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Pharmacologic Treatment of Insomnia

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Tasman’s Psychiatry

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Abstract

Insomnia is a common complaint in patients with psychiatric disorders. Pharmacologic approaches to the treatment of insomnia are often recommended in combination with sleep hygiene education and cognitive behavioral therapy. Currently, the insomnia treatment medications include benzodiazepines, nonbenzodiazepines, melatonin receptor agonist, dual orexin receptor antagonists, and histamine H1 receptor antagonist. All have demonstrated efficacy in treating one or more insomnia symptoms and have been shown to have satisfactory safety characteristics in clinical trials with populations of normal subjects and individuals suffering with chronic insomnia. Therefore, the most recently approved insomnia treatment medications no longer have an implied limitation on their duration of use, and the indications specifically note efficacy for sleep onset and sleep maintenance. All of benzodiazepines, nonbenzodiazepines, and dual orexin receptor antagonists are categorized as Schedule IV controlled substances; however, ramelteon and doxepin have no abuse liability and are classed as a nonscheduled medication. Although various medications for depression, psychosis, and other psychotropic agents are prescribed with the primary intention of improving sleep onset, maintenance, and quality, generally, there is limited insomnia efficacy evidence in non-psychiatric populations, and there are significant safety concerns with all of these medications. Traditionally, insomnia caused by some underlying disease, such as a psychiatric disorder, has been referred to as secondary insomnia. However, it has become clear that in many cases insomnia can persist independently, even after the causative illness has resolved. The concept of comorbid insomnia as an alternative to secondary insomnia has been proposed, and it is appropriate to treat comorbid insomnia from the earliest stages of onset and recurrence of psychiatric disorders.

This chapter is an update from the 4th edition. Previous edition authors were David N. Neubauer, Jared Minkel, and Andrew D. Krystal

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References

  • Allard, S., Sainati, S., Roth-Schechter, B., et al. (1998). Minimal interaction between fluoxetine and multiple-dose zolpidem in healthy women. Drug Metabolism and Disposition, 26, 617–622.

    CAS  PubMed  Google Scholar 

  • Allard, S., Sainati, S. M., & Roth-Schechter, B. F. (1999). Coadministration of short-term zolpidem with sertraline in healthy women. Journal of Clinical Pharmacology, 39, 184–191.

    Article  CAS  PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). American Psychiatric Publishing.

    Book  Google Scholar 

  • Ancoli-Israel, S., Richardson, G. S., Mangano, R. M., et al. (2005). Long-term use of sedative hypnotics in older patients with insomnia. Sleep Medicine, 6, 107–113.

    Article  PubMed  Google Scholar 

  • Asian, S., Isik, E., & Cosar, B. (2002). The effects of mirtazapine on sleep: A placebo controlled, double-blind study in young healthy volunteers. Sleep, 25, 677–679.

    Google Scholar 

  • Asnis, G. M., Chakraburtty, A., DuBoff, E. A., et al. (1999). Zolpidem for persistent insomnia in SSRI-treated depressed patients. Journal of Clinical Psychiatry, 60, 668–676.

    Article  CAS  PubMed  Google Scholar 

  • Baglioni, C., Battagliese, G., Feige, B., et al. (2011). Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies. Journal of Affective Disorders, 135(1–3), 10–19.

    Article  PubMed  Google Scholar 

  • Bateson, A. N. (2006). Further potential of the GABA receptor in the treatment of insomnia. Sleep Medicine, 7(Suppl 1), S3–S9.

    Article  Google Scholar 

  • Bent, S., Padula, A., Moore, D., et al. (2006). Valerian for sleep: A systematic review and meta-analysis. American Journal of Medicine, 119, 1005–1012.

    Article  PubMed  Google Scholar 

  • Beuckmann, C. T., Suzuki, M., Ueno, T., et al. (2017). In vitro and in silico characterization of lemborexant (E2006), a novel dual orexin receptor antagonist. The Journal of Pharmacology and Experimental Therapeutics, 362(2), 287–295.

    Article  CAS  PubMed  Google Scholar 

  • Cohrs, S., Rodenbeck, A., Guan, Z., et al. (2004). Sleep-promoting properties of quetiapine in healthy subjects. Psychopharmacology, 174, 421–429.

