Compositions comprising alprazolam for treating primary insomnia and insomnia associate with anxiety states and process for preparing them

Abstract

Disclosed is a composition comprising alprazolam for treating primary insomnia and insomnia associated with anxiety states and the corresponding use and method comprising the administration of alprazolam sublingual tablets having a disintegration time lower than 30 seconds and having the alprazolam preferably in non-crystalline or partially crystalline form according to the X-ray diffraction crystallography expanded for the position delta 9-12.5 (2 theta), to a patient suffering from said disorder. There is also disclosed a method for preparing a composition according to the invention, where the alprazolam is solved in a pharmaceutical acceptable solvent and a binder, preferably polyvinylpyrrolidone, is incorporated to the solution. A pre-made mixture of part of the cross-linked carboxymethyl-cellulose and the rest of the ingredients of the composition is impregnated with the solution and is dried and grinded, and is added to the rest of the cross-linked carboxymethyl-cellulose and the flavoring additives, being then mixed and compressed.

Description

FIELD OF THE INVENTION[0001]The present invention refers to a method for treating patients suffering from primary insomnia and insomnia associated with anxiety states and a sublingual pharmaceutical composition containing alprazolam as the active principle useful for the treatment of primary insomnia and insomnia associated with anxiety states. The invention also describes the elaboration procedure of the composition and the features of the obtained sublingual or oral tablets. The invention further refers to the use of alprazolam and / or a composition comprising alprazolam for the manufacture of a medicament for the treatment of primary insomnia by sublingual administration.BACKGROUND ART[0002]Sleeping is a physiological process which is controlled by two biological processes, the homeostatic mechanism and the circadian rhythm. Most adults need about eight hours average of sleeping each night, on a regular basis, in order to feel rested and alert during the daytime. Any change in thi...

AI Technical Summary

Benefits of technology

[0030]Consequently, a major object of the present invention is to provide a pharmaceutical form for oral administration, preferably sublingual, of alprazolam, of rapid disintegration, rapid start of therapeutic action in the treatment of primary insomnia or associated with anxiety states and not having the disadvantages of benzodiazepines.

[0031]Another object of the present invention is to provide a form of administration of alprazolam for the treatment of primary insomnia or associated with anxiety states, which reduces to its minimum expression or avoids the first step of liver metabolism.

[0040]Another objet of the invention is to provide a new use of a composition of alprazolam for the manufacture of a pharmaceutical composition according to the invention for treating anxiety states and for preventing panic attack.

[0041]Surprisingly, it has been found that it is possible to obtain small size and weight tablets containing small doses of alprazolam homogeneously distributed and having a disintegrating time that can be preferably lower than 1 minute, more preferably lower than 30 seconds, and still more preferably lower than 15 seconds and having desired solubility and bioavailability characteristics which allow for rapid start of action. Particularly, said tablets have shown to be effective in the treatment of primary insomnia or associated with anxiety states. In the short-time treatment of insomnia associated with anxiety states as will be described in more detail with respect to embodiment examples, alprazolam administered in sublingual tablets according to the present invention showed to be efficient in more than 90% of the patients who used it. Alprazolam sublingual tablets were clinically shown to be more efficient than oral tablets with the same alprazolam content, in reducing latency time in insomnia, in statistically significant terms.

Problems solved by technology

Any change in this routine disrupts the delicate balance between two processes that interact to regulate sleeping.

This precludes the recovery that the body needs during the nighttime rest, the possible consequences being daytime somnolence, low concentration, tiredness and disability to feel active during the day.

A study by the National Sleep Foundation of the United States in 2002 reported that 74% of American adults experiment problems in sleeping several nights a week or more, 39% sleep less than seven hours per night and 37% exhibit somnolence during the daytime, thus interfering with their daily activities.

Despite that the consequences associated with chronic insomnia remain debatable, the following associations have been noted:increased risk of mortality is associated with short sleep lengths;insomnia is the best predictor of the future development of depression;catastrophic worry about the consequences of not sleeping is is common among patients with chronic insomnia and serves to maintain the sleep disturbance;increased risk exists of developing anxiety, alcohol and drug use disorders, and nicotine dependence;poor health and decreased activity occur;

Additionally, the chronic and wrong use of these compounds, i.e. without medical monitoring, has lead to physical and psychological dependence in some cases.

However, many benzodiazepines have side effects which limit their usefulness in certain populations of patients.

These problems include synergism with other CNS depressants (especially alcohol), development of tolerance with dose repetition, dependence, withdrawal, insomnia rebounding after dosing discontinuation, the effects of hang over the next day and weakening of psycho-motor functioning and memory.

When benzodiazepines are used, some of their effects are desired with respect to the specific disorder treated, but others are considered side effects.

Even at the dose levels used, for example against insomnia, the sedative effect of benzodiazepines may be a great disadvantage.

However, it has not yet been approved for use in the short-term treatment of insomnia, neither in the United States nor in Europe.

In addition, at commercial scale, the procedure described therein has presented frequent practical problems of agglomeration during granulation.

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