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Sleep Disorders (PDQ®)

  • Updated: 04/09/2014

Medications Commonly Used to Promote Sleep

Drug Category Medication Dose Comments 
Nonbenzodiazepine benzodiazepine receptor agonistzaleplon (Sonata)5–20 mgUseful for problems falling asleep only.
zolpidem tartrate (Ambien)5–10 mgUseful for problems falling asleep only.
zolpidem tartrate extended-release (Ambien CR)6.25–12.5 mgBiphasic release; useful for problems both falling asleep and staying asleep; do not crush or split tablets.
eszopiclone (Lunesta)1–3 mgUseful for problems both falling asleep and staying asleep; do not take with or right after meal.
Benzodiazepinealprazolam (Xanax)0.25–2 mgHigher risk of withdrawal; side effects: lack of motor coordination, falls, and cognitive impairment.
lorazepam (Ativan)0.5–4 mgSide effects: lack of motor coordination, falls, and cognitive impairment.
clonazepam (Klonopin)0.5–4 mgSide effects: lack of motor coordination, falls, and cognitive impairment.
temazepam (Restoril)15–30 mgSide effects: lack of motor coordination, falls, and cognitive impairment.
Melatonin receptor agonistramelteon (Rozerem)8 mgLittle negative effect on cognition, somnolence, motor coordination, or nausea; useful for problems falling asleep only.
Antihistaminediphenhydramine (Benadryl)25–100 mgUseful for problems falling asleep only; good side-effect profile.
hydroxyzine (Vistaril, Atarax)10–100 mgUseful for problems falling asleep only; anticholinergic side effects.
Tricyclic antidepressantdoxepin (Sinequan)10–25 mgLower doses used for treatment of primary insomnia when antidepressant effect not needed; risk of anticholinergic side effects and weight gain.
amitriptyline (Elavil)10–15 mgLower doses used for treatment of primary insomnia when antidepressant effect not needed; risk of anticholinergic side effects and weight gain.
nortriptyline (Pamelor)10–50 mgRisk of anticholinergic side effects and weight gain.
Second-generation antidepressanttrazodone (Desyrel)25–200 mgRisk of orthostatic hypotension and falls.
mirtazapine (Remeron)7.5–45 mgIf depression not a concern, 7.5–15 mg best for sleep, hot flashes, increased appetite, and less morning sedation. Be aware of fall risk.
Antipsychoticquetiapine (Seroquel)25–100 mgRisk of weight gain, metabolic syndrome, abnormal/involuntary movements; possible cardiovascular effects (e.g., prolonged QT interval).
chlorpromazine (Thorazine)10–50 mgRisk of weight gain, metabolic syndrome, abnormal/involuntary movements; possible cardiovascular effects (e.g., hypotension).
Chloral derivativechloral hydrate0.5–1.0 gUsed mainly for sleep maintenance; risk of gastric irritation; risk of dependence and withdrawal; lethal in overdose.