Sedating antidepressants insomnia treatment
Sedative-hypnotics include nonbenzodiazepine receptor agonists (zaleplon, zolpidem, eszopiclone); short-acting benzodiazepine receptor agonists (triazolam); intermediate-acting benzodiazepine receptor agonists (estazolam, temazepam); and selective melatonin agonists (ramelteon).Both eszopiclone and sustained-release zolpidem are effective for both sleep-onset and sleep-maintenance insomnia, with a reduced abuse potential and long-term efficacy of up to 6 months as compared with nonselective benzodiazepine receptor agonists.
Insomnia may be viewed as both a symptom and a syndrome.
Short-acting (eg, triazolam) and intermediate-acting (eg, estazolam, temazepam) benzodiazepine receptor agonists are useful for sleep-onset insomnia.
These agents have been the hypnotics of choice for many years because of their relative safety compared with the barbiturates, as well as their low cost.
The sedating antidepressants most commonly used to help with sleep include Trazodone (Desyrel), Amitriptyline (Elavil), and Doxepin (Sinequan).
It should be noted that when these medications are used for sleeping and pain relieving properties, it is in much lower doses than when used in the treatment of depression.
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The older sedative-hypnotics that have a prolonged half-life increase the risk for next-day sedation and daytime psychomotor impairment and pose an increased risk for abuse and dependence.