Ethchlorvynol chemical structure
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Ethchlorvynol

Ethchlorvynol is a sedative and hypnotic drug. It has been used to treat insomnia, but has been largely superseded and is only offered where an intolerance or allergy to other drugs exists. more...

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Along with expected sedative effects of relaxation and drowsiness ethchlorvynol can cause skin rashes, faintness, restlessness and euphoria. Early adjustment side effects can include nausea and vomiting, numbness, blurred vision, stomach pains and temporary dizziness. An overdose is marked by confusion, fever, peripheral numbness and weakness, reduced coordination and muscle control, slurred speech, reduced heartbeat.

It is addictive and after prolonged use can cause withdrawal symptoms including convulsions, hallucinations and memory loss. Due to these problems it is unusual for ethchlorvynol to be prescribed for periods exceeding seven days.

Ethchlorvynol is a member of the class of sedative-hypnotic tertiary carbinols such as methylparafynol. It is not a barbituric acid derivative. The systematic name of ethchlorvynol is usually given as ethyl 2-chlorovinyl ethynyl carbinol or 1-chloro-3-ethyl-1-penten-4-yl-3-ol. Its empirical formula is C7H9ClO. In the United States Abbott Laboratories used to sell it under the tradename Placidyl. Since Abbott and Banner Pharmacaps, which manufactured the generic version, discontinued production in 1999, ethchlorvynol is no longer available in the United States.

References and End Notes

  • PubChem Substance Summary: Ethchlorvynol National Center for Biotechnology Information. Accessed 1 September 2005 (UTC)
  • Electronic Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations Food and Drug Administration. Accessed 12 December 2005 (UTC)
  1. ^  Green List: Annex to the annual statistical report on psychotropic substances (form P) 23rd edition. August 2003. International Narcotics Board, Vienna International Centre. Accessed 1 September 2005 (UTC)

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Hypnotics may protect against falling in insomnia patients
From Geriatrics, 6/1/05

Contrary to common belief, insomnia--not hypnotic use--in elderly nursing home residents is correlated with a higher risk of subsequent falls.

In this secondary analysis of a large, longitudinal assessment database, researchers analyzed 34,163 residents (age 65 and older; 76% women) in 437 Michigan nursing homes in 2001. Predictors were baseline reports of insomnia (previous month) and use of hypnotics (previous week). Hypnotics included aprobarbital, flurazepam, quazepam, triazolam, pentobarbital, ethchlorvynol, estazolam, and temazepam. Potential confounding factors, eg, cognitive status, functional status, proximity to death, illness burden, and number of medications, were considered.

Hypnotic use did not predict falls (adjusted odds ratio [AOR]=1.13; 95% CI=0.98,1.30), researchers found. Neither did insomnia predict future falls (AOR=1.52; 95% CI=1.38, 1.66). Untreated insomnia (AOR=1.55; 95% CI=1.41, 1.71) and hypnotic-treated (unresponsive) insomnia (AOR=1.32; 95% CI=1.02,1.70) predicted more falls than did absence of insomnia. Adjusting for confounding factors, insomnia and hypnotic use were not linked to subsequent hip fracture.

Based on these preliminary findings, researchers expressed reluctance to suggest hypnotic use can protect against future falls. However, Alon Avidan, MD, MPH, director, Sleep Disorders Clinic, Department of Neurology at University of Michigan, said the drugs may offer benefit. "Hypnotics, when appropriately used and selected, may consolidate sleep, prevent insomnia, and reduce the risk of falling due to getting out of bed in the middle of the night drowsy."

While this study demonstrates hypnotics cause an increased risk of falls in nursing home residents, Dr. Avidan said the analysis, controlling for variables, showed that insomnia, not hypnotics, is a risk factor for falls. Further, neither insomnia, nor use of hypnotics, is a risk factor for hip fracture. "We propose that hypnotics, by keeping patients asleep instead of wandering, protect them from falling. It may be time to rethink the notion that hypnotics are risky for geriatric patients. Now, insomnia treatment is not only a quality of life issue, but perhaps a safety issue as well."

Source: Avidan AY, Fries BE, James ML, Szafara KL, Wright GT, Chervin RD. Insomnia and hypnotic use, recorded in the Minimum Data Set, as predictors of falls and hip fractures in Michigan nursing homes. J Am Geriatr Soc 2005 (online).

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