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Related Concept Videos

Management of Insomnia01:19

Management of Insomnia

250
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
250
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
176
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

382
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
382
CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

267
CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
267
Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

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Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
251
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

281
Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
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Medications Used for Pediatric Insomnia.

Vijayabharathi Ekambaram1, Judith Owens2

  • 1Department of Psychiatry, University of Central Florida, HCA Florida Healthcare Program, 8383 N. Davis Hwy, Pensacola, FL 32514, USA.

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Pediatric insomnia negatively impacts children's health and development. This review examines FDA-approved, over-the-counter, and off-label medications for pediatric insomnia, emphasizing combination with behavioral therapy for lasting results.

Keywords:
ChildrenInsomniaMedicationsPediatricsPharmacotherapySleep disorders

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Area of Science:

  • Pediatric Sleep Medicine
  • Pharmacology
  • Child Psychology

Background:

  • Pediatric insomnia poses significant risks to children's physical, mental, cognitive, and social well-being, diminishing quality of life.
  • Currently, no medications are specifically approved by the Food and Drug Administration (FDA) for treating pediatric insomnia.
  • Existing pharmacologic treatments for pediatric insomnia are largely based on adult data or limited case reports.

Purpose of the Study:

  • To review FDA-approved (in adults), over-the-counter, and off-label medications for pediatric insomnia.
  • To provide clinicians with general principles, practice guidelines, and pharmacologic considerations for selecting medications in pediatric patients.
  • To highlight the importance of integrating pharmacologic management with evidence-based behavioral therapies.

Main Methods:

  • Comprehensive literature review of FDA-approved medications (adult indications), over-the-counter sleep aids, and commonly used off-label drugs in pediatric insomnia.
  • Analysis of existing practice guidelines and clinical data pertaining to the pharmacologic management of pediatric insomnia.
  • Synthesis of information to guide clinical decision-making for medication selection in children.

Main Results:

  • The review categorizes available pharmacologic options, including prescription drugs approved for adult insomnia, readily available over-the-counter medications, and off-label treatments used in pediatric populations.
  • It outlines key considerations for clinicians regarding drug selection, dosage, potential side effects, and monitoring in children.
  • Evidence supports the adjunctive role of behavioral therapies in achieving sustained improvements in pediatric insomnia.

Conclusions:

  • Pharmacologic management of pediatric insomnia requires careful consideration of available evidence, primarily derived from adult studies and case reports, due to the lack of FDA-approved pediatric treatments.
  • Clinicians should integrate pharmacologic strategies with behavioral therapies, which offer proven long-lasting outcomes for pediatric insomnia.
  • This review serves as a guide for healthcare providers to optimize medication selection and management in the pediatric population.