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Types Of Medications Used In The Treatment Of Insomnia - Part 1 Sedative-Hypnotic Medications ("Sleep Medications") are medicines that have been shown to reduce the length of time it takes to fall asleep and/or increase sleep duration. These medicines are usually taken at bedtime to relieve the symptoms of insomnia, although some newer medications may be appropriate for use on an "as needed" basis, whenever symptoms occur. The sedative-hypnotic medicines that have been approved by the United States Food and Drug Agency (FDA) have undergone rigorous testing in clinical trials, and have been shown to be safe and effective.
There are different classes of sedative-hypnotic medications. However, most of these medicines fall into a class of drugs known as benzodiazepines, or into a newer class of drugs known as "non-benzodiazepine, benzodiazepine receptor agonists." The benzodiazepines approved for the treatment of insomnia include: •Dalmane (flurazepam) •Doral (quazepam) •Halcion (triazolam) •Prosom (estazolam) •Restoril (temazepam) The benzodiazepines were formerly the most commonly used treatment for insomnia. However, concerns regarding patterns of inappropriate use (abuse), dependence, adverse effects such as impairments in memory or movement, and next-day "hangover" led to caution in prescribing these medications. While many people continue to use these medications without problems, the benzodiazepines are no longer the "first line" treatment for insomnia. Within recent years, physicians have been much more likely to prescribe treatment with newer drugs in the "non-benzodiazepine, benzodiazepine receptor agonist" class that seem to have better safety profiles. The "non-benzodiazepine, benzodiazepine receptor agonists" include: •Zolpidem (Ambien) •Zaleplon (Sonata) Zolpidem and zaleplon are known to reduce the time it takes to fall asleep, and in this regard their effects are probably quite similar. Zolpidem has effects that persist later into the night, and may help the sufferer stay asleep longer. The different characteristics of these medications mean that they may be used in different ways. Zolpidem must be taken at bedtime, and may be used when the sleeper has difficulty falling asleep and/or staying asleep. Zaleplon may be taken at bedtime or later (e.g., after getting into bed and having difficulty falling asleep or after a nighttime awakening), as long as there are four hours or more of time left to sleep. The usual starting doses of zolpidem and zaleplon are 5 mg (elderly) and 10 mg (adult). Many elderly patients may use higher doses (e.g., 10 mg). |
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