MEDICATIONS FOR ANXIETY AND SLEEP
Group Main Use |
Medication Brand/Generic |
Form | Dose Schedule | Dose Range | Most Common Side Effects for Group | Pros for Group | Cautions for Group |
Benzodiazepines (anxiety, panic, sleep) |
Xanax (Alprazolam) |
Tablets 0.25, 0.5, 1.0, 2.0mg XR |
as needed up to 4 times a day or regular | 0.25 to 8mg a day usually less than 2-4mg a day |
Sedation, sometimes atypical
agitation. May slow reaction time at first or in higher doses. |
Very effective in short and long
term use for anxiety and panic. Helps quickly. Excellent temporary use while SRI or other med is building to effectiveness. Can be used as second med to boost others and help anxiety, sleep, agitation panic, and occasionally depression or psychosis. No labs needed. No serious side effects except possible addiction or interactions. Relatively few side effects. |
All Benzodiazepines have small
risk of addiction and interactions that are real but should not be
overstated. Thus infrequent use in children or adolescents except
emergency. Use in adults typically short term for same reasons, except when especially effective for panic and some anxiety cases. Clonazepam likely least habit forming. |
Ativan (Lorazepam) |
Tablets 0.5mg 1.0mg 2.0mg |
as needed or regular up to 3 times a day | |||||
Klonopin (Clonapzepam) |
Tablets 0.5mg 1.0mg 2.0mg wafers (oral dissolve) |
as needed or regular up to 2-3 times a day | 0.25 to 6mg a day | Clonazepam most sedating and may build up due to long half life and cause unsteady gait, sedation. | |||
Restoril (Temazepam) |
Tablets 7.5mg 15mg 30mg |
bedtime only (used for sleep only) | 7.5 to 30mg | Sedation Occasional anterograde amnesia (Halcion) |
Usually used for less than a few or several weeks at a time for sleep. Advised not to use every night. | ||
Halcion (Triazolam) |
Tablets 0.125mg 0.25mg |
0.125 to 0.5mg | |||||
Dalmane (Flurazepam) |
Tablets 15mg 30mg |
15-30mg | |||||
Non-Benzodiazepines (sleep) |
Ambien (Zolpidem) Ambien CR |
Tablets 5 mg, 10mg 6.25, 12.5mg |
bedtime | 5-15mg | Sedation | Not a benzodiazepine. Few side effects. Quick onset, short duration. CR medium. | Advised not to use every night and for only limited time periods or effect wears off. |
Sonata (Zalepion) |
Capsule 5mg 10mg |
bedtime | 5-20mg | Sedation | Same as Ambien. | Same as Ambien. | |
Lunesta (Eszopiclone) |
Tablets 1, 2, 3mg |
bedtime | 1-3mg | Sedation | Same; medium duration | New, less habit forming. | |
Rozerem (Rameleton) |
Tablet 8mg |
bedtime | 4-16mg | Sedation | Same; medium duration. Works via melatonin system. | New. Avoid Fluvoxamine, rifampin, fluconazoie, icetoconazole. Less habit forming. |
All these medications should be taken 7 days a week to be effective. Simultaneous use of alcohol or cigarettes and especially street drugs should be avoided. All antidepressants may increase mania risk in persons with Bipolar (manic-depressive) disorder. All medications should be avoided if possible in pregnancy. This chart is intended to be a summary guide, not a full and complete list.
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