{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:52:06Z","timestamp":1791276726647,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Benzodiazepines (BZDs) are associated with dependence, tolerance, withdrawal, and various adverse effects, and switching to other drug classes is often recommended. Although non\u2010BZD hypnotics are reported in package inserts to have similar but less frequent adverse events, real\u2010world patients often have complex psychiatric and medical backgrounds, and the actual frequency of subjective adverse events may differ substantially from that reported in package inserts. This study aimed to elucidate subjective symptoms potentially related to psychotropic medications using real\u2010world patient data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included patients at the Akebono Clinic who were taking a single hypnotic agent. A total of 314 patients were analyzed. Insomnia severity was assessed using the Athens Insomnia Scale, and 11 self\u2010reported adverse events were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The frequency of insomnia was 72% for non\u2010BZDs, 52% for BZDs, and 70% for dual orexin receptor antagonists (DORAs) (significantly lower for BZDs;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0036). Among the 11 self\u2010reported symptoms, two items (thirst and nightmares) were reported as \u201calways\u201d or \u201coften\u201d by more than 10% of patients; three items (constipation, head heaviness\/headache, and abnormal behavior during sleep) by 5%\u201310%; and four items (lightheadedness, vertigo, abdominal pain, and tremor) by 3%\u20135%. There were no differences in adverse\u2010event frequencies among non\u2010BZDs, BZDs, and DORAs. Multivariate analyses showed that adverse events were associated with female sex, age &lt;\u200960\u2009years, and schizophrenia, depression, and anxiety disorders, but not with hypnotic drug classes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subjective adverse events in patients taking hypnotics occurred more frequently than those reported in package inserts, indicating a clear discrepancy between controlled trial data and real\u2010world clinical experience. Because adverse events were more strongly associated with patient characteristics\u2014such as psychiatric comorbidities, physical conditions, and concomitant medications\u2014than with hypnotic drug class, routine assessment of subjective symptoms through interviews or questionnaires is essential in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/npr2.70162","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T03:20:17Z","timestamp":1787973617000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Self\u2010Reported Adverse Events in Psychiatric Outpatients Taking Hypnotics: Higher Real\u2010World Frequencies Than Those Listed in Package Inserts"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7966-9586","authenticated-orcid":false,"given":"Fumi","family":"Akasaka","sequence":"first","affiliation":[{"name":"Akebono Clinic  Ishinomaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5084-9107","authenticated-orcid":false,"given":"Kuni","family":"Akasaka","sequence":"additional","affiliation":[{"name":"Akebono Clinic  Ishinomaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutake","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Surgery Tokai University Hospital  Isehara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9247-1472","authenticated-orcid":false,"given":"Naohito","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Research Division Saiseikai Research Institute of Health Care and Welfare  Minatoku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Haruki","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Science Tokai University Hospital  Isehara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7800-3880","authenticated-orcid":false,"given":"Sotaro","family":"Sadahiro","sequence":"additional","affiliation":[{"name":"Akebono Clinic  Ishinomaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences\/Clinical Psychiatry","author":"Sadock B. 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