SLEEP ALL NIGHT

The most commonly  sleep medications that needs to be prescribed consists of two classes of sedative-hypnotic drugs: 

• benzodiazepines and
• non-benzodiazepine, benzodiazepine receptor agonists

In addition to these categories, a new medication, Ramelteon, under the brand name Rozerem, becames more widely available since 2006 that aids sleep with a unique mechanism of action.

Sleep medications covers the following prescription sleep medications:

• Benzodiazepines
• Non-Benzodiazepine Sleep Aids
• Rozerem (melatonin receptor agonists)
• Antidepressants as Sleep Aids

Benzodiazepines Sleep Aids:

Although all of the benzodiazepines are used for the treatment of insomnia, the first 5 in the list are used most commonly for sleep disorders

• Dalmane (Flurazepam)
• Doral (Quazepam)
• Halcion (Triazolam)
• ProSom (Estazolam)
• Restoril (Temazepam)
• Klonopin (Clonazepam)
• Ativan (Lorazepam)
• Xanax (Alprazolam)

Non-Benzodiazepine Sleep Aids

In recent years, a newer class of medications has been developed often termed the “non-benzodiazepine, benzodiazepine receptor agonists”:

• These newer medications appear to have better safety profiles and less adverse effects.
• These medications are associated with a lower risk of abuse and dependence than the benzodiazepines.
• Examples of medications in this class include:

• These medications are known to reduce the time it takes to fall asleep
• Their effects are quite similar to those in the benzodiazepine class
• These medicines appear to have different characteristics and may be used in different ways.
• Consult your family doctor

Rozerem

• Rozerem (Ramelteon) is a prescription insomnia medication that was approved by the FDA in July 2005
• Rozerem has a unique mechanism of action – melatonin receptor agonist.
• It selectively targets specific receptors in the brain that are responsible for controlling the body’s sleep-wake cycle
• It works by mimicking melatonin, a naturally occurring hormone that is produced during the sleep period
• Rozerem has been shown to be safe in older adults, as well as those with mild-to-moderate chronic obstructive pulmonary disease (COPD) and mild-to-moderate sleep apnea.

Antidepressants as Sleep Aids (By: William Deardorff, PhD, ABPP)

• Depression is a common occurrence in a chronic pain condition, and insomnia is quite common in depression
• If the individual with chronic pain is also experiencing clinical depression, treating the depression with psychological treatment and an appropriate antidepressants (antidepressant medication), may also help with the sleep disruption as well as other symptoms of depression.
• The sedating antidepressants most commonly used to help with sleep include Trazodone (Desyrel), Amitriptyline (Elavil), and Doxepin (Sinequan).

Last update Dec 4, 2009