Alternate medications for sleep (off label use):
ACh, NA, 5-HT, and DA promote wakefulness, so antagonists of these can be sedating:
- Antidepressants (e.g. ❌)
- Antipsychotics (e.g. ❌)
GABA ❌ are sleep promoting:
- Anxiolytics (e.g. alprazolam, ❌)
Histamine is a potent wake-promoting neurotransmitter, so ❌ at H1 receptors have sedating properties:
- ❌. Long ❌ of action = daytime drowsiness.
Unwanted effects: headache, psychomotor impairment, ❌ effects, paradoxical excitation (children, elderly)
Melatonin:
-• Produced in the ❌ gland
• Under control of circadian system (SCN)
• Late evening ❌ = arousal ❌, facilitates sleep onset
• Prescription except when supplied: for primary insomnia (adults ❌ years or older, up to ❌ weeks), by a NZ registered, trained pharmacist, in the original pack. Tablets 3mg or MR 2mg.
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amitriptyline, mirtazapine, doxepin
amitriptyline, mirtazapine, doxepin
Promethazine, diphenhydramine
Promethazine, diphenhydramine
antimuscarinic
antimuscarinic