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Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence

While evidence supports the benefits of medications for the treatment of chronic insomnia, there is ongoing debate regarding their appropriate duration of use. A panel of sleep experts conducted a clinical appraisal regarding the use of insomnia medications, as it relates to the evidence supporting...

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Autores principales: Zee, Phyllis C., Bertisch, Suzanne M., Morin, Charles M., Pelayo, Rafael, Watson, Nathaniel F., Winkelman, John W., Krystal, Andrew D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9959182/
https://www.ncbi.nlm.nih.gov/pubmed/36836164
http://dx.doi.org/10.3390/jcm12041629
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author Zee, Phyllis C.
Bertisch, Suzanne M.
Morin, Charles M.
Pelayo, Rafael
Watson, Nathaniel F.
Winkelman, John W.
Krystal, Andrew D.
author_facet Zee, Phyllis C.
Bertisch, Suzanne M.
Morin, Charles M.
Pelayo, Rafael
Watson, Nathaniel F.
Winkelman, John W.
Krystal, Andrew D.
author_sort Zee, Phyllis C.
collection PubMed
description While evidence supports the benefits of medications for the treatment of chronic insomnia, there is ongoing debate regarding their appropriate duration of use. A panel of sleep experts conducted a clinical appraisal regarding the use of insomnia medications, as it relates to the evidence supporting the focus statement, “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time”. The panelists’ assessment was also compared to findings from a national survey of practicing physicians, psychiatrists, and sleep specialists. Survey respondents revealed a wide range of opinions regarding the appropriateness of using the US Food and Drug Administration (FDA)-approved medications for the treatment of insomnia lasting more than 3 weeks. After discussion of the literature, the panel unanimously agreed that some classes of insomnia medications, such as non-benzodiazepines hypnotics, have been shown to be effective and safe for long-term use in the appropriate clinical setting. For eszopiclone, doxepin, ramelteon and the newer class of dual orexin receptor antagonists, the FDA label does not specify that their use should be of a limited duration. Thus, an evaluation of evidence supporting the long-term safety and efficacy of newer non-benzodiazepine hypnotics is timely and should be considered in practice recommendations for the duration of pharmacologic treatment of chronic insomnia.
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spelling pubmed-99591822023-02-26 Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence Zee, Phyllis C. Bertisch, Suzanne M. Morin, Charles M. Pelayo, Rafael Watson, Nathaniel F. Winkelman, John W. Krystal, Andrew D. J Clin Med Review While evidence supports the benefits of medications for the treatment of chronic insomnia, there is ongoing debate regarding their appropriate duration of use. A panel of sleep experts conducted a clinical appraisal regarding the use of insomnia medications, as it relates to the evidence supporting the focus statement, “No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time”. The panelists’ assessment was also compared to findings from a national survey of practicing physicians, psychiatrists, and sleep specialists. Survey respondents revealed a wide range of opinions regarding the appropriateness of using the US Food and Drug Administration (FDA)-approved medications for the treatment of insomnia lasting more than 3 weeks. After discussion of the literature, the panel unanimously agreed that some classes of insomnia medications, such as non-benzodiazepines hypnotics, have been shown to be effective and safe for long-term use in the appropriate clinical setting. For eszopiclone, doxepin, ramelteon and the newer class of dual orexin receptor antagonists, the FDA label does not specify that their use should be of a limited duration. Thus, an evaluation of evidence supporting the long-term safety and efficacy of newer non-benzodiazepine hypnotics is timely and should be considered in practice recommendations for the duration of pharmacologic treatment of chronic insomnia. MDPI 2023-02-17 /pmc/articles/PMC9959182/ /pubmed/36836164 http://dx.doi.org/10.3390/jcm12041629 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Zee, Phyllis C.
Bertisch, Suzanne M.
Morin, Charles M.
Pelayo, Rafael
Watson, Nathaniel F.
Winkelman, John W.
Krystal, Andrew D.
Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence
title Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence
title_full Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence
title_fullStr Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence
title_full_unstemmed Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence
title_short Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence
title_sort long-term use of insomnia medications: an appraisal of the current clinical and scientific evidence
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9959182/
https://www.ncbi.nlm.nih.gov/pubmed/36836164
http://dx.doi.org/10.3390/jcm12041629
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