Drugs for Treating Insomnia
Match the brand names in Section I with the generics in Section II
____1. Oleptro (Angelini Labopharm)
____2. Ambien (Sanofi-Aventis)
____3. Rozerem (Takeda Pharmaceuticals)
____4. Levate (Valeant Pharmaceuticals)
1.zolpidem 5mg 10mg; controlled release: 6.25mg, 12.5mg; sublingual:1.75mg, 3.5mg; solution: 5mg/ actuation
A imidazopyridine hypnotic that is related to benzodiazepines and interacts w/ GABA-benzodiazepine receptor complexes. Monitor for daytime sleepiness and respiratory depression. Zolpidem is recommended for use as short-term sleep aid. Monitor for abuse, dependence, or tolerance, with long-term use( requires evaluation for continued use) and central nervous system depression. Side effects include fatigue, blurred vision, headache, nausea, or dizziness., or behaviors that patient has no memory of performing after taking (e,g., driving, preparing food, or eating).
Next-morning impairment” is the main concern with zolpidem. The Food and Drug Administration recently issued a warning that patients who take the extended release formulation (CR) should not drive or engage in other actions that require complete mental alertness the day after taking zolpidem. Due to this concern, it is also recommended that the lowest effective dose of zolpidem should be used; higher doses may be more likely to impair next-morning activities.
2.trazodone 50mg, 100mg, 150mg, 300mg; 24 hour: 150mg, 300mg
An antidepressant whose exact mechanism is unknown but thought to inhibit the reuptake of serotonin and believed to cause subsensitization (reduced sensitivity due to chronic cellular changes) in 5-HT presynaptic adrenoreceptors. It should be initiated at lower doses and tapered slowly when discontinuation occurs. Monitor liver function prior to initiation, signs/symptoms of serotonin syndrome. Side effects may include hypotension, dizziness, constipation, and diarrhea. Assess for and report suicidal ideation or self-harming behaviors. Report priapism (sustained, painful erection).
A selective melatonin receptor agonist that binds to MT1 and MT2 receptors and induces sleep. Side effects may include fatigue, drowsiness, dizziness, menstrual irregularities, abnormal thinking patterns, and behavioral changes. Complex sleep-related behaviors also may occur, such as driving, food preparation, or making phone calls while asleep.
4.amitriptyline 10mg, 25,mg, 50mg, 75mg, 100mg, 150mg
A tertiary tricyclic antidepressant that increases synaptic concentration of serotonin and/or norepinephrine in the central nervous system through inhibition of reuptake by presynaptic neuronal membrane. Side effects include dizziness, hypotension, urinary retention, blurred vision, and constipation. Assess for suicidal tendencies or unusual changes in behavior. Monitor blood pressure and pulse rate during initial therapy. Monitor ECG in older adults and in patients who take higher doses of this medication or who have a history of cardiac disease. Avoid abrupt discontinuation.
Lexi-Comp Online, Hudson, Ohio:Lexi-Comp, Inc.; 2015.
Abimbola Farinde, PharmD is a healthcare professional who has gained experience in the field and practice of psychopharmacology/mental health, and geriatric pharmacy. She has worked with active duty soldiers with dual diagnoses of a traumatic brain injury and a psychiatric disorder providing medication therapy management and disease state management. Dr. Farinde has also worked with mentally impaired and developmentally disabled individuals. Dr. Farinde always strives to maintain a commitment towards achieving professional growth as she transitions from one phase of her career to the next.