J Korean Med Assoc.  2009 Jul;52(7):719-726. 10.5124/jkma.2009.52.7.719.

Pharmacotherapy of Insomnia

Affiliations
  • 1Department of Psychiatry, Gachon University College of Medicine, Korea. sjkim@gilhospital.com

Abstract

As insomnia is a common symptom caused by diverse disorders, treatment tools for the insomnia differ depending on the underlying cause. Hypnotics can be used for primary insomnia. As hypnotics show excellent short-term efficacy, they would be useful as short-term ( < 4 weeks) treatments for transient insomnia. There has been much controversy over long-term hypnotic use for chronic insomnia. Evidence supporting safety and efficacy of the long-term hypnotic use is insufficient. Therefore, rather than using hypnotics alone, non-pharmacological treatments are recommended more for chronic primary insomnia. Although various benzodiazepines have widely been used as hypnotics, there have been concerns over tolerance, rebound insomnia, dependency, cognitive decline and psychomotor slowness. In efforts to relieve these concerns, selective benzodiazepine agonists like zolpidem have been introduced as novel hypnotics. Sedating antidepressants, melatonin and anti-histamine have also been used in order to manage insomnia. However, their efficacy for primary insomnia has yet to be proven.

Keyword

Insomnia; Benzodiazepine; Zolpidem; Pharmacotherapy

MeSH Terms

Antidepressive Agents
Benzodiazepines
Dependency (Psychology)
Hypnotics and Sedatives
Melatonin
Pyridines
Sleep Initiation and Maintenance Disorders
Antidepressive Agents
Benzodiazepines
Hypnotics and Sedatives
Melatonin
Pyridines

Cited by  1 articles

Is Hand Massage with the Preferred Aroma Oil better than Lavender on Stress and Sleep for Long-term Care Facility Residents?
Mi Jung Park, Heeok Park
Korean J Adult Nurs. 2019;31(2):156-164.    doi: 10.7475/kjan.2019.31.2.156.


Reference

1. Kryger MH, Roth T, Dement WC, editors. Principle and practice of sleep medicine. 2005. Philadelphia: Elsevier;444–467. 726–760.
2. Bain KT. Management of chronic insomnia in elderly persons. Am J Geriatr Pharmacother. 2006. 4:168–192.
Article
3. Wilson S, Nutt D. Drug treatment of chronic insomnia - dawn at the end of a long night? J Psychopharmacol. 2008. 22:703–706.
Article
4. Riemann D, Perlis ML. The treatments of chronic insomnia: A review of benzodiazepine receptor agonists and psychological and behavioral therapies. Sleep Med Rev. 2009. 13:205–214.
Article
5. Dubovsky S. Sadock BJ, Sadock VA, editors. Benzodiazepine receptor agonists and antagonists. Comprehensive textbook of psychiatry. 2005. Philadelphia: Lippincott Williams & Wilkins;2781–2791.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr