Insomnia Drugs / Medications

There are several different types of medications available for the treatment of insomnia:

Sedative-Hypnotic Medications:

Hypnotic medications are the most popular drug of choice for insomniacs. These Food and Drug Administration (FDA) approved medications can be further divided into five benzodiazepine compounds (Valium-like drugs) and three non-benzodiazepine compounds. Before prescribing a hypnotic, your physician will want to consider whether the insomnia is secondary to a medical condition or depression, whether it is related to transient stressors, or whether there are environmental factors that can be modified being drug administration begins.

Benzodiazepine hypnotics work through their actions at a specific neurotransmitter receptor site (part of the GABA receptor complex). These hypnotic medications are all rapidly absorbed after being administered. These medications have the potential of being highly habit forming. The 5 benzodiazepine hypnotics that are FDA approved are Dalmane (Generic name = flurzepam), Doral (quazepam), Halcion (triazolam), ProSom (estazolam) and Restoril (temazepam).

Non- benzodiazepine hypnotic medications work through their action on one of the subtypes of the GABA-benzodiazepine receptors. The three medications that have received FDA approval are Ambien (zolpidem tartrate), Sonata (zaleplon) and Lunesta (eszopiclone). All three of these medications have been found to be safe and effective in the treatment of insomnia.

Over the Counter Medications:

The majority of over the counter insomnia medications contain antihistamine agents. Antihistamines have a powerful sedating action on the body. However they also carry certain side effects. They can cause impairment in perception ability, psychomotor skills and visual impairment, even leading in to the next day. Further adverse effects can include dry mouth, dry eyes, confusion and urinary retention.

Sedating Anti-depressants:

In patients where the physician has determined that insomnia is secondary to depression, sedating anti-depressants may be used to improve sleep as the underlying mood or anxiety disorder improves.

Several new drugs have excited researchers with their sleep inducing ability. Although these are yet to gain FDA approval they are well worth keeping an eye on. Perhaps the one with the most promise is a drug known as Estorra. Research results have indicated that Estorra not only helped subject get a better night’s sleep, it also helped them function better during the day. This dual effect has never been exhibited before in a sleep inducing medication. Unlike some other hypnotics, Estorra also showed no signs of losing it’s effectiveness over time. The effects after six months were virtually the same as after one week (Krystal, A. Sleep, Nov. 1, 2003; vol 26).