Trouble sleeping? If so, your doctor may be just as likely as ever to order the world's most popular prescription sleep medication, Halcion, despite the surprise move by the British government Wednesday to ban the drug because of safety concerns.
Many sleep specialists and internists in Maryland said yesterday that the growing debate over Halcion's safety reflects an overreaction to scattered reports of adverse reactions, and they clung to the belief that the drug is safe if used properly.
"It's a very effective medication that we've used for years without complications," said Dr. Richard Allen, co-director of the Johns Hopkins sleep disorders center. "It's a hysterical reaction. It's ridiculous."
"I admit there's a controversy, but it's not a controversy based on scientific reports," said Dr. Thomas Hobbins, director of the Maryland Sleep Disorders Center in Towson. "The drug works, and it's helpful when used properly."
The British Health Ministry took action against Halcion after it received 390 reports of adverse reactions, including depression and short-term amnesia. The agency said the drug appeared to be associated with a much higher frequency of psychiatric side effects than other drugs in its class.
In the United States, there have been scattered reports of Halcion users' erupting into aggressive and even violent behavior. Several years ago, a 57-year-old woman in Utah said she killed her mother while on Halcion, and she sued the drug's manufacturer, Upjohn, for damages. A judge dismissed criminal charges against her, and Upjohn settled with her for an undisclosed amount while emphatically denying that the drug was to blame.
But yesterday, many doctors here said large controlled trials showed the drug to be relatively safe, although they emphasized that Halcion is supposed to be taken for short periods of time -- two to six weeks, at most -- and preferably not every night.
Dr. Allen said some insomniacs have reported forgetting things in the morning after taking Halcion at bedtime. If that occurs, he said, reducing the dosage can prevent further occurrences of amnesia. He said he has never had a patient turn violent after taking Halcion.
Dr. Scott A. Spier, director of the psychiatric consultation service at Mercy Medical Center, said the amnesiac reactions are well known: Although this is uncommon, he said, some patients will wake up in the morning, go about their business and then forget what they did.
More than 7 million people in the United States take Halcion, making it the most commonly prescribed sleep medication. Many doctors consider it their first choice because its effects are short-lived, lasting four hours or so. Patients tend to wake up refreshed, not hung-over.
At the Giant pharmacy on Cradlerock Way in Columbia, pharmacist Chris Musser said consumers hadn't started calling with questions about the drug's safety, although she said she wouldn't be surprised if that happened in light of the publicity.
"Maybe in the next couple months we'll see a significant drop, but we're still filling them today and yesterday," Ms. Musser said.