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November 1984

Is Drug Treatment of Night Terrors Warranted?

Am J Dis Child. 1984;138(11):1086. doi:10.1001/archpedi.1984.02140490086028

Sir.—A recent report1 on the drug treatment of night terrors (also called pavor nocturnus) in children concluded that "Midazolam regularizes and balances the sleep stages and, being very well tolerated, it can be used in the treatment of night terrors in children of all ages." Pediatricians should be aware that there is an increasing number of reports suggesting that night terrors should be treated with drugs. However, there are no data that this benzodiazepine (midazolam), diazepam,2 flurazepam hydrochloride,3 bromazepam,4 amitriptyline hydrochloride,5 or imipramine hydrochloride6,7 is indicated for the night terrors commonly encountered in pediatric practice. Most of these drug studies are nonblinded therapeutic trials involving only a few adult or pediatric patients who also had psychiatric or neurologic problems. Also, we have encountered pediatricians who occasionally use phenobarbital to treat night terrors without appreciating the sleep disturbances produced by this drug.8