Doctor's Notes on Insomnia Medication Names and Side Effects
Insomnia is difficulty falling asleep, staying asleep or both that results in inadequate sleep; the problems are the signs and symptoms of insomnia. Transient insomnia lasts less than 3 weeks (usual is 1 week) while chronic insomnia lasts more than 6 months. Insomnia is the most common sleep complaint and is itself a symptom associated with variety of medical, psychiatric and sleep disorders.
There are many potential direct and associated causes of transient and chronic insomnia. For example, any short-term or chronic stress can trigger insomnia, mental health disorders like depression, anxiety, bipolar and others are associated with insomnia, older people (due to medical illnesses, social stressors) have a higher rate of insomnia, hormonal changes (more often in women), long distance travel (jet lag) and night shift workers are associated with an increased risk of insomnia. There are many other potential risk factors.
Insomnia Medication Names and Side Effects Symptoms
Antidepressant drugs include, but are not limited to
- amitriptyline (Elavil, Endep),
- nortriptyline (Pamelor), nefazodone (Serzone), and
- trazodone (Desyrel).
How do antidepressant drugs work?
Antidepressant drugs are believed to work by altering levels of brain chemicals known as neurotransmitters. Some antidepressant drugs cause drowsiness as a side effect. Because this side effect may last for a long time, it can benefit an individual whose problem is awakening after initially falling asleep. Antidepressant drugs may also be used for people who have insomnia caused by depression.
Who should not use these medications?
PPersons taking a monamineoxidase inhibitor (MAOI, another class of antidepressant drug) should not take these medications. Additionally, anyone with the following conditions should not take antidepressants:
- Allergy to antidepressant drugs
- History of seizures
- IIrregular heart rhythm
- Narrow-angle glaucoma
- Kidney disease causing retention of urine
Uses: Take the prescribed dose 30 minutes before bedtime. Elderly individuals are prescribed smaller doses.
Drug or food interactions: Do not use within 14 days of taking an MAOI. Other drugs that depress the brain's functioning, such as alcohol or barbiturates, may increase drowsiness, cause a hangover effect in the morning, and increase the risk of toxicity. Cimetidine (Tagamet) may increase blood levels of antidepressant drugs, thereby increasing the risk of toxicity.
Pregnancy and breastfeeding: Antidepressants are Pregnancy Category C. This means there are no adequate and well-controlled studies in pregnant women for most antidepressants. Consult a physician to determine if the potential benefit justifies the potential risk to the fetus. Because many drugs are excreted in human milk, caution should be exercised when administered to a nursing woman as the effect of on a nursing infant is not known.
Insomnia Medication Names and Side Effects Causes
Insomnia is usually a transient or short-term condition (lasting less than 3 months). In some cases insomnia can become chronic (more than 6 months).
Transient insomnia specifically lasts up to 1 week and is associated with acute situational stress factors such as a job interview or exam. It usually resolves once the person has adjusted to stress factor, or it is no longer a concern. It can however reemerge when new or similar stressors occur. Causes of short-term (acute) insomnia are typically related to more significant or persistent stress sources, which may be environmental factors such as too much noise, light, temperature extremes, or an uncomfortable bed ,or situational factors including relationship concerns or losses (for example, death of a family member).
Causes of chronic insomnia are more variable and are associated with underlying causes.
- Chronic pain
- Severe emphysema
- Chronic kidney disease (especially if undergoing dialysis)
- Chronic fatigue syndrome
- Parkinson's disease
- Other movement disorders
- Cluster headaches
- Stimulants (for example, caffeine)
- Addictive substance abuse or withdrawal (for example, attempting to quit smoking)
- Overuse of sedative-hypnotic drugs
- Restless leg syndrome (RLS) is characterized by the urge to move the legs usually accompanied by an uncomfortable sensation in the legs such a crawling, burning, aching or cramping sensations. RLS often occurs at night while sitting and relaxing, and the sensation and the urge to move is often relieved by movement.
- Periodic limb movement disorder (PLMD) occurs during sleep and involves periodic movements of the lower legs, causing brief mini-awakenings (arousals from sleep). Severe cases can cause significant sleep interruption and insomnia.
- Sleep apnea is a less common cause of insomnia. This condition is associated with loud snoring and frequent brief awakenings during the night. Many factors, including abnormalities or altered anatomy of the structures in the nose or throat, may cause this condition.
- Circadian rhythm disorders (disruption of an individual's "biological clock") may occur when a person stays up later and sleeps later, then has difficulty returning to a more normal sleep schedule. People who work during the night ("graveyard shift") frequently have problems with insomnia. Insomnia due to jet lag is also a disruption of the normal Circadian rhythm.
Primary insomnia may be diagnosed when all other disorders have been excluded. Primary insomnia is often referred to as psychophysiologic insomnia. This disorder often results from a period of stress in a person's life. Normally, this condition resolves over time, but for some, insomnia results in ongoing tension and an inability to sleep. Bad sleep habits develop, and the person begins to worry about his or her sleep, worsening the symptoms of insomnia. The bad habits must be "unlearned," and the person educated regarding good sleep hygiene practices.
Insomnia is a condition characterized by difficulty falling or staying asleep. There is no set definition of insomnia in terms of hours of sleep, and insomnia can have many forms. Some people with insomnia may have no trouble falling asleep but wake up too soon. Other people may have the opposite problem, or they have problems with falling asleep as well as staying asleep. The common factor is poor-quality sleep that doesn't leave you feeling refreshed when you wake up.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.