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Ramelteon, marketed as Rozerem by Takeda Pharmaceuticals North America, is the first in a new class of sleep agents that selectively binds to the MT1 and MT2 receptors in the suprachiasmatic nucleus (SCN), instead of binding to GABAA receptors, such as with drugs like zolpidem, eszopiclone, and zaleplon. Ramelteon is approved by the U.S. Food and Drug Administration (FDA) for long-term use. Ramelteon does not show any appreciable binding to GABAA receptors, which are associated with anxiolytic, myorelaxant, and amnesic effects. ==Medical uses== Ramelteon can be used for insomnia, particularly delayed sleep onset. Ramelteon has not been shown to produce dependence and has shown no potential for abuse, and the withdrawal and rebound insomnia that is typical with GABA modulators is not present in ramelteon. Some clinicians also use ramelteon for the treatment of Delayed sleep phase syndrome. Ramelteon was recently found to significantly reduce delirium in hospitalized at-risk patients. This multicenter prospective, blinded, randomized, placebo-controlled study found that "Ramelteon was associated with a lower risk of delirium (3% vs 32%; P = .003)". A systematic review, published in 2014, concluded "ramelteon was found to be beneficial in preventing delirium in medically ill individuals when compared to placebo." In a double-blind multicenter trial, ramelteon did reduce the time to fall asleep by approximately 15–20 minutes after four weeks compared to placebo (approx. 29-32 versus 48 minutes) Total sleep time improved about 40 minutes, however, this was identical to improvement with placebo at the end of trial. Subjective reported sleep time was greater in ramelteon treated persons. Ramelteon, when compared to placebo, had a much faster onset of effects: one or two weeks. However, the effects were roughly equivalent to placebo at four weeks. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「ramelteon」の詳細全文を読む スポンサード リンク
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