Prescription Medications and OTC's used to Treat Insomnia

Over-the-Counter(OTC)Drugs as Short Term Sleep Aids


About 20% or more adults depend on sleep aids such as prescriptions, over the counter (OTC) drugs, or even alcohol for their insomnia problems. Insomnia medications can be helpful in resolving the problem, but they could also be addicting after certain period of time. When starting with medication for insomnia problems people should start with over the counter treatment. According to the American Academy of Sleep Medicine, antihistamine is the most common ingredient in OTC sleep aids. Over-the-counter sleep medications rely on the sedating effects of the antihistamine which induces drowsiness to facilitate sleep. Most OTC drugs include antihistamines which induces drowsiness and thus helps in resolving the problem. Diphenhydramine is the most common antihistamine used in OTC sleep aids. Some contain diphenhydramine alone such as in Nytol, Sleep-Eez, Sominex. Others contain combinations of diphenhydramine with pain relievers like Excedrin P.M. and Tylenol P.M.

Side effects of these drugs include: Feeling sleepy and tired during the day, dizziness, blurry vision, dry mouth, cognitive impairment. People who should not take these drugs: patients with angina, glaucoma, dysrythmias, urinary issues, chronic lung disease should consult their physicians before taking any OTC medications for insomnia.

PRESCRIPTION SLEEP MEDS

Non-benzodiazipines:
These are the new drugs, the effect of which lasts for a short time. Some of the commonly prescribed drugs that are included in this category are:


Zolpidem (ambien) – This is one of the most commonly prescribed medication for insomnia. This medication is also available in an extended release form – Ambien CR, which is one of the first insomnia medication available in an extended release form. This drug should not be taken until and unless the patient is sure to sleep for atleast 7 to 8 hours.
Zaleplon (sonata) – This is a short acting drug and its effect is diminished after 4 hours. This drug is beneficial to patients who have difficulty staying asleep.
Other drugs include Eszopiclone (Lunesta), Ramelteon (Rozerem),etc.


Side Effects:
When patients are on non-benzodiazipines they have low risk of developing a dependency for that type of drug, however have high risk of the side effects caused by that drug. They could have severe allergic reaction, anaphylaxis, facial swelling (angioedema). Also these drugs may also cause patients to perform strange behaviors like driving, making phone calls, or even eating while they are asleep.


General side effects includes, drowsiness, fatigue, headache, dizziness, diarrhea, unpleasant taste.


Interactions: These drugs have interactions with alcohol and other CNS depressants.

Benzodiazipine Hypnotics:
These drugs target the effects of the neurotransmitter gamma amniobutyric acid. However these drugs have a very high risk of tolerance and dependence. Drugs included in this type are,flurazepam (Dalmane), clonazepam (Klonopin) and quazepam (Doral) which are long acting benzodiazipines, while triazolam (Halcion), lorazepam (Ativan), alprazolam (Xanax), temazepam (Restoril), oxazepam (Serax), prazepam (Centrax), estazolam (ProSom), and flunitrazepam (Rohypnol) are short acting in this category.



Side effects: Older people are more susceptible to side effects than younger individuals. The side effects of these class of drugs include severe allergic reaction, anaphylaxis, facial swelling (angioedema), respiratory problems, might increase the problem of depression among certain individuals, high daytime drowsiness, urinary problems, strange behaviors like sleepwalking, sleep driving, eating while asleep. These drugs could also cause memory loss. Since these drugs cross the placenta pregnant women or nursing mothers cannot take this drug.

Related Links:

http://www.aurorahealthcare.org/yourhealth/healthgate/getcontent.asp?URLhealthgate="21258.html"
http://insomnia-relief.com/information/?p=9
http://www.healthcentral.com/sleep-disorders/insomnia-introduction-000027_8-145.html


References:

Saisan, J., Kemp,G.,Barston, S. (2008,July). Sleeping Pills, Sleeping aids, And Medications Prescription, OTC, And Natural Slep Aids; What you need to know. Helpguide.org Understand, Prevent, and resolve life's challanges. Retrieved on 10th October, 2009 from http://helpguide.org/life/sleep_aids_medication_insomnia_treatment.htm#authors

Palo Alto Medical Foundation. (2009). FDA Warning: Sleep Medications may cause dangerous side effects. Retrieved on 1st October, 2009 from
http://www.pamf.org/news/drugalerts/0307sleep.html