Insomnia - Medications

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What medications are used to treat insomnia?

The main classes of medications used to treat insomnia are the sedatives and hypnotics, such as the benzodiazepines and the non-benzodiazepine sedatives.

Several medications in the benzodiazepine class have been used successfully for the treatment of insomnia, and the most common ones include:

  • quazepam (Doral),
  • triazolam (Halcion),
  • estazolam (ProSom),
  • temazepam (Restoril),
  • flurazepam (Dalmane), and
  • lorazepam (Ativan).

Another common benzodiazepine, diazepam (Valium), is typically not used to treat insomnia due to its longer sedative effects.

Non-benzodiazepine sedatives are also used commonly for the treatment of insomnia and include most of the newer drugs. Some of the most common ones are:

  • zaleplon (Sonata),
  • zolpidem (Ambien or Ambien CR [note that as of January 1, 2014 the FDA changed the recommended dosage and precautions], Zolpimist, Intermezzo), and
  • eszopiclone (Lunesta).

Melatonin, a chemical released from the brain which induces sleep, has been tried in supplement form for treatment of insomnia as well. It has been generally ineffective in treating common types of insomnia, except in specific situations in patients with known low levels of melatonin. Melatonin may be purchased over-the-counter (without a prescription).

Ramelteon (Rozerem), which is an insomnia drug that acts by mimicking the action of melatonin, is a newer drug. It has been used effectively in certain groups of patients with insomnia.

There are also other medications that are not in the sedative or hypnotic classes, which have been used in the treatment of insomnia. Sedative antihistamines, diphenhydramine (Benadryl) have been used as sleep aids because of their sedative effects; however, this is not a recommended use of these or other similar drugs due to many side effects and long-term drowsiness the following day.

Some anti-depressants (for example, trazodone [Desyrel], amitriptyline [Elavil, Endep], doxepin [Sinequan, Adapin]) can be used effectively to treat insomnia in patients who also may suffer from depression. Some anti-psychotics have been used to treat insomnia, although their routine use for this purpose is generally not recommended.

A doctor or sleep specialist is the best person to discuss these different medications, and to decide which one may be the best for each specific individual. Many of these drugs have a potential for abuse and addiction and need to be used with caution. None of these medications may be taken without the supervision of the prescribing physician.

Return to Insomnia

See what others are saying

Comment from: Fat Controller, 45-54 Male (Patient) Published: March 20

I have had chronic insomnia for over 15 years. At the time I was a metropolitan passenger train driver. Two years into my insomnia, after trying a broad range of medications including a host of anti-depressants, of which none worked. I was on an early morning train run when I "grayed out" arriving at the destination station and had a low speed collision with the train in front of me. As a result of this I was sent to a neurologist and he prescribed Surmontil (anti-depressant) and it was a wonder drug for me. From the very first night of taking this I slept like a baby. That was 13 plus years ago and now I find that Surmontil is no longer available and I have to try with the help of my doctor to find a new drug. It's not going to be easy; I tried the first 1 last night and managed only 2 hours sleep. I am now a Train Controller with more regular hours than when I was driving but if a solution isn"t found then I may have to quit.

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