Pharmacologic management of insomnia: past, present, and future.
Views on the etiology and morbidities associated with insomnia are evolving and affect clinicians' approach to the pharmacologic management of insomnia. Currently, benzodiazepine receptor agonists (BzRAs) and a single melatonin receptor agonist are recognized as safe and efficacious hypnotics. Variability in BzRAs, pharmacokinetics, and manipulation of dose provide clinicians with options that meet the needs of most patients. Other drugs (eg, sedating antidepressants) also are used commonly in clinical practice to treat insomnia, but evidence is lacking to support this most cases. Improvement in managing insomnia will result from systematic research with these drugs, with drugs in development, and with novel uses, such as co-therapy.
Curry
Denise Troy
DT
Sleep Medicine and Research Center, St John's Mercy Medical Center and St Luke's Hospital, Chesterfield, MO 63017, USA.
Eisenstein
Rhody D
RD
Walsh
James K
JK
D004358:Drug Therapy / Q000639:trends*; D005544:Forecasting; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007192:Indenes / Q000627:therapeutic use; D008517:Phytotherapy / Q000379:methods; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000628:therapy*
D006993:Hypnotics and Sedatives; D007192:Indenes; C495910:ramelteon