) for lemborexant treatment groups were all below 2.4 cm and the 95% CIs included zero, indicating that the effects were neither clinically meaningful nor statistically significant. Symmetry analysis further supported the lack of clinically meaningful impairment with lemborexant. Conclusions When assessed starting ~9 h after lemborexant administration at bedtime the previous night, there was no statistically significant or clinically meaningful effect on driving performance in healthy adults and elderly, as assessed by either mean differences in SDLP relative to placebo or symmetry analysis. In this study, lemborexant at doses up to 10 mg was well-tolerated. Clinical Trial Registration clinicaltrials.gov, NCT02583451. https://clinicaltrials.gov/ct2/show/NCT02583451.
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Affiliation(s)
- Annemiek Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Stefan Jongen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | | | - Gleb Filippov
- Neurology Business Group, Eisai, Inc., Woodcliff Lake, NJ
| | - Kate Pinner
- Neurology Business Group, Eisai Ltd., Hatfield, UK
| | - Carlos Perdomo
- Neurology Business Group, Eisai, Inc., Woodcliff Lake, NJ
| | - Ishani Landry
- Neurology Business Group, Eisai, Inc., Woodcliff Lake, NJ
| | - Oneeb Majid
- Neurology Business Group, Eisai Ltd., Hatfield, UK
| | - Anita C M Van Oers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Cees J Van Leeuwen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Eric F P M Vuurman
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Micallef J, Dupouey J, Jouve E, Truillet R, Lacarelle B, Taillard J, Daurat A, Authié C, Blin O, Rascol O, Philip P, Mestre D. Cannabis smoking impairs driving performance on the simulator and real driving: a randomized, double-blind, placebo-controlled, crossover trial. Fundam Clin Pharmacol 2018; 32:558-570. [DOI: 10.1111/fcp.12382] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Joëlle Micallef
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Julien Dupouey
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Elisabeth Jouve
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Romain Truillet
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Bruno Lacarelle
- Laboratoire de Pharmacocinétique et Toxicologie; Assistance Publique Hôpitaux de Marseille; Marseille France
| | - Jacques Taillard
- Université de Bordeaux, CNRS, Sommeil Attention et Neuropsychiatrie, USR 3413; Bordeaux France
| | - Agnès Daurat
- Université Toulouse II, CNRS, EPHE, CLLE-LTC UMR 5263; Toulouse France
| | - Colas Authié
- Institut de la Vision, CNRS, UPMC, INSERM, UMR 7210; Paris France
| | - Olivier Blin
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neurosciences; Clinical Investigation Center INSERM CIC1436 and Clinique Spatiale MEDES; University Hospital and University of Toulouse3; Toulouse France
| | - Pierre Philip
- Université de Bordeaux, CNRS, Sommeil Attention et Neuropsychiatrie, USR 3413; Bordeaux France
| | - Daniel Mestre
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, UMR 7287; Marseille France
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van de Loo AJAE, Bervoets AC, Mooren L, Bouwmeester NH, Garssen J, Zuiker R, van Amerongen G, van Gerven J, Singh J, der Ark PV, Fedgchin M, Morrison R, Wajs E, Verster JC. The effects of intranasal esketamine (84 mg) and oral mirtazapine (30 mg) on on-road driving performance: a double-blind, placebo-controlled study. Psychopharmacology (Berl) 2017; 234:3175-3183. [PMID: 28755104 PMCID: PMC5660834 DOI: 10.1007/s00213-017-4706-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 07/17/2017] [Indexed: 11/25/2022]
Abstract
RATIONALE The purpose of this study is to evaluate the single dose effect of intranasal esketamine (84 mg) compared to placebo on on-road driving performance. Mirtazapine (oral, 30 mg) was used as a positive control, as this antidepressant drug is known to negatively affect driving performance. METHODS Twenty-six healthy volunteers aged 21 to 60 years were enrolled in this study. In the evening, 8 h after treatment administration, participants conducted the standardized 100-km on-road driving test. Primary outcome measure was the standard deviation of lateral position (SDLP), i.e., the weaving of the car. Mean lateral position, mean speed, and standard deviation of speed were secondary outcome measures. For SDLP, non-inferiority analyses were conducted, using +2.4 cm (relative to placebo) as a predefined non-inferiority margin for clinical relevant impairment. RESULTS Twenty-four participants completed the study. No significant SDLP difference was found between esketamine and placebo (p = 0.7638), whereas the SDLP after mirtazapine was significantly higher when compared to placebo (p = 0.0001). The upper limit of the two-sided 95% confidence interval (CI) of the mean difference between esketamine and placebo was +0.86 cm, i.e., <+2.4 cm, thus demonstrating that esketamine was non-inferior to placebo. Non-inferiority could not be concluded for mirtazapine (+3.15 cm SDLP relative to placebo). No significant differences in mean speed, standard deviation of speed, and mean lateral position were observed between the active treatments and placebo. CONCLUSIONS No significant difference in driving performance was observed 8 h after administering intranasal esketamine (84 mg) or placebo. In contrast, oral mirtazapine (30 mg) significantly impaired on road driving performance.
