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Record W2522476758 · doi:10.15406/jpcpy.2016.06.00368

Zopiclone use with Depressed Patients

2016· article· en· W2522476758 on OpenAlexaboutno aff
J. Thomas Dalby

Bibliographic record

VenueJournal of Psychology & Clinical Psychiatry · 2016
Typearticle
Languageen
FieldMedicine
TopicTreatment of Major Depression
Canadian institutionsnot available
Fundersnot available
KeywordsZopicloneSocial psychiatryPsychologyHealth psychologyPsychiatryClinical psychologyPsychotherapistMedicinePublic healthInsomniaMental health

Abstract

fetched live from OpenAlex

Submit Manuscript | http://medcraveonline.com of combinations of antidepressants for the treatment of major depressive disorder. A missing consideration in combined medication regimens for treating depressed patients is the concurrent use of hypnotics. Zopiclone is a non-benzodiazepine hypnotic agent introduced as an alternative to benzodiazepines in 1986. Since then, accumulated empirical evidence has indicated that the drug has all the properties of benzodiazepines including adverse behavioral effects. This conclusion that zopiclone is a benzodiazepine clone is now biochemically logical as the drug binds at the benzodiazepine GABA sites as a full agonist. It is the most widely prescribed sedative hypnotic prescribed in Canada. Long term reviews of its clinical use in promoting sleep conclude that “zopiclone is effective, well-tolerated and an excellent alternative to benzodiazepines in the short term treatment of insomnia” [2]. The Canadian product monograph also emphasizes short-term treatment and that “treatment with Imovane should not usually exceed 7-10 consecutive days. Use for more than 2-3 consecutive weeks requires complete re-evaluation of the patient [3].” The link between sleep disturbances and mental disorders is clear and substantial [4]. DSM-5 encourages concurrent diagnosis of sleep disorders although this is likely still under diagnosed. The Imovane (zopiclone) monograph issues a caution for the use of the drug with depressed patients, indicates that it is not a treatment for depression and that Imovane may even mask patients’ symptoms. Yet, little information is available on what the standard of practice of using this drug with depressed patients is like. Kassam & Patten [5] described Canadian population estimates of benzodiazepine and zopiclone use in Canada and showed that patients with Major Depressive Disorder had an elevated frequency in using these agents. However, those estimates (for the previous 12 month period) are based on survey data beginning in the mid 1990’s and did show increased use of zopiclone by six years later (12.3 percent in 2000/2001). Little additional information on the practice of zopiclone use with patients who had Major Depressive Disorder is available. The files of one hundred consecutive patients (50 males; 50 females - mean age 40.1 years) referred for mental health IME’s from third-party disability insurers were reviewed, all who had a diagnosis of Major Depressive Disorder on referral (nearly all from family physicians) and whose diagnosis was confirmed through our assessment with formal objective psychological testing and clinical examination. Forty-six of these patients were taking Imovane at the time of their evaluation. As well, four more patients indicated that their use of a tricyclic antidepressant was taken in the evening to assist sleep rather than to specifically improve mood.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.029
Threshold uncertainty score0.425

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.053
GPT teacher head0.408
Teacher spread0.354 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2016
Admission routes1
Has abstractyes

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