    Article  CAS  PubMed  Google Scholar 

  • Connor, K., Budd, K., Snavely, D., et al. (2012). Efficacy and safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: A 3-month phase 3 trial (trial #1). Journal of Sleep Research, 21(SI), 97.

    Google Scholar 

  • De Crescenzo, F., D’Alò, G. L., Ostinelli, E. G., et al. (2022). Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: A systematic review and network meta-analysis. Lancet, 400(10347), 170–184.

    Article  PubMed  Google Scholar 

  • DeMicco, M., Wang-Weigand, S., & Zhang, J. (2006). Long-term therapeutic effects of ramelteon treatment in adults with chronic insomnia: A 1 year study. Sleep, 29(Abstract Suppl), A234.

    Google Scholar 

  • Erman, M., Krystal, A., Zammit, G., et al. (2006a). Zolpidem extended-release 12.5 mg, taken for 24 weeks “as needed” up to 7 nights/week, improves subjective measures of therapeutic global impression, sleep onset, and sleep maintenance in patients with chronic insomnia. International Journal of Neuropsychopharmacology, 9(Suppl 1), S256.

    Google Scholar 

  • Erman, M., Seiden, D., Zammit, G., et al. (2006b). An efficacy, safety, and dose-response study of ramelteon in patients with chronic primary insomnia. Sleep Medicine, 7, 17–24.

    Article  PubMed  Google Scholar 

  • Fava, M., McCall, W. V., Krystal, A., et al. (2006). Eszopiclone co-administered with fluoxetine in patients with insomnia coexisting with major depressive disorder. Biological Psychiatry, 59, 1052–1060.

    Article  CAS  PubMed  Google Scholar 

  • Foldvary-Schaefer, N., De Leon, S. I., Karafa, M., et al. (2002). Gabapentin increases slow-wave sleep in normal adults. Epilepsia, 43, 1493–1497.

    Article  CAS  PubMed  Google Scholar 

  • Germain, A., Richardson, R., Moul, D. E., et al. (2012). Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US military veterans. Journal of Psychosomatic Research, 72(2), 89–96.

    Article  PubMed  Google Scholar 

  • Glass, J. R., Sproule, B. A., Herrmann, N., et al. (2008). Effects of 2-week treatment with temazepam and diphenhydramine in elderly insomniacs: A randomized, placebo-controlled trial. Journal of Clinical Psychopharmacology, 28(2), 182–188.

    Article  CAS  PubMed  Google Scholar 

  • Gotter, A. L., Winrow, C. J., Brunner, J., et al. (2013). The duration of sleep promoting efficacy by dual orexin receptor antagonists is dependent upon receptor occupancy threshold. BMC Neuroscience, 14(90), 90.

    Article  PubMed  PubMed Central  Google Scholar 

  • Green, B. (2003). Posttraumatic stress disorder: Symptom profiles in men and women. Current Medical Research and Opinion, 19, 200–204.

    Article  PubMed  Google Scholar 

  • Hajak, G., Rodenbeck, A., Voderholzer, U., et al. (2001). Doxepin in the treatment of primary insomnia: A placebo-controlled, double-blind, polysomnographic study. Journal of Clinical Psychiatry, 62, 453–463.

    Article  CAS  PubMed  Google Scholar 

  • Herring, W. J., Snyder, E., Budd, K., et al. (2012a). Orexin receptor antagonism for treatment of insomnia: A randomized clinical trial of suvorexant. Neurology, 79(23), 2265–2274.

    Article  CAS  PubMed  Google Scholar 

  • Herring, W., Snyder, E., Paradis, E., et al. (2012b). Long term safety and efficacy of suvorexant in patients with primary insomnia. Sleep, 35, A217.

    Google Scholar 

  • Hesse, L. M., von Moltke, L. L., & Greenblatt, D. J. (2003). Clinically important drug interactions with zopiclone, zolpidem and zaleplon. CNS Drugs, 17, 513–532.

    Article  CAS  PubMed  Google Scholar 

  • ICSD-3. (2014). International classification of sleep disorders (3rd ed.). American Academy of Sleep Medicine.