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Affiliation(s)
- Aurora J. A. E. van de Loo
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacology, Utrecht University, Universiteitsweg 99, 3584CG, Utrecht, the Netherlands ,Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Adriana C. Bervoets
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacology, Utrecht University, Universiteitsweg 99, 3584CG, Utrecht, the Netherlands
| | - Loes Mooren
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacology, Utrecht University, Universiteitsweg 99, 3584CG, Utrecht, the Netherlands
| | - Noor H. Bouwmeester
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacology, Utrecht University, Universiteitsweg 99, 3584CG, Utrecht, the Netherlands
| | - Johan Garssen
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacology, Utrecht University, Universiteitsweg 99, 3584CG, Utrecht, the Netherlands ,Nutricia Research, Utrecht, the Netherlands
| | - Rob Zuiker
- Centre for Human Drug Research (CHDR), Leiden, the Netherlands
| | | | - Joop van Gerven
- Centre for Human Drug Research (CHDR), Leiden, the Netherlands
| | | | - Peter Van der Ark
- Janssen Research & Development, Janssen Pharmaceutica N.V, Beerse, Belgium
| | | | | | - Ewa Wajs
- Janssen Research & Development, Janssen Pharmaceutica N.V, Beerse, Belgium
| | - Joris C. Verster
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacology, Utrecht University, Universiteitsweg 99, 3584CG, Utrecht, the Netherlands ,Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands ,Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
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Vermeeren A, Vets E, Vuurman EF, Van Oers AC, Jongen S, Laethem T, Heirman I, Bautmans A, Palcza J, Li X, Troyer MD, Wrishko R, McCrea J, Sun H. On-the-road driving performance the morning after bedtime use of suvorexant 15 and 30 mg in healthy elderly. Psychopharmacology (Berl) 2016; 233:3341-51. [PMID: 27424295 PMCID: PMC4989000 DOI: 10.1007/s00213-016-4375-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/29/2016] [Indexed: 01/09/2023]
Abstract
RATIONALE Suvorexant is a first-in-class orexin receptor antagonist for treating insomnia. There is a general concern that hypnotics may impair next-morning driving ability. OBJECTIVE The objective of this study was to evaluate next-morning driving performance in older adults after single and repeated doses of suvorexant. METHODS Double-blind, randomized, placebo-controlled, 4-period crossover study in 24 healthy volunteers (10 females), aged 65-80 years. Subjects were treated with suvorexant (15 and 30 mg) for eight consecutive nights, zopiclone 7.5 mg nightly on days 1 and 8, and placebo. Driving performance was assessed on days 2 and 9 (9 h after dosing) using a 1-h standardized highway driving test in normal traffic, measuring standard deviation of lateral position (SDLP). Drug-placebo differences in SDLP >2.4 cm were considered to reflect clinically meaningful driving impairment. RESULTS Driving performance as measured by SDLP was not impaired following suvorexant. Mean drug-placebo differences in SDLP following suvorexant 15 and 30 mg on day 2 and 9 were 0.6 cm or less. Their 90 % CIs were all below the threshold of 2.4 cm for clinical relevance and included zero, indicating effects were not clinically meaningful or statistically significant. Symmetry analysis showed no significant differences between the number of participants who had SDLP differences >2.4 cm and those who had SDLP differences <-2.4 cm following suvorexant. CONCLUSIONS There was no clinically meaningful residual effect of suvorexant 15 and 30 mg on next-morning driving (9 h after bedtime dosing) in healthy older adults, as assessed by mean changes in SDLP and by the number of participants on drug versus placebo that exceeded a predetermined threshold for clinically meaningful impairment.
