Effect of flunitrazepam on sleep and memory

Effects of pregnanolone and flunitrazepam on the retention of response sequences in rats

Neuroactive steroids produce effects similar to other GABA(A) modulators (e.g., benzodiazepines and barbiturates) and have a large therapeutic potential; however, a greater understanding of the effects of these substances on learning and memory is needed. To specifically assess the effects of a neurosteroid on memory, pregnanolone (1-18 mg/kg) was administered to male Long-Evans rats responding under a repeated acquisition and delayed-performance procedure in which different 4-response sequences were acquired and then retested after varying delays. Responding was maintained under a second-order fixed-ratio (FR) 2 schedule of food reinforcement, and incorrect responses (errors) produced a 5-sec timeout. For comparison purposes, both a high (flunitrazepam) and low efficacy agonist/antagonist (flumazenil) of the GABA(A) receptor complex were also administered both alone and in combination. Retention of each sequence was quantified as percent savings in errors-to-criterion and this dependent measure was shown to be sensitive to increases in delay. When administered 15 min prior to the end of either a 30- or 180-minute delay, pregnanolone produced both dose- and delay-dependent decreases in percent savings, response rate and accuracy; this effect was selective in that decreases in retention occurred at doses lower than those that disrupted response rate or accuracy. Flunitrazepam (0.056-1mg/kg) produced similar disruptions in retention and these disruptions were antagonized by 5.6 mg/kg of flumazenil. Both an ineffective (0.056 mg/kg) and an effective (0.18 mg/kg) dose of flunitrazepam also potentiated the dose- and delay-dependent disruptions in retention produced by pregnanolone. These data indicate that the neurosteroid pregnanolone disrupts retention in a manner similar to the benzodiazepine flunitrazepam, and suggests that the interaction of flunitrazepam and pregnanolone on retention may be mediated by the GABA(A) receptor complex.

REM sleep effects as a biomarker for the effects of antidepressants in healthy volunteers

The potential use of rapid eye movement (REM) sleep effects as a biomarker for the therapeutic effects of antidepressants in healthy volunteers is reviewed. A literature search was performed to select studies investigating the effects of antidepressants on REM sleep. To assess the specificity of REM sleep effects as a biomarker, the effects of other central nervous system drugs on REM sleep were also investigated. A significant REM sleep reduction was shown for 16 of 21 investigated antidepressants after single-dose (mean reduction 34.1%) and for 11/13 drugs after multiple-dose administration (mean reduction 29.2%). The median increase in REM latency was approximatety 60% after single- or multiple-dose administration. REM sleep effects were linearly normalized to therapeutic doses, by dividing the REM sleep effect by the investigated dose and multiplying by the therapeutic dose. Normalized REM sleep effects were highly variable (range -27.0% to 81.8% for REM sleep; range -17.0% to 266.3% for REM latency) and demonstrated no relationship with relevant pharmacological properties of the investigated drugs. No quantifiable dose-response relationship could be constructed after single and multiple dose administration. REM sleep effects were not specific for antidepressants. Benzodiazepines, for example, caused an average dose normalized REM sleep reduction of 8.7% and a median 8.6% increase of REM latency. This review demonstrates that although REM sleep effects occur with most of the antidepressants, it is by itself of limited value as a biomarker for antidepressant action. The specificity for antidepressants is limited, and it does not show a quantitative dose-response relationship to antidepressant agents. This is at least partly due to the complex relationships between drug pharmacokinetics and the variable time course of REM and other sleep stages throughout the night. Models that take these complex relationships into account may provide more comprehensive and quantifiable results.

Long-, intermediate- and short-acting benzodiazepine effects on human sleep EEG spectra

The effects of 10 mg haloxazolam (HAX), 4 mg flunitrazepam (FNZ), and 0.5 mg triazolam (TRI), each administered for seven consecutive nights were studied in the sleep electroencephalograms (EEG) of 17 (six HAX, five FNZ and six TRI) healthy male student volunteers. Recordings of C3-A1 EEG data from one baseline night, three drug nights (first, fourth and seventh) and two withdrawal nights (second and fourth) were analyzed using a fast Fourier transformation method. All three drugs induced similar changes in the 0.5 Hz to 40 Hz power spectrum; namely (i) higher frequency (including the sigma and beta bands) activity increased and lower frequency activity reduced on the drug nights; (ii) the enhancement of sigma activity peaked during non-rapid eye movement sleep following the first administration and was maintained at high levels on all drug nights; (iii) beta activity increased through the night after administration of HAX and FNZ, but not TRI, which suggests a blood concentration level dependent increase of beta activity; and (iv) only HAX showed a residual effect on the fourth withdrawal night. These results indicate that (i) chronic administration of these three benzodiazepine derivatives produce similar profiles in sleep EEG spectral changes, with some differences depending on their half-lives and doses; (ii) the mechanism of sigma enhancement is sensitive to even the initial administration night of BDZ; and (iii) frequencies below and above the sigma band are less sensitive to BDZ and also show an increase through the night after administration, suggesting differences in the mechanisms reflected by these EEG frequency bands.