    Google Scholar 

  • Jacobson, L. H., Hoyer, D., & de Lecea, L. (2022). Hypocretins (orexins): The ultimate translational neuropeptides. Journal of Internal Medicine, 291(5), 533–556.

    Article  CAS  PubMed  Google Scholar 

  • Janowsky, D., Curtis, G., Zisook, S., et al. (1983). Ventricular arrhythmias possibly aggravated by trazodone. American Journal of Psychiatry, 140, 796–797.

    Article  CAS  PubMed  Google Scholar 

  • Johnson, M. W., Suess, P. E., & Griffiths, R. R. (2006). Ramelteon: A novel hypnotic lacking abuse liability and sedative adverse effects. Archives of General Psychiatry, 63, 1149–1157.

    Article  CAS  PubMed  Google Scholar 

  • Karim, A., Tolbert, D., & Cao, C. (2006). Disposition kinetics and tolerance of escalating single doses of ramelteon, a high-affinity MT1 and MT2 melatonin receptor agonist indicated for treatment of insomnia. Journal of Clinical Pharmacology, 46, 140–148.

    Article  CAS  PubMed  Google Scholar 

  • Kato, K., Hirai, K., Nishiyama, K., et al. (2005). Neurochemical properties of ramelteon (TAK-375), a selective MT1/MT2 receptor agonist. Neuropharmacology, 48, 301–310.

    Article  CAS  PubMed  Google Scholar 

  • Koppel, C., Tenczer, J., & Ibe, K. (1987). Poisoning with over-the-counter doxylamine preparations: An evaluation of 109 cases. Human Toxicology, 6(5), 355–359.

    Article  CAS  PubMed  Google Scholar 

  • Krystal, A. D. (2009). A compendium of placebo-controlled trials of the risks/benefits of pharmacological treatments for insomnia: The empirical basis for US clinical practice. Sleep Medicine Reviews, 13(4), 265–274.

    Article  PubMed  Google Scholar 

  • Krystal, A. D., & Davidson, J. (2007). The use of prazosin for the treatment of trauma nightmares and sleep disturbance in combat veterans with posttraumatic stress disorder. Biological Psychiatry, 61(8), 925–927.

    Article  CAS  PubMed  Google Scholar 

  • Krystal, A. D., Walsh, J. K., Laska, E., et al. (2003). Sustained efficacy of eszopiclone over 6 months of nightly treatment: Results of a randomized, doubleblind, placebo-controlled study in adults with chronic insomnia. Sleep, 26, 793–799.

    Article  PubMed  Google Scholar 

  • Krystal, A. D., Erman, M., Zammit, G. K., et al. (2008). Long-term efficacy and safety of zolpidem extended-release 12.5 mg, administered 3 to 7 nights per week for 24 weeks, in patients with chronic primary insomnia: A 6-month, randomized, double-blind, placebo-controlled, parallel-group, multicenter study. Sleep, 31(1), 79–90.

    Article  PubMed  PubMed Central  Google Scholar 

  • Krystal, A. D., Durrence, H. H., Scharf, M., et al. (2010). Efficacy and safety of doxepin 1 mg and 3 mg in a 12-week sleep laboratory and outpatient trial of elderly subjects with chronic primary insomnia. Sleep, 33(11), 1553–1561.

    Article  PubMed  PubMed Central  Google Scholar 

  • Krystal, A. D., Lankford, A., Durrence, H. H., et al. (2011). Efficacy and safety of doxepin 3 and 6 mg in a 35-day sleep laboratory trial in adults with chronic primary insomnia. Sleep, 34(10), 1433–1442.

    PubMed  PubMed Central  Google Scholar 

  • Krystal, A. D., Richelson, E., & Roth, T. (2013). Review of the histamine system and the clinical effects of H1 antagonists: Basis for a new model for understanding the effects of insomnia medications. Sleep Medicine Reviews, 17(4), 263–272.

    Article  PubMed  Google Scholar 

  • Kudo, Y., & Kurihara, M. (1990). Clinical evaluation of diphenhydramine hydrochloride for the treatment of insomnia in psychiatric patients: A double-blind study. Journal of Clinical Pharmacology, 30, 1041–1048.