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Affiliation(s)
- Annemiek Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Eva Vets
- SGS Life Science Services, Antwerp, Belgium
| | - Eric F.P.M. Vuurman
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Anita C.M. Van Oers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Stefan Jongen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Tine Laethem
- Merck Translational Medicine Europe, MSD Europe Inc., Brussels, Belgium
| | - Ingeborg Heirman
- Merck Translational Medicine Europe, MSD Europe Inc., Brussels, Belgium
| | - An Bautmans
- Merck Translational Medicine Europe, MSD Europe Inc., Brussels, Belgium
| | | | | | | | | | | | - Hong Sun
- Merck & Co., Inc., Kenilworth, NJ USA
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7
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Vermeeren A, Sun H, Vuurman EFPM, Jongen S, Van Leeuwen CJ, Van Oers ACM, Palcza J, Li X, Laethem T, Heirman I, Bautmans A, Troyer MD, Wrishko R, McCrea J. On-the-Road Driving Performance the Morning after Bedtime Use of Suvorexant 20 and 40 mg: A Study in Non-Elderly Healthy Volunteers. Sleep 2015; 38:1803-13. [PMID: 26039969 DOI: 10.5665/sleep.5168] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 04/04/2015] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVE To evaluate next-morning driving performance in adults younger than 65 years, after single and repeated doses of suvorexant 20 and 40 mg. DESIGN Double-blind, placebo-controlled, 4-period crossover study. SETTING Maastricht University, The Netherlands. PARTICIPANTS 28 healthy volunteers (15 females), aged 23 to 64 years. INTERVENTIONS Suvorexant (20 and 40 mg) for 8 consecutive nights; zopiclone 7.5 mg nightly on day 1 and 8; placebo. MEASUREMENTS Performance on day 2 and 9 (9 h after dosing) using a one-hour standardized highway driving test in normal traffic, measuring standard deviation of lateral position (SDLP). Drug-placebo changes in SDLP > 2.4 cm were considered to reflect meaningful driving impairment. RESULTS Mean drug-placebo changes in SDLP following suvorexant 20 and 40 mg were 1.01 and 1.66 cm on day 2, and 0.48 and 1.31 cm on Day 9, respectively. The 90% CIs of these changes were all below 2.4 cm. Symmetry analysis showed that more subjects had SDLP changes > 2.4 cm than < -2.4 cm following suvorexant 20 and 40 mg on day 2, and following suvorexant 40 mg on day 9. Four female subjects requested that a total of 5 driving tests--all following suvorexant--stop prematurely due to self-reported somnolence. CONCLUSIONS As assessed by mean changes in standard deviation of lateral position (SDLP), there was no clinically meaningful residual effect of suvorexant in doses of 20 and 40 mg on next-morning driving (9 h after bedtime dosing) in healthy subjects < 65 years old. There may be some individuals who experience next-day effects, as suggested by individual changes in SDLP and prematurely stopped tests. CLINICAL TRIAL REGISTRATION clinicaltrials.gov NCT01311882.
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Affiliation(s)
- Annemiek Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Hong Sun
- Merck & Co., Inc., Kenilworth, NJ
| | - Eric F P M Vuurman
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Stefan Jongen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Cees J Van Leeuwen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Anita C M Van Oers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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8
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Moták L, Bayssac L, Taillard J, Sagaspe P, Huet N, Terrier P, Philip P, Daurat A. Naturalistic conversation improves daytime motorway driving performance under a benzodiazepine: a randomised, crossover, double-blind, placebo-controlled study. ACCIDENT; ANALYSIS AND PREVENTION 2014; 67:61-66. [PMID: 24631977 DOI: 10.1016/j.aap.2014.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 02/01/2014] [Accepted: 02/12/2014] [Indexed: 06/03/2023]
Abstract
The adverse effects of benzodiazepines on driving are widely recognised. The aims of this study were both to determine the impact of naturalistic conversation on the driving ability of drivers under a benzodiazepine, and to measure the accuracy of drivers' assessments of the joint effects of the benzodiazepine and conversation. Sixteen healthy male participants (29.69 ± 3.30 years) underwent a randomised, crossover, double-blind, placebo-controlled study with the benzodiazepine lorazepam (2mg). They drove 200 km (125 miles) on a motorway in the morning. We measured two driving ability-related variables (i.e., lane-keeping performance), and collected a set of self-assessed variables (i.e., self-assessment of driving performance) during two 10-min sequences of interest (no conversation vs. conversation). An analysis of variance revealed an interaction whereby lane-keeping performance under lorazepam was worse in the no-conversation condition than in the conversation condition. No such difference was detected under placebo. Pearson's correlation coefficients revealed that self-assessments were (i) not at all predictive of lane-keeping when performed before the drive, but (ii) moderately predictive of lane-keeping performance when performed during or after the drive. We conclude that conversation with a passenger may contribute to safer lane-keeping when driving under a benzodiazepine. Moreover, a degree of awareness may be attained after some experience of driving under the influence of this type of medication.
