Pharmacologic Treatment of Insomnia

Insomnia is a common disorder causing difficulty in falling asleep or staying asleep, with associated daytime impairment. A multitude of medications have been used to treat insomnia including benzodiazepines, nonbenzodiazepines, a melatonin receptor agonist, sedating antidepressants, atypical antipsychotics and over-the-counter substances. These medicines vary in efficacy and side effect profile. Factors that need to be considered when deciding upon which drug to use include symptom pattern, cost, past treatment responses, comorbid conditions, and drug interactions. Research supports the efficacy of benzodiazepines, nonbenzodiazepines, and ramelteon; however, more studies need to be done to assess the usefulness of other classes of medication, long-term usage of hypnotics and the combination of drugs from various classes of medication.