[Managing insomnia in the elderly patient: from pharmacology to subthreshold depression]

Insomnia is the most common and widespread sleep disorder. Managing insomnia in the elderly patient becomes a difficult challenge for the presence of a multi-disease and multi-drug condition. An organic and functional background that becomes even more fragile when the picture is complicated by psychomotor agitation and cognitive impairment. From the contribution of four experts of different fields and disciplines, stems the need to share an integrated vision that starts from the pharmacological basis of hypnotic drugs, delineates the features of depression in the elderly, addressed the delicate issue of chronic use/abuse of benzodiazepines and ultimately arrives to the management of behavioral disturbances. The pathway includes studies of clinical pharmacology and investigates the potential properties of trazodone, a multifunctional drug capable of acting on different biochemical and neurotransmitter pathways.