    Article  CAS  PubMed  Google Scholar 

  • Kuriyama, A., & Tabata, H. (2017). Suvorexant for the treatment of primary insomnia: A systematic review and meta-analysis. Sleep Medicine Reviews, 35, 1–7.

    Article  PubMed  Google Scholar 

  • Leibenluft, E., Albert, P. S., Rosenthal, N. E., et al. (1996). Relationship between sleep and mood in patients with rapid-cycling bipolar disorder. Psychiatry Research, 63, 161–168.

    Article  CAS  PubMed  Google Scholar 

  • McClintock, S. M., Husain, M. M., Wisniewski, S. R., et al. (2011). Residual symptoms in depressed outpatients who respond by 50% but do not remit to antidepressant medication. Journal of Clinical Psychopharmacology, 31(2), 180–186.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mendelson, W. B. (2005). A review of the evidence for the efficacy and safety of trazodone in insomnia. Journal of Clinical Psychiatry, 66, 469–476.

    Article  CAS  PubMed  Google Scholar 

  • Meuleman, J., Nelson, R. C., & Clark, R. L. (1987). Evaluation of temazepam and diphenhydramine as hypnotics in a nursing-home population. Drug Intelligence and Clinical Pharmacy, 21(9), 716–720.

    Article  CAS  PubMed  Google Scholar 

  • Meyrel, M., Scott, J., & Etain, B. (2022). Chronotypes and circadian rest-activity rhythms in bipolar disorders: A meta-analysis of self- and observer rating scales. Bipolar Disorders, 24(3), 286–297.

    Article  PubMed  Google Scholar 

  • Mignot, E. (2013). The perfect hypnotic? Science, 340(6128), 36–38.

    Article  CAS  PubMed  Google Scholar 

  • Mignot, E., Mayleben, D., Fietze, I., et al. (2022). Safety and efficacy of daridorexant in patients with insomnia disorder: Results from two multicentre, randomised, double-blind, placebo-controlled, phase 3 trials. Lancet Neurology, 21(2), 125–139.

    Article  CAS  PubMed  Google Scholar 

  • Miyamoto, M., Nishikawa, H., Doken, Y., et al. (2004). The sleep-promoting action of ramelteon (TAK-375) in freely moving cats. Sleep, 27, 1319–1325.

    Article  PubMed  Google Scholar 

  • Mohler, H., Fritschy, J. M., & Rudolph, U. (2002). A new benzodiazepine pharmacology. Journal of Pharmacology and Experimental Therapeutics, 300, 2–8.

    Article  CAS  PubMed  Google Scholar 

  • Moline, M., Zammit, G., Cheng, J. Y., et al. (2021). Comparison of the effect of lemborexant with placebo and zolpidem tartrate extended release on sleep architecture in older adults with insomnia disorder. Journal of Clinical Sleep Medicine, 17(6), 1167–1174.

    Article  PubMed  PubMed Central  Google Scholar 

  • Montgomery, I., Oswald, I., Morgan, K., et al. (1983). Trazodone enhances sleep in subjective quality but not in objective duration. British Journal of Clinical Pharmacology, 16, 139–144.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Morin, C., Koetter, U., Bastien, C., et al. (2005). Valerian–hops combination and diphenhydramine for treating insomnia: A randomized placebo-controlled clinical trial. Sleep, 28(11), 1465–1471.

    Article  PubMed  Google Scholar 

  • Murphy, P., Moline, M., Mayleben, D., et al. (2017). Lemborexant, a dual orexin receptor antagonist (DORA) for the treatment of insomnia disorder: Results from a Bayesian, adaptive, randomized, double-blind, placebo-controlled study. Journal of Clinical Sleep Medicine, 13(11), 1289–1299.

    Article  PubMed  PubMed Central  Google Scholar 

  • National Institutes of Health. (2005). National Institutes of Health State of the Science conference statement on manifestations and management of chronic insomnia in adults, June 13–15, 2005. Sleep, 28, 1049–1057.

