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.

Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management

Maxwell LambPharmD, BCPS,

Michelle ColvardPharmD, BCPP,

Jonathan ListerPharmD, BCPP, and

Eric JohnsonPharmD, 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

Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management

Clozapine plasma level toxicity induced by a pharmacokinetic interaction with bupropion: A case report

Guanfacine for the management of the behavioral manifestations of delirium in older hospitalized adults

Managing ciprofloxacin-clozapine interaction with immunoassay-based monitoring: A case report

Evaluating the efficacy of blister packaging in improving medication adherence within psychiatry: A systematic literature review