Table 1.

Specificity of Insomnia Therapies

Treatment	Pharmacologic Specificity	Specificity of Effect on Brain Function	Target
Suvorexant	Highly Specific	Highly Specific	Antagonism of Orexin receptors
Doxepin 3–6 mg	Highly Specific	Highly Specific	Antagonism of H1 Histamine receptors
Prazosin	Highly Specific	Highly Specific	Antagonism of α1 Adrenergic receptors
Ramelteon	Highly Specific	Highly Specific	Agonism of Melatonin M1/M2 receptors
Benzodiazepines	Highly Specific	Non-Specific	Binding to Benzo binding site on GABA-A Receptor Complex leads to broad CNS inhibition
Non-Benzodiazepines	Highly Specific	Non-Specific	Binding to Benzo binding site on GABA-A Receptor Complex leads to broad CNS inhibition
Antidepressants	Non-Specific	Non-Specific	Antagonism of 5HT and NE Transporters, 5HT2, α1, Adrenergic, H1 Histaminergic, and Muscarinic Cholinergic antagonism
Antipsychotics	Non-Specific	Non-Specific	Dopamine D2, Dopamine D1, 5HT2, α1, Adrenergic, H1 Histaminergic, and Muscarinic Cholinergic antagonism
OTC “Antihistamines”	Non-Specific	Non-Specific	Antagonism of H1 Histamine receptors and Cholinergic Receptors