    Google Scholar 

  • Nierenberg, A. A., Keefe, B. R., Leslie, V. C., et al. (1999). Residual symptoms in depressed patients who respond acutely to fluoxetine. Journal of Clinical Psychiatry, 60, 221–225.

    Article  CAS  PubMed  Google Scholar 

  • NIH Consensus Statement. (2005). NIH state-of-the-science conference statement on manifestations and management of chronic insomnia in adults. NIH Consensus and State-of-the-Science Statements, 22(2), 1–30.

    Google Scholar 

  • Penninkilampi, R., & Eslick, G. D. (2018). A systematic review and meta-analysis of the risk of dementia associated with benzodiazepine use, after controlling for protopathic bias. CNS Drugs, 32(6), 485–497.

    Article  CAS  PubMed  Google Scholar 

  • Perlis, M. L., Giles, D. E., Buysse, D. J., et al. (1997). Which depressive symptoms are related to which sleep electroencephalographic variables? Biological Psychiatry, 42, 904–913.

    Article  CAS  PubMed  Google Scholar 

  • Perlis, M. L., McCall, W. V., Krystal, A. D., et al. (2004). Long-term, non-nightly administration of zolpidem in the treatment of patients with primary insomnia. Journal of Clinical Psychiatry, 65, 1128–1137.

    Article  CAS  PubMed  Google Scholar 

  • Qaseem, A., Kansagara, D., Forciea, M. A., et al. (2016). Management of chronic insomnia disorder in adults: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165(2), 125–133.

    Article  PubMed  Google Scholar 

  • Rao, R. (1997). Serotonin syndrome associated with trazodone. International Journal of Geriatric Psychiatry, 12, 129–130.

    Article  CAS  PubMed  Google Scholar 

  • Raskind, M. A., Peskind, E. R., Kanter, E. D., et al. (2003). Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: A placebo-controlled study. American Journal of Psychiatry, 160(2), 371–373.

    Article  PubMed  Google Scholar 

  • Raskind, M. A., Peskind, E. R., Hoff, D. J., et al. (2007). A parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with posttraumatic stress disorder. Biological Psychiatry, 61(8), 928–934.

    Article  CAS  PubMed  Google Scholar 

  • Raskind, M. A., Peskind, E. R., Chow, B., et al. (2018). Trial of prazosin for post-traumatic stress disorder in military veterans. The New England Journal of Medicine, 378(6), 507–517.

    Article  CAS  PubMed  Google Scholar 

  • Richardson, G. S. (2005). The human circadian system in normal and disordered sleep. Journal of Clinical Psychiatry, 66, 3–9; quiz, 42–43.

    Google Scholar 

  • Richardson, G. S., Roehrs, T. A., Rosenthal, L., et al. (2002). Tolerance to daytime sedative effects of HI antihistamines. Journal of Clinical Psychopharmacology, 22, 511–515.

    Article  CAS  PubMed  Google Scholar 

  • Rickels, K., Morris, R. J., Newman, H., et al. (1983). Diphenhydramine in insomniac family practice patients: A double-blind study. Journal of Clinical Pharmacology, 23(5–6), 234–242.

    Article  CAS  PubMed  Google Scholar 

  • Roehrs, T., & Roth, T. (2004). ‘Hypnotic’ prescription patterns in a large managed-care population. Sleep Medicine, 5, 463–466.

    Article  PubMed  Google Scholar 

  • Roehrs, T. A., & Roth, T. (2006). Safety of insomnia pharmacotherapy. Sleep Medicine Clinics, 1, 399–407.

    Article  Google Scholar 

  • Roth, T., Zorick, F., Wittig, R., et al. (1982). The effects of doxepin HCl on sleep and depression. Journal of Clinical Psychiatry, 43, 366–368.

    CAS  PubMed  Google Scholar 

  • Roth, T., Walsh, J. K., Krystal, A., et al. (2005). An evaluation of the efficacy and safety of eszopiclone over 12 months in patients with chronic primary insomnia. Sleep Medicine, 6, 487–495.

    Article  PubMed  Google Scholar 

  • Roth, T., Rogowski, R., Hull, S., et al. (2007). Efficacy and safety of doxepin 1 mg, 3 mg, and 6 mg in adults with primary insomnia. Sleep, 30(11), 1555–1561.

