Prescription sleeping pills
Today's prescription sleeping pills don't carry the same level of risks of dependence and overdoses as sleeping pills of the past. But risks remain — especially for older adults, pregnant or breast-feeding women, and people with certain medical conditions, including liver or kidney disease.
The most common side effects with prescription sleeping pills are daytime drowsiness, dizziness, lightheadedness, cognitive and motor impairment, and dependence. Long-term use may be habit-forming, and rebound insomnia may occur when medications are discontinued. Less common side effects include sleep-related behaviors, such as walking, driving and eating while not fully awake. Be sure to discuss the potential risks and benefits with your doctor.
Here's a list of commonly prescribed sleeping pills and potential side effects:
- Doxepin (Silenor). Although the exact mechanism isn't known, doxepin is thought to work by blocking the effects of histamine in the brain, allowing you to stay asleep after you fall asleep. Doxepin may cause weight gain.
- Estazolam. Estazolam works by depressing the central nervous system, causing sedation. Estazolam may interact with many other medications and can be habit-forming.
- Eszopiclone (Lunesta). Eszopiclone works by helping to increase certain chemicals in the brain that cause sleep. Stopping eszopiclone abruptly may cause symptoms of withdrawal such as anxiety, unusual dreams, nausea and vomiting.
- Ramelteon (Rozerem). Ramelteon works by acting on melatonin receptors in the brain, which helps you fall asleep. Ramelteon may interact with alcohol.
- Temazepam (Restoril). Temazepam works by depressing the central nervous system, causing sedation. Temazepam may interact with alcohol and many medications, and it can be habit-forming.
- Zaleplon (Sonata). Zaleplon works by depressing the central nervous system, causing drowsiness. Zaleplon may interact with other medications and can be habit-forming.
- Zolpidem (Ambien, , Edluar, Zolpimist). Zolpidem works by helping to increase certain chemicals in the brain that cause sleep. Zolpidem may become less effective over time. Recently the recommended dose for women was lowered because of data showing that next-day blood levels of the drug may be high enough to impair activities that require alertness, such as driving.
To reduce your risk of side effects and of becoming dependent on drugs to promote sleep, your doctor likely will prescribe sleeping pills for two to four weeks. If you experience side effects, such as feeling groggy the next day, talk to your doctor about whether you need to change your dose or change medications. You may need to try more than one prescription sleeping pill before finding one that is right for you.
Sep. 28, 2013
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- Bonnet MH, et al. Treatment of insomnia. http://www.uptodate.com/home. Accessed Aug. 5, 2013.
- Buysse DJ. Insomnia. JAMA. 2013;309:706.
- Clinical guideline for the evaluation and management of chronic insomnia in adults. Philadelphia, Pa.: University of Pennsylvania Health System. http://www.aasmnet.org/Resources/ClinicalGuidelines/040515.pdf. Accessed Aug. 5, 2013.
- Diphenhydramine. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Aug. 6, 2013.
- Zhang D, et al. Next-day residual sedative effect after nighttime administration of an over-the-counter antihistamine sleep aid, diphenhydramine, measured by positron emission tomography. Journal of Clinical Psychopharmacology. 2010;30:694.
- Foral P, et al. Insomnia: A therapeutic review for pharmacists. The Consultant Pharmacist. 2011;26:332.
- Melatonin. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Aug. 5, 2013.
- Valerian. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Aug. 5, 2013.
- Doxylamine. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Aug. 6, 2013.
- Sullivan SS. Insomnia pharmacology. Medical Clinics of North America. 2010;94:563.
- Risk of next?morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidem (Ambien, Ambien CR, Edluar, and Zolpimist). U.S. Food and Drug Administration. http://www.fda.gov/drugs/drugsafety/ucm334033.htm. Accessed Aug. 6, 2013.
- Lunesta (prescribing information). Marlborough, Mass.: Sunovion Pharmaceuticals, Inc.; 2012. http://sunovion.force.com. Accessed Aug. 6, 2013.
- 13. Roth T, et al. Efficacy and safety of sleep-promoting agents. Sleep Medicine Clinics. 2008;3:175.
- Doxepin (prescribing information). San Diego, Calif.: Somaxon Pharmaceuticals, Inc., 2010. http://www.silenor.com/pub/hcp/. Accessed Aug. 6, 2013.
- Estazolam (prescribing information). Corona, Calif.: Actavis, Inc.; 2008. http://www.actavis.com/en/Products/SearchProductResults.htm?group=alpha&c=E. Accessed Aug. 6, 2013.
- Ambien (prescribing information). Bridgewater, N.J.: Sanofi-Aventis; 2013. http://products.sanofi.us/ambien/ambien.pdf. Accessed Aug. 6, 2013.
- Ramelteon. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Aug. 6, 2013.
- Restoril (prescribing information). Hazelwood, Mo.: Mallinckrodt Inc.; 2010. http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/018163s054lbl.pdf. Accessed Aug. 6, 2013.
- Sonata (prescribing information). Bristol, Tenn.: King Pharmaceuticals, Inc.; 2013. http://www.pfizer.com/products/product-detail/sonata_civ. Accessed Aug. 6, 2013.