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Affiliation(s)
- Ladislav Moták
- Laboratoire Cognition, Langues, Langage, Ergonomie (CLLE-LTC), UMR 5263, CNRS, Université de Toulouse Le Mirail, Toulouse, France
| | - Laëtitia Bayssac
- Laboratoire Cognition, Langues, Langage, Ergonomie (CLLE-LTC), UMR 5263, CNRS, Université de Toulouse Le Mirail, Toulouse, France
| | - Jacques Taillard
- Université de Bordeaux, CNRS, Sommeil, Attention et Neuropsychiatrie, USR 3413, Bordeaux, France
| | - Patricia Sagaspe
- Université de Bordeaux, CNRS, Sommeil, Attention et Neuropsychiatrie, USR 3413, Bordeaux, France
| | - Nathalie Huet
- Laboratoire Cognition, Langues, Langage, Ergonomie (CLLE-LTC), UMR 5263, CNRS, Université de Toulouse Le Mirail, Toulouse, France
| | - Patrice Terrier
- Laboratoire Cognition, Langues, Langage, Ergonomie (CLLE-LTC), UMR 5263, CNRS, Université de Toulouse Le Mirail, Toulouse, France
| | - Pierre Philip
- Université de Bordeaux, CNRS, Sommeil, Attention et Neuropsychiatrie, USR 3413, Bordeaux, France
| | - Agnès Daurat
- Laboratoire Cognition, Langues, Langage, Ergonomie (CLLE-LTC), UMR 5263, CNRS, Université de Toulouse Le Mirail, Toulouse, France.
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Vermeeren A, Vuurman EFPM, Leufkens TRM, Van Leeuwen CJ, Van Oers ACM, Laska E, Rico S, Steinberg F, Roth T. Residual effects of low-dose sublingual zolpidem on highway driving performance the morning after middle-of-the-night use. Sleep 2014; 37:489-96. [PMID: 24587571 DOI: 10.5665/sleep.3482] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVE To evaluate next-morning driving performance after middle-of-the-night use of zolpidem 3.5 mg in a buffered sublingual formulation (ZST). DESIGN Single-center, four-period, randomized, double-blind, placebo-controlled, crossover study. SETTING Maastricht University, The Netherlands. PARTICIPANTS Forty healthy volunteers (20 females). INTERVENTIONS Single dose of ZST administered in the middle of the night at 3 and 4 h before driving, zopiclone 7.5 mg at bedtime 9 h before driving, and placebo. MEASUREMENTS Performance in a 100-km standardized highway driving test in normal traffic measuring standard deviation of lateral position (SDLP) - an index of weaving. Drug-placebo changes in SDLP > 2.5 cm were considered to reflect clinically relevant driving impairment. RESULT For ZST, Max McNemar symmetry analyses showed that the proportion of drivers classified as impaired was increased 3 h after dosing (P < 0.012), but not 4 h after dosing. Mean increases in SDLP from placebo, although statistically significant, were small (1.46 cm [P < 0.0001] at 3 h and 0.83 cm [P = 0.0174] at 4 h). The morning after zopiclone, 45% of the drivers were classified as impaired with a mean increase in SDLP of 2.46 cm (P < 0.0001). There were no significant sex differences in effects of ZST and zopiclone. CONCLUSION Zolpidem 3.5 mg in a buffered sublingual formulation has a minimal risk of impairing driving performance in the morning ≥ 4 hours after middle-of-the night use. When taken 3 hours before driving, the drug may have impairing effects so caution should be exercised if medication is taken other than as indicated. CLINICAL TRIAL INFORMATION ClinicalTrials.gov Identifier: NCT01106859; Trial Name: Driving Performance After Middle of the Night Administration of 3.5 mg Zolpidem Tartrate Sublingual Tablet; http://clinicaltrials.gov/ct2/show/NCT01106859.
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Affiliation(s)
- Annemiek Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Eric F P M Vuurman
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Tim R M Leufkens
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Cees J Van Leeuwen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Anita C M Van Oers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Eugene Laska
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY and New York University, Langone School of Medicine, New York, NY
| | | | | | - Thomas Roth
- Henry Ford Hospital Sleep Disorders and Research Center, Detroit, MI
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