New medications for insomnia and lowering heartbeat
Australians suffering from sleeplessness can now access Circadin, a new prescription-only melatonin treatment now available for adults aged 55 years and above with primary insomnia.
Dr Philip Morris, an Australian psychiatrist and specialist in the mental health of older adults, explained that it is a significant advancement for Australians with primary insomnia because Circadin belongs to a recent class of insomnia treatment containing melatonin, a naturally occurring hormone which helps regulate the sleep-wake cycle (known as the circadian rhythm).
Circadin is the first and only prolonged release melatonin treatment registered by the Therapeutic Goods Administration for primary insomnia. It works by releasing melatonin over a period of time, assisting people to sleep by mimicking the normal pattern of melatonin levels during the night.
Insomnia, characterised by poor quality of sleep, is a very common disorder that increases in prevalence as people age. Melatonin is thought to play a role in primary insomnia because the body’s natural production of melatonin generally decreases as people get older, at the same time the incidence of primary insomnia increases.
The condition is 1.5 times higher in women than in men and is estimated to affect 36% of Australians at some stage of their lives, with approximately 5% requiring treatment for the condition.
Sleep disorders can be key contributors to serious health problems including injuries and chronic disease. In Australia it is estimated that approximately 9% of work-related injuries and 8% of non work-related motor vehicle accidents are caused by sleep disorders.
In addition, sleep disorders have been found to be the underlying cause of approximately 8% of depression, 3% of diabetes and 1% of both kidney and cardiovascular diseases.
“Effectively managing primary insomnia is more complicated than just helping people get to sleep in the first place. It’s also about ensuring people wake feeling rested and refreshed, known as ‘sleep quality’,” explained Dr David Michail, respiratory physician and sleep expert.
Clinical trials have found side effects caused by Circadin are similar to those of placebo (inactive medication). It is important that people who are commencing treatment discuss the potential side effects and how these can be managed with their doctor.
Circadin is available for the short-term treatment (up to three weeks) of primary insomnia characterised by poor quality of sleep in adults aged 55 years and over. Circadin is available by prescription only and costs approximately $32.00 for a pack of 21 tablets (approximately $1.50 per day). It is not available on the Pharmaceutical Benefits Scheme.
Drug for lowering the heartbeat
People with heart failure can have their chances of surviving improve by 25% through medication use of the drug ivabradine which can lower the heart rate to an average 65 beats a minute compared with 75 beats in those taking a placebo pill.
Swedish-led research therapy on more than 6,500 mainly middle-aged heart failure patients was given in addition to standard blood-pressure lowering treatment – mainly beta blocker drugs – to bring down the heart rate to the lower end of the 60-80 range considered normally healthy.
Beta blockers are the most widely used treatment but side effects including extreme fatigue can mean many people cannot tolerate them at doses high enough to make a significant difference.
Ivabradine, which is marketed in Australia as Coralan, is made by the French firm Servier, which funded the research. It costs about $80 for a month’s supply and is more commonly used as a treatment for angina.
