Mental Health Clinician Volume 4: Issue 2

Insomnia is the most common sleep disorder, and antidepressants are increasingly being used for its management. This article reviews the existing data concerning the use of antidepressants in the treatment of primary insomnia.

INTRODUCTION

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that often presents before the child enters the educational system and is characterized by developmental deficits with impairments in three main areas [1] personal, [2] social, and [3] academic or occupational functioning. ¹ The neurodevelopmental disorders represent a group of conditions with an onset early in the developmental period. Sleep disorders are commonly reported by parents of children with an ASD diagnosis with between 50% to 80% of parents reporting sleep problems with their children. ^2–5 Problems can be categorized into dyssomnias (problems falling and/or remaining asleep) and parasomnias

Melatonin is an endogenous indolamine produced by the pineal gland which may have a role in the biological regulation of circadian rhythms, sleep, and mood. Melatonin receptor activation in the hypothalamus likely regulates circadian rhythms. In the United States, melatonin is marketed as a dietary supplement. Clinical trials in children and adults have shown modest clinical benefit in the treatment of insomnia. Adverse events reported in patients receiving melatonin were not significantly different in type or occurrence from those reported in patients receiving placebo. Considering the potential for benefit, lack of significant adverse events, and lack of abuse potential, melatonin may be considered a valid therapeutic option for improving outcomes in certain pediatric and adult patients with insomnia.

Melatonin agonists have become an area of interest in the treatment of sleep disorders. This article reviews the available data on this class of medications, with a focus on ramelteon and tasimelteon.

A potential case of refeeding syndrome in a patient with severe mental illness

Amber R. DouglassPharmD, BCPS, BCPP, FAAPP,

Eliana SpeyBS, and

Kimberly A. EhrhardPharmD, BCPP

Trends in sedative-hypnotic therapy

Antidepressant management of insomnia disorder in the absence of a mood disorder

Autism spectrum disorders and sleep disturbances in a pediatric patient

INTRODUCTION

Role in therapy of melatonin for the treatment of insomnia in children and adults

Melatonin agonists in the management of sleep disorders: A focus on ramelteon and tasimelteon

Off-label use of atypical antipsychotic agents for treatment of insomnia

Orexin receptor antagonists: Novel hypnotic agents

The long-term use of sedative hypnotics in chronic insomnia

Insomnia treatment for the medically ill hospitalized patient

Treatment of sleep disturbances in post-traumatic stress disorder

A potential case of refeeding syndrome in a patient with severe mental illness

Use of psychostimulants in the management of treatment-resistant major depressive disorder

Implementation of mMINDS monitoring for alcohol withdrawal at an inpatient academic psychiatric facility

A case of Alice in Wonderland Syndrome associated with topiramate in a patient with vestibular migraine

Memantine leading to physical aggression in the treatment of chronic catatonia secondary to schizophrenia: A case report

CPNP Announcements

The annual state of CPNP report

CPNP Announcements

Pursuing provider status

Book Review: Get the residency: ASHP's guide to residency interviews and preparation