Medications for Insomnia

Hypnotics

Common names include:

• Zaleplon]]> (Sonata)
• ]]>Zolpidem]]> (Ambien)
• ]]>Triazolam]]> (Halcion)
• ]]>Estazolam]]> (ProSom)
• ]]>Temazepam]]> (Restoril)
• ]]>Eszopiclone]]> (Lunesta)
• ]]>Ramelteon]]> (Rozerem)

Hypnotics, or sedatives, are drugs that cause relaxation and help induce and maintain sleep. They affect chemicals in the brain that may be out of balance and causing the insomnia. These drugs are for short-term use. In any situation where long-term use is required, use should be closely monitored by your doctor. These drugs can react with other drugs you may be taking. Before starting a hypnotic, tell your doctor about any and all drugs (including herbs and natural supplements) you are taking. Do not take any medications unless your doctor approves them.

Before using these drugs, you should tell your doctor if you have any of the following conditions:

• Drug allergies
• History of ]]>drug]]> or ]]>alcohol addiction]]>
• ]]>Depression]]> or suicidal thoughts
• Liver disease
• Kidney disease
• ]]>Asthma]]> , ]]>bronchitis]]> , ]]>emphysema]]> , or other lung diseases
• ]]>Myasthenia gravis]]>
• ]]>Sleep apnea]]> (stopping breathing for short periods while asleep)
• Presently are pregnant or are trying to become pregnant

These medications will make you sleepy and perhaps dizzy. When taking one of these drugs, use the following guidelines:

• Use caution while driving, operating machinery, or doing any hazardous activities.
• Take the medication with a full glass of water and just before going to bed.
• Do not drink alcohol while taking hypnotics.
• Do not take this medication unless you are able to get adequate rest before you must become active again.
• Do not stop taking the drug suddenly if you have been taking it for several days or longer.

Possible side effects include:

• Allergic reaction (swelling of the face or mouth, difficulty breathing, rash)
• Hallucinations, strange behavior, or severe confusion
• Suicidal thoughts
• Changes in your vision
• Drowsiness, dizziness, or clumsiness
• Amnesia (loss of memory)
• Sores in the mouth and throat
• Yellowing of the skin and eyes
• ]]>Depression]]>
• Fatigue
• Nausea, vomiting, ]]>diarrhea]]> , or ]]>constipation]]>
• Vivid dreams
• ]]>Headache]]>
• Unpleasant taste
• Rebound insomnia when the medication is suddenly stopped (except with ramelteon)

Sedating Antidepressants

Common names include:

• Amitriptyline]]> (Elavil)
• ]]>Doxepin]]> (Sinequan)
• ]]>Trimipramine]]> (Surmontil)
• ]]>Nefazodone]]>
• ]]>Trazodone]]> (Desyrel)
• ]]>Mirtazapine]]> (Remeron)

Sedating antidepressants work by treating the underlying depression that may be the cause of the insomnia, while at the same time having a sedative effect. They have not been found to be effective in people with insomnia who are not depressed. While there are many medications for depression, sedating antidepressants are effective in treating people who have both insomnia and depression.

Before starting an antidepressant, tell your doctor about any and all drugs (including herbs and natural supplements) you are taking. Do not take any medications unless your doctor approves them.

Before using these drugs, you should tell your doctor if you have any of the following conditions:

• Any drug allergies
• Liver disease
• Kidney disease
• Asthma
• ]]>Glaucoma]]> , or pressure inside the eye
• ]]>Diabetes]]>
• Enlarged prostate, bladder problems, or difficulty urinating
• Thyroid disease
• High or low blood pressure or any heart problems
• Stomach or intestinal problems
• Pregnancy or breastfeeding
• ]]>Manic-depressive disorder]]>
• Blood problems

Take these medications with a full glass of water. Some of these medications may take four weeks or more before you feel its full therapeutic effect.

Possible side effects include:

• Allergic reaction (swelling of the face or mouth, difficulty breathing, rash)
• ]]>Seizures]]>
• Fast or irregular heart beat
• ]]>Heart attack]]>
• ]]>High blood pressure]]>
• Painful or inappropriate erections (trazadone)
• Yellowing of the skin and eyes
• Dry mouth and eyes
• Mild tremor or agitation
• Difficulty urinating
• Fever, with muscle stiffness or weakness
• Drowsiness, dizziness, or clumsiness
• Nausea or constipation

Antihistamine

Common medications include:

• Diphenhydramine]]> (Benadryl)
• ]]>Doxylamine]]> (Unisom)

An antihistamine is a medication that blocks an allergic reaction in the body. Because one of its side effects is drowsiness, it is sometimes used to induce sleep. This and any other over-the-counter sleep aid should be taken only with the approval of your doctor. It can be taken with or without food, and with a full glass of water. These drugs can react with other drugs you may be taking. Before starting an antihistamine, tell your doctor about any drugs you are taking.

Before using these drugs, you should tell your doctor if you have any of the following conditions:

• Glaucoma, or pressure inside the eye
• Stomach ]]>ulcer]]>
• Enlarged prostate, bladder problems, ordifficulty urinating
• ]]>Overactive thyroid]]>
• ]]>High blood pressure]]> or any heart problems
• Asthma

Possible side effects include:

• Dry mouth
• Sleepiness, fatigue, or dizziness
• Headache
• Difficulty urinating
• Constipation
• Blurred vision
• Delirium

When to Contact Your Doctor

Hypnotics and sedating antidepressants can have side effects. Call your doctor right away if you experience:

• Fast or irregular heart beat
• Chest pain or pressure
• Trouble breathing
• High blood pressure
• Yellowing of the skin and eyes
• Difficulty urinating

Many of these medications need to be tapered off when stopping them. Stopping your medication abruptly can lead to “rebound insomnia,” which worsens your condition. Talk your doctor before stopping your medication.