Suvorexant
Suvorexant ($ Belsomra) Hypnotic (Orexin antagonist) Features Dosing 10mg 1 qhs prn insomnia (do not take within 30min of eating) […]
Sedating
Lemborexant
Lemborexant ( $ Dayvigo) Hypnotic (Orexin antagonist) Features Dosing 5mg 1 qhs prn insomnia (do not take within 30min of
Daridorexant
Daridorexant(Quivig $) Hypnotic (Orexin antagonist) hypnotic deepen sleep Features Dosing 25-50mg qhs prn insomnia (do not take within 30min of
Ramelteon
Ramelteon(Rozerem) Hypnotic (melatonin agonist) Features Dosing 8mg/night. Can take PRN, but may work better when taken at the same time
Valerian
Valerian CAM (GABA agonist; serotonin 5-HT5A agonist) Features Dosing 450-600mg 2 hr before bedtime Management Liver risks. EMR Text
Eszopiclone
Eszopiclone (Lunesta) Hypnotic (GABA-A receptor agonist at subtype involved in sleep (alpha-1); metabolite is agonist at anxiolytic subtype (alpha-2,3,5)) Features
Zolpidem
Zolpidem (Ambien) Hypnotic (GABA-A receptor agonist at subtype involved in sleep (alpha-1)) Features Dosing 5-10 mg/night (6.25-12.5 for CR). Use
Diphenhydramine
Although over the counter, the prescription version (hydroxyzine) is safer with fewer anticholinergic risks.
Dextromethorphan
Think of it as low-potency ketamine. Rapid acting as Auvelity in depression, or as monotherapy (3rd line) in bipolar depression. Abuse potential.