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Insomnia: drug treatment.

W F Tsoi1

  • 1Department of Psychological Medicine, National University of Singapore.

Annals of the Academy of Medicine, Singapore
|March 1, 1991
PubMed
Summary

This review updates on hypnotics for insomnia, emphasizing short-term use and the shift from barbiturates to benzodiazepines. New hypnotics and long-term alternatives are also discussed.

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Area of Science:

  • Pharmacology
  • Sleep Medicine

Background:

  • Insomnia is a symptom requiring evaluation before medication.
  • Hypnotics offer short-term relief for sleep disturbances.

Purpose of the Study:

  • To review and update current knowledge on hypnotic medications.
  • To discuss the mechanisms, effects, and drawbacks of traditional and newer hypnotics.

Main Methods:

  • Literature review of hypnotic drug classes.
  • Analysis of pharmacokinetic and pharmacodynamic properties.
  • Comparison of efficacy and side effect profiles.

Main Results:

  • Benzodiazepines have largely replaced barbiturates due to safety.
  • Benzodiazepines affect sleep architecture and have side effects like tolerance and dependence.
  • Newer hypnotics (quazepam, zopiclone, zolpidem) aim to mitigate drawbacks.
  • Antipsychotics, antidepressants, and antihistamines are options for long-term management.

Conclusions:

  • Short-term hypnotic therapy is recommended.
  • Careful patient evaluation is crucial for effective insomnia management.
  • Long-term insomnia may require non-hypnotic pharmacotherapies.

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