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Minkel J, Krystal AD. Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons. Sleep Med Clin. 2013;8(3):333-350doi: 10.1016/j.jsmc.2013.06.002.
Minkel, J., & Krystal, A. D. (2013). Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons. Sleep medicine clinics, 8(3), 333-350. https://doi.org/10.1016/j.jsmc.2013.06.002
Minkel, Jared, and Krystal, Andrew D. "Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons." Sleep medicine clinics vol. 8,3 (2013): 333-350. doi: https://doi.org/10.1016/j.jsmc.2013.06.002
Minkel J, Krystal AD. Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons. Sleep Med Clin. 2013 Sep 01;8(3):333-350. doi: 10.1016/j.jsmc.2013.06.002. PMID: 24015116; PMCID: PMC3763861.
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Sleep Med Clin. 2013 Sep 01;8(3):333-350. doi: 10.1016/j.jsmc.2013.06.002.

Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons.

Sleep medicine clinics

Jared Minkel, Andrew D Krystal

PMID: 24015116 PMCID: PMC3763861 DOI: 10.1016/j.jsmc.2013.06.002

Abstract

A number of medications are available for treating patients with insomnia. These medications include agents approved as insomnia therapies by the U.S. Food and Drug Administration (FDA), agents approved by the FDA for another condition that are used "off-label" to treat insomnia, and agents available "over-the-counter" that are taken by individuals with insomnia. These agents differ in their properties, their safety and efficacy when used for different insomnia patient subtypes, and the available data on their efficacy and safety in these subtypes. As a result, optimizing the medication treatment of insomnia for a given patient requires that the clinician select an agent for use which has characteristics that make it most likely to effectively and safely address the type of sleep difficulty experienced by that individual. This article is intended to assist clinicians and researchers in carrying out this optimization. It begins by reviewing the basic characteristics of the medications used to treat insomnia. This is followed by a review of the fundamental ways that individuals with insomnia may differ and affect the choice of medication therapy. This review includes discussions that illustrate how to best choose a medication based on the characteristics of the available medications, the key differences among insomnia patients, and the available research literature. Lastly, we discuss future directions for the optimizing pharmacologic management of insomnia. It is hoped that the treatment tailoring methods discussed herein serve as a means of improving the clinical management of insomnia and, thus, improve the lives of the many patients who suffer from this common and impairing condition.

Keywords: Insomnia; Pharmacotherapy

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