Radioimmunoassay for nitrazepam in plasma.

A radioimmunoassay (RIA) has been developed for the determination of therapeutic levels of the widely used hypnotic and anticonvulsant agent nitrazepam directly in 10 μl samples of plasma. The antiserum to nitrazepam, which was obtained following immunization of rabbits with an albumin conjugate of 3-hemisuccinyloxy-nitrazepam, does not cross-react with its major metabolites 7-amino-nitrazepam and 7-acetylamino-nitrazepam. The specificity of the RIA has been validated by comparison with a high-pressure liquid chromatographic procedure in the determination of intact nitrazepam in plasma following oral administration of 5 and 10 mg of the drug to man. The RIA intra- and inter-assay coefficients of variation did not exceed 7 and 9.5%, respectively. The RIA has a limit of sensitivity of 4 ng/ml using 10 μl of plasma and is ideally suited for routine clinical monitoring of nitrazepam in epileptic patients who are not receiving other benzodiazepines and for detailed pharmacokinetic and bioavailability studies in pediatric or geriatric patients from whom relatively small blood specimens are available.     

Increased sensitivity to nitrazepam in old age.

The effects of a single 10 mg oral dose of nitrazepam were compared with those of a placebo in healthy young and old people. Both the young and the elderly slept better on three successive nights after nitrazepam but they felt less awake at 12 and 36 hours (P less than 0-01). Elderly people made significantly more mistakes in a psychomotor test than did the young, despite similar plasma concentrations of nitrazepam and half lives in the two groups. This difference in response to psychomotor testing is probably explained by an increased sensitivity of the ageing brain to the action of nitrazepam.