Ramelteon: Efficacy and Abuse Potential

Ramelteon (Rozerem) became available for treatment of insomnia during the past year. Most of the widely prescribed hypnotic drugs are benzodiazepines or other benzodiazepine-receptor–agonists. In contrast, ramelteon is a melatonin-receptor–agonist and is thought to be nonaddictive.

In a partially manufacturer-sponsored, randomized crossover trial, researchers at Johns Hopkins used a previously published method to assess potential for abuse with ramelteon. Fourteen people with histories of sedative abuse were admitted to a clinical research unit and received a different medication each morning: ramelteon in one of three large doses, triazolam (a benzodiazepine hypnotic) in one of three doses, or placebo. Subjects were able to distinguish tria…