    Article  PubMed  PubMed Central  Google Scholar 

  • Roth, T., Krystal, A., Steinberg, F. J., et al. (2013). Novel sublingual low-dose zolpidem tablet reduces latency to sleep onset following spontaneous middle-of-the-night awakening in insomnia in a randomized, doubleblind, placebo-controlled, outpatient study. Sleep, 36(2), 189–196.

    Article  PubMed  PubMed Central  Google Scholar 

  • Saletu-Zyhlarz, G. M., Abu-Bakr, M. H., Anderer, P., et al. (2002). Insomnia in depression: Differences in objective and subjective sleep and awakening quality to normal controls and acute effects of trazodone. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 26, 249–260.

    Article  CAS  PubMed  Google Scholar 

  • Salin-Pascual, R. J., Herrera-Estrella, M., Galicia-Polo, L., et al. (1999). Olanzapine acute administration in schizophrenic patients increases delta sleep and sleep efficiency. Biological Psychiatry, 46, 141–143.

    Article  CAS  PubMed  Google Scholar 

  • Saper, C. B., Chou, T. C., & Scammell, T. E. (2001). The sleep switch: Hypothalamic control of sleep and wakefulness. Trends in Neuroscience, 24, 726–731.

    Article  CAS  Google Scholar 

  • Sateia, M. J., Buysse, D. J., Krystal, A. D., et al. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine, 13(2), 307–349.

    Article  PubMed  PubMed Central  Google Scholar 

  • Scharf, M., Rogowski, R., Hull, S., et al. (2008). Efficacy and safety of doxepin 1 mg, 3 mg, and 6 mg in elderly patients with primary insomnia: A randomized, double-blind, placebo-controlled crossover study. Journal of Clinical Psychiatry, 69(10), 1557–1564.

    Article  CAS  PubMed  Google Scholar 

  • Schmid, D. A., Wichniak, A., Uhr, M., et al. (2006). Changes of sleep architecture, spectral composition of sleep EEG, the nocturnal secretion of cortisol, ACTH, GH, prolactin, melatonin, ghrelin, and leptin, and the DEX-CRH test in depressed patients during treatment with mirtazapine. Neuropsychopharmacology, 31, 832–844.

    Article  CAS  PubMed  Google Scholar 

  • Seiden, D., Zee, P., Weigand, S., et al. (2005). Double-blind, placebo-controlled outpatient clinical trial of ramelteon for the treatment of chronic insomnia in an elderly population. Sleep, 28(Abstract Suppl), A228.

    Google Scholar 

  • Smith, M. T., Perlis, M. L., Park, A., et al. (2002). Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. American Journal of Psychiatry, 159, 5–11.

    Article  PubMed  Google Scholar 

  • Stein, M. B., Kroft, C. D., & Walker, J. R. (1993). Sleep impairment in patients with social phobia. Psychiatry Research, 49, 251–256.

    Article  CAS  PubMed  Google Scholar 

  • Sun, H., Kennedy, W., Wilbraham, D., et al. (2013). Phase II randomized, 4-way crossover, double-blind, placebo-controlled, multi-center, dose-finding trial with esmirtazapine in patients with primary insomnia. Sleep, 36, 259–267.

    PubMed  PubMed Central  Google Scholar 

  • Takeda Pharmaceuticals North America. (2005). Rozerem prescribing information. Takeda Pharmaceuticals North America.

    Google Scholar 

  • Tashiro, M., & Yanai, K. (2007). Molecular imaging of histamine receptors in the human brain. Brain and Nerve, 59, 221–231.

    CAS  PubMed  Google Scholar 

  • Taylor, F., & Raskind, M. A. (2002). The α1-adrenergic antagonist prazosin improves sleep and nightmares in civilian trauma posttraumatic stress disorder. Journal of Clinical Psychopharmacology, 22(1), 82–85.

    Article  CAS  PubMed  Google Scholar 

  • Taylor, F. B., Martin, P., Thompson, C., et al. (2008). Prazosin effects on objective sleep measures and clinical symptoms in civilian trauma PTSD: A placebo-controlled study. Biological Psychiatry, 63(6), 629–632.

