Drugs for Chronic Insomnia
January 9, 2023 (Issue: 1667)
Cognitive behavioral therapy for insomnia (CBT-I) is
recommended for initial treatment of chronic insomnia.
CBT-I includes stimulus control, sleep education
and hygiene, sleep restriction, relaxation training, and
cognitive therapy. When CBT-I...more
- EL Sutton. Insomnia. Ann Intern Med 2021; 174:ITC33. doi:10.7326/AITC202103160
- MJ Sateia et al. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 2017; 13:307. doi:10.5664/jcsm.6470
- F De Crescenzo et al. Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis. Lancet 2022; 400:170. doi:10.1016/s0140-6736(22)00878-9
- Low-dose sublingual zolpidem (Intermezzo) for insomnia due to middle-of-the-night awakening. Med Lett Drugs Ther 2012; 54:25.
- BD Brielmaier. Eszopiclone (Lunesta): a new nonbenzodiazepine hypnotic agent. Proc (Bayl Univ Med Cent) 2006; 19:54. doi:10.1080/08998280.2006.11928127
- T Roth et al. An evaluation of the efficacy and safety of eszopiclone over 12 months in patients with chronic primary insomnia. Sleep Med 2005; 6:487. doi:10.1016/j.sleep.2005.06.004
- FDA requires lower dosing of zolpidem. Med Lett Drugs Ther 2013; 55:5.
- FDA Drug Safety Communication: FDA approves new label changes and dosing for zolpidem products and a recommendation to avoid driving the day after using Ambien CR. May 14, 2013. Available at: https://bit.ly/3W1wrig. Accessed December 19, 2022.
- In brief: Lowering the dose of Lunesta. Med Lett Drugs Ther 2014; 56:48.
- N Gunja. In the zzz zone: the effects of z-drugs on human performance and driving. J Med Toxicol 2013; 9:163. doi:10.1007/s13181-013-0294-y
- N Gunja. The clinical and forensic toxicology of z-drugs. J Med Toxicol 2013; 9:155. doi:10.1007/s13181-013-0292-0
- JS Poceta. Zolpidem ingestion, automatisms, and sleep driving: a clinical and legal case series. J Clin Sleep Med 2011; 7:632. doi:10.5664/jcsm.1468
- Inhibitors and inducers of CYP enzymes, P-glycoprotein, and other transporters. Med Lett Drugs Ther 2021 October 20 (epub). Available at: medicalletter.org/downloads/CYP_PGP_Tables.pdf.
- BN Wikner et al. Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations. Pharmacoepidemiol Drug Saf 2007; 16:1203. doi:10.1002/pds.1457
- MJ Rapoport et al. Benzodiazepine use and driving: a meta-analysis. J Clin Psychiatry 2009; 70:663. doi:10.4088/jcp.08m04325
- B Albrecht et al. Benzodiazepine use and aggressive behaviour: a systematic review. Aust N Z J Psychiatry 2014; 48:1096. doi:10.1177/0004867414548902
- I Hernandez et al. Exposure-response association between concurrent opioid and benzodiazepine use and risk of opioid-related overdose in Medicare Part D beneficiaries. JAMA Netw Open 2018; 1:e180919. doi:10.1001/jamanetworkopen.2018.0919
- FDA Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. August 31, 2016. Available at: http://bit.ly/3UInBW8. Accessed December 19, 2022.
- S Grigoriadis et al. Pregnancy and delivery outcomes following benzodiazepine exposure: a systematic review and meta-analysis. Can J Psychiatry 2020; 65:821. doi:10.1177/0706743720904860
- ACOG Committee on Practice Bulletins—Obstetrics. ACOG practice bulletin: clinical management guidelines for obstetrician-gynecologists number 92, April 2008 (replaces practice bulletin number 87, November 2007). Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol 2008; 111:1001. doi:10.1097/aog.0b013e31816fd910
- C Roch et al. Nonclinical pharmacology of daridorexant: a new dual orexin receptor antagonist for the treatment of insomnia. Psychopharmacology (Berl) 2021; 238:2693. doi:10.1007/s00213-021-05954-0
- Suvorexant (Belsomra) for insomnia. Med Lett Drugs Ther 2015; 57:29.
