SONATA

	SONATA Description / Definitions Abuse Addiction / Dependence Side Effects Withdrawal Symptoms Treatment

DESCRIPTION / DEFINITIONS: Sonata® (zaleplon) is an Anxiolytic, Sedative & Hypnotic drug prescribed for the treatment of insomnia. According to its label, “Sonata is indicated for the short-term treatment of insomnia. Sonata has been shown to decrease the time to sleep onset for up to 30 days in controlled clinical studies under. It has not been shown to increase total sleep time or decrease the number of awakenings.The clinical trials performed in support of efficacy ranged from a single night to 5 weeks in duration. The final formal assessments of sleep latency were performed at the end of treatment.”

ABUSE: Sonata can have withdrawal symptoms. Sonata is a Schedule IV Controlled Subtance.

ADDICTION / DEPENDENCE: Half Life and Metabolism.

SIDE EFFECTS: Colitis, nausea, amnesia, confusion (see list below)

WITHDRAWAL SYMPTOMS: Insomnia, anxiety (see list below).

TREATMENT: Medical detoxification.

DESCRIPTION / DEFINITIONS

Sonata® (zaleplon) is an Anxiolytic, Sedative & Hypnotic drug prescribed for the short-term treatment of insomnia. According to its label, “Because sleep disturbances may be the presenting manifestation of a physical and/or psychiatric disorder, symptomatic treatment of insomnia should be initiated only after a careful evaluation of the patient. The failure of insomnia to remit after 7 to 10 days of treatment may indicate the presence of a primary psychiatric and/or medical illness that should be evaluated.”

The label also states, “Subunit modulation of the GABA-BZ receptor chloride channel macromolecular complex is hypothesized to be responsible for some of the pharmacological properties of benzodiazepines, which include sedative, anxiolytic, muscle relaxant, and anticonvulsive effects in animal models."

ABUSE

Sonata can have withdrawal symptoms. Sonata is a Schedule IV Controlled Subtance.

ADDCTION / DEPENDENCE

HALF LIFE AND METABOLISM

The biological half life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

The half life of Sonata is approximately 1 hour.

Sonata is mainly metabolized through the P450 pathway in the liver and the enzymes primarily handling the metabolism is CYP3A4 but it is not clear how much of the metabolism is done by other enzymes.

The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.

SIDE EFFECTS

The following information is taken from the Sonata label:

abdominal pain abnormal gait abnormal liver function tests abnormal vision abnormality of accommodation acne agitation albuminuria alopecia alt (sgpt) increased amnesia anaphylactic/anaphylactoid reactions anemia angina pectoris anorexia anxiety apathy aphthous stomatitis apnea arthralgia arthritis arthrosis ast (sgot) increased asthenia asthma ataxia back pain bigeminy biliary pain bilirubinemia bladder pain blepharitis breast pain bronchitis bruxism bundle branch block bursitis cardiospasm cataract specified cerebral ischemia cheilitis chest pain chest pain substernal chills cholelithiasis circumoral paresthesia cns stimulation colitis confusion conjunctivitis constipation contact dermatitis corneal erosion cyanosis cystitis deafness decreased urine stream delayed menstrual period delusions depersonalization depression diabetes mellitus diplopia dizziness dry eyes dry mouth dry skin duodenal ulcer dysarthria dysmenorrhea dyspepsia dysphagia dyspnea dystonia dysuria ear pain

ecchymosis eczema edema emotional lability enteritis eosinophilia epistaxis eructation esophagitis euphoria eye hemorrhage eye pain face edema facial paralysis fever flatulence gastritis gastroenteritis generalized edema gingivitis glaucoma glossitis goiter gout gum hemorrhage hallucinations hangover effect headache hematuria hiccup hostility hyperacusis hypercholesteremia hyperesthesia hyperglycemia hyperkinesias hypertension hypertonia hyperuricemia hyperventilation hypesthesia hypoglycemia hypoglycemic reaction hypokinesia hypotension hypothyroidism hypotonia impotence incoordination increased appetite increased salivation insomnia intestinal obstruction joint disorder (mainly swelling, stiffness, and pain) ketosis kidney calculus kidney pain labyrinthitis lactose intolerance laryngitis leucorrhea leukocytosis libido decreased lymphadenopathy lymphocytosis maculopapular rash malaise melanosis melena menopause menorrhagia metrorrhagia migraine mouth ulceration myalgia myasthenia

myoclonus myositis nausea neck rigidity nervousness neuralgia neuropathy nystagmus osteoporosis palpitation paresthesia parosmia peptic ulcer pericardial effusion peripheral edema photophobia photosensitivity reaction pleural effusion pneumonia postural hypotension pruritus psoriasis psychomotor retardation ptosis pulmonary embolus purpura pustular rash rash rectal hemorrhage reflexes decreased reflexes increased retinal detachment sinus bradycardia skin discoloration skin hypertrophy sleep talking sleep walking slurred speech snoring somnolence sputum increased stomatitis stupor sweating syncope tachycardia taste loss taste perversion tenosynovitis thinking abnormal (mainly difficulty concentrating thirst thrombophlebitis tinnitus tongue discoloration tongue edema tremor trismus ulcerative stomatitis urethritis urinary frequency urinary incontinence urinary retention urinary urgency urticaria vaginal hemorrhage vaginitis vasodilatation ventricular extrasystoles ventricular tachycardia vertigo vesiculobullous rash visual field defect voice alteration watery eyes weight gain weight loss

WITHDRAWAL SYMPTOMS

Sonata can be a very difficult drug to stop taking.

anxiety

hyperesthesia

TREATMENT

Withdrawal from Sonata should only be done under the care of a health practitioner. The safest way is to withdraw at an inpatient medical detox facility. At a inpatient medical detox facility with a protocol that includes hydration, vitamins and supplements, most patients can safely stop taking Sonata in about seven days. Patients can withdraw from Sonata on an outpatient basis but it will normally take at least four weeks.