Table 1.
FDA approved medications for the treatment of insomnia.
| Generic name | Therapeutic indication | Dosage (mg) | Known side effects | Mechanism of action | |
|---|---|---|---|---|---|
| BENZODIAZEPINE RECEPTOR AGONISTS | |||||
| BDZs | Estazolam | Insomnia | 0.5–2 | Dizziness, drowsiness, next day sedation, memory loss, anxiety, loss of coordination. | Positive allosteric modulator of GABAA receptors |
| Quazepam | 7.5–15 | Rebound insomnia. | |||
| Allergic reactions. | |||||
| Triazolam | 0.125–0.50 | Complex sleep related behaviors: sleep-driving, making phone calls, eating. | |||
| Flurazepam | 15–30 | Abnormal thoughts and behavior: worsening of depression, suicidal thoughts or actions, increased aggressiveness. | |||
| Temazepam | 7.5–30 | ||||
| NonBDZs | Zaleplon | Sleep-onset insomnia | 2.5–10 | Dizziness, headache, drowsiness, nausea, vomiting. | |
| Zolpidem | Sleep-onset and sleep maintenance insomnia | 5–20 | Complex sleep related behaviors. | ||
| Abnormal thoughts and behavior. | |||||
| Eszopiclone | 1–3 | Physical dependence. | |||
| SEDATING ANTIDEPRESSANTS | |||||
| Doxepin | Sleep-maintenance insomnia | 3–6 | Sedation, nasopharyngitis, gastrointestinal effects, hypertension. | 5-HT & NE reuptake inhibitor H1 receptor antagonist | |
| Complex sleep related behaviors. | |||||
| Abnormal thoughts and behavior. | |||||
| MELATONIN RECEPTOR AGONISTS | |||||
| Ramelteon | Sleep-onset insomnia | 8 | Drowsiness, tiredness, dizziness. Allergic reactions. | MT1 & MT2 receptor agonist | |
| Complex sleep related behaviors | |||||
| Abnormal thoughts and behavior. | |||||
| Hormone effects: decreased interest in sex, problems getting pregnant. | |||||
All information was obtained from the FDA website (www.fda.gov). Abbreviations: BDZs, benzodiazepines; 5-HT, serotonin; NE, norepinephrine; H, histamine; MT, melatonin.