- Lemborexant (Dayvigo) for insomnia. Med Lett Drugs Ther 2020; 62:97.
- Daridorexant (Quviviq) for insomnia. Med Lett Drugs Ther 2022; 64:107.
- A Kuriyama et al. Ramelteon for the treatment of insomnia in adults: a systematic review and meta-analysis. Sleep Med 2014; 15:385. doi:10.1016/j.sleep.2013.11.788
- AD Krystal et al. Efficacy and safety of doxepin 3 and 6 mg in a 35-day sleep laboratory trial in adults with chronic primary insomnia. Sleep 2011; 34:1433. doi:10.5665/sleep.1294
- MH Wiegand. Antidepressants for the treatment of insomnia: a suitable approach? Drugs 2008; 68:2411. doi:10.2165/0003495-200868170-00001
- WB Mendelson. A review of the evidence for the efficacy and safety of trazodone in insomnia. J Clin Psychiatry 2005; 66:469. doi:10.4088/jcp.v66n0409
- EDA Hermes et al. Use of second-generation antipsychotic agents for sleep and sedation: a provider survey. Sleep 2013; 36:597. doi:10.5665/sleep.2554
- SL Anderson and JP Vande Griend. Quetiapine for insomnia: a review of the literature. Am J Health Syst Pharm 2014; 71:394. doi:10.2146/ajhp130221
- T Atkin et al. Drugs for insomnia beyond benzodiazepines: pharmacology, clinical applications, and discovery. Pharmacol Rev 2018; 70:197. doi:10.1124/pr.117.014381
- In Brief: Respiratory depression with gabapentinoids. Med Lett Drugs Ther 2020; 62:81.
- C Fox et al. Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. J Am Geriatr Soc 2011; 59:1477. doi:10.1111/j.1532-5415.2011.03491.x
- SL Gray et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med 2015; 175:401. doi:10.1001/jamainternmed.2014.7663
- S Tordjman et al. Melatonin: pharmacology, functions, and therapeutic benefits. Curr Neuropharmacol 2017; 15:434. doi:10.2174/1570159x14666161228122115
- LAE Erland and PK Saxena. Melatonin natural health products and supplements: presence of serotonin and significant variability of melatonin content. J Clin Sleep Med 2017; 13:275. doi:10.5664/jcsm.6462
- AB Dollins et al. Effect of inducing nocturnal serum melatonin concentrations in daytime on sleep, mood, body temperature, and performance. Proc Natl Acad Sci USA 1994; 91:1824. doi:10.1073/pnas.91.5.1824
- AL Lopresti et al. An investigation into an evening intake of a saffron extract (affron) on sleep quality, cortisol, and melatonin concentrations in adults with poor sleep: a randomized, double-blind, placebo-controlled, multidose study. Sleep Medicine 2021; 86:7. doi:10.1016/j.sleep.2021.08.001
- DM Taibi et al. A systematic review of valerian as a sleep aid: safe but not effective. Sleep Med Rev 2007; 11:209. doi:10.1016/j.smrv.2007.03.002
- J Sarris and GJ Byrne. A systematic review of insomnia and complementary medicine. Sleep Med Rev 2011; 15:99. doi:10.1016/j.smrv.2010.04.001
- KA Carter et al. Common sleep disorders in children. Am Fam Physician 2014; 89:368.
- AW Buckley et al. Practice guideline: treatment for insomnia and disrupted sleep behavior in children and adolescents with autism spectrum disorder: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2020; 94:392. doi:10.1212/wnl.0000000000009033
- NL Phillips et al. Behavioral interventions for sleep disturbances in children with neurological and neurodevelopmental disorders: a systematic review and meta-analysis of randomized controlled trials. Sleep 2020; 43:zsaa040. doi:10.1093/sleep/zsaa040
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