Nitrazepam (Mogadon) as a Sleep-Inducing Agent

An analysis based on a double-blind comparison with phenobarbitone

¹ University Psychiatric Clinic, Vinderen, Oslo 3, Norway

A double-blind, cross-over trial with nitrazepam (Mogadon) 5 mg. and phenobarbitone 100 mg. was carried out on twenty-six psychiatric in-patients, mostly neurotics. Each drug was given three nights in succession, in random order; placebo was given one night before and two nights between the active drugs, in a single-blind manner. Sleep was recorded both objectively (inspection by night nurse) and subjectively (patient's own statement to doctor).

Each active drug gave better sleep than placebo, both by objective and subjective assessment. However, this part of the trial was not unbiased. The active drugs did not differ significantly in overall effect on total sleeping time, time profile of sleep during the night, or "hang-over" effect.

As nitrazepam is claimed to have a mode of action different from that of the barbiturates, an attempt was made to reveal differential clinical effects of the two drugs by correlating preference for either drug with different clinical symptoms. There was found to be a highly significant tendency for patients complaining of early insomnia because of disturbing thoughts to report better sleep after phenobarbitone than after nitrazepam, and vice versa. There was also a tendency for patients with overt anxiety to report better sleep after phenobarbitone than after nitrazepam, and vice versa, but the significance of this was more doubtful.