    Article  CAS  PubMed  Google Scholar 

  • Vermeeren, A. (2004). Residual effects of hypnotics: Epidemiology and clinical implications. CNS Drugs, 18, 297–328.

    Article  CAS  PubMed  Google Scholar 

  • Walsh, J. K. (2004). Drugs used to treat insomnia in 2002: Regulatory-based rather than evidence-based medicine. Sleep, 27, 1441–1442.

    Article  PubMed  Google Scholar 

  • Walsh, J. K., & Schweitzer, P. K. (1999). Ten-year trends in the pharmacological treatment of insomnia. Sleep, 22, 371–375.

    Article  CAS  PubMed  Google Scholar 

  • Walsh, J. K., Roth, T., Randazzo, A., et al. (2000). Eight weeks of non-nightly use of zolpidem for primary insomnia. Sleep, 23, 1087–1096.

    Article  CAS  PubMed  Google Scholar 

  • Walsh, J. K., Roehrs, T., & Roth, T. (2005). Pharmacologic treatment of primary insomnia. In M. H. Kryger, T. Roth, & W. C. Dement (Eds.), Principles and practice of sleep medicine (4th ed., pp. 749–760). Elsevier Saunders.

    Chapter  Google Scholar 

  • Walsh, J. K., Zammit, G., Schweitzer, P. K., et al. (2006). Tiagabine enhances slow wave sleep and sleep maintenance in primary insomnia. Sleep Medicine, 7, 155–161.

    Article  PubMed  Google Scholar 

  • Winokur, A., DeMartinis, N. A., III, McNally, D. P., et al. (2003). Comparative effects of mirtazapine and fluoxetine on sleep physiology measures in patients with major depression and insomnia. Journal of Clinical Psychiatry, 64, 1224–1229.

    Article  CAS  PubMed  Google Scholar 

  • Young, D. M. (1995). Psychiatric morbidity in travelers to Honolulu, Hawaii. Comprehensive Psychiatry, 36, 224–228.

    Article  CAS  PubMed  Google Scholar 

  • Yukuhiro, N., Kimura, H., Nishikawa, H., et al. (2004). Effects of ramelteon (TAK-375) on nocturnal sleep in freely moving monkeys. Brain Research, 1027, 59–66.

    Article  CAS  PubMed  Google Scholar 

  • Zammit, G., Roth, T., Erman, M., et al. (2005). Double-blind, placebo-controlled polysomnography and outpatient trial to evaluate the efficacy and safety of ramelteon in adult patients with chronic insomnia. Sleep, 28(Abstract Suppl), A228–A229.

    Google Scholar 

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Authors and Affiliations

  1. Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita-city, Akita, Japan

    Kazuo Mishima

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  1. Kazuo Mishima
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Editors and Affiliations

  1. Department of Psychiatry, University of Louisville, Louisville, KY, USA

    Allan Tasman

  2. Department of Psychiatry, University of Michigan Rogel Cancer Cent, Ann Arbor, MI, USA

    Michelle B. Riba

  3. Mayo Clinic College of Medicine, Oakland, CA, USA

    Renato D. Alarcón

  4. Columbia University Medical Center, New York, USA

    César A. Alfonso

  5. Kyushu University, Fukuoka, Japan

    Shigenobu Kanba

  6. Department of Psychiatry, University of Nairobi, Nairobi, Kenya

    David M. Ndetei

  7. Malaysian Research Inst on Ageing, Universiti Putra Malaysia, Selangor, Malaysia

    Chee H. Ng

  8. Department of Psychiatry, University of Munich, München, Bayern, Germany

    Thomas G. Schulze

  9. Serbian Academy of Sciences and Arts, Belgrade, Serbia

    Dusica Lecic-Tosevski

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    Shigenobu Kanba

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    Rif S. El-Mallakh

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    Joseph Zohar

  4. No affiliation provided

    Andrew D. Krystal

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Mishima, K. (2023). Pharmacologic Treatment of Insomnia. In: Tasman, A., et al. Tasman’s Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42825-9_137-1

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