The Medical Letter on Drugs and Therapeutics
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Drugs for Insomnia

Pharmacological treatment of insomnia includes prescription drugs, non-prescription medications, and "natural" remedies. Behavioral approaches such as cognitive behavioral therapy, which are not discussed here, are also used. Pharmacologic treatment and behavioral therapy are often combined.

BENZODIAZEPINE RECEPTOR AGONISTS — Zolpidem (Ambien, and others), zaleplon (Sonata, and generics), and eszopiclone (Lunesta, and generics) are not structural benzodiazepines, but they bind to benzodiazepine receptors. All of them decrease sleep latency and are approved for use in patients with sleep-onset insomnia. Benzodiazepine receptor agonists differ mainly in their duration of action (see Table 1).

Zolpidem is the most widely prescribed hypnotic in the US. The FDA has required manufacturers of zolpidem to lower the recommended dose for women and to recommend consideration of ... more      

The Medical Letter is a subscriber-funded nonprofit organization that publishes critical appraisals of new prescription drugs and comparative reviews of drugs for common diseases.

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