Medications Commonly Used to Promote Sleep
| Drug Category | Medication | Dose | Comments |
| Nonbenzodiazepine benzodiazepine receptor agonist | zaleplon (Sonata) | 5–20 mg | Useful for problems falling asleep only. |
| zolpidem tartrate (Ambien) | 5–10 mg | Useful for problems falling asleep only. | |
| zolpidem tartrate extended-release (Ambien CR) | 6.25–12.5 mg | Biphasic release; useful for problems both falling asleep and staying asleep; do not crush or split tablets. | |
| eszopiclone (Lunesta) | 1–3 mg | Useful for problems both falling asleep and staying asleep; do not take with or right after meal. | |
| Benzodiazepine | alprazolam (Xanax) | 0.25–2 mg | Higher risk of withdrawal; side effects: lack of motor coordination, falls, and cognitive impairment. |
| lorazepam (Ativan) | 0.5–4 mg | Side effects: lack of motor coordination, falls, and cognitive impairment. | |
| clonazepam (Klonopin) | 0.5–4 mg | Side effects: lack of motor coordination, falls, and cognitive impairment. | |
| temazepam (Restoril) | 15–30 mg | Side effects: lack of motor coordination, falls, and cognitive impairment. | |
| Melatonin receptor agonist | ramelteon (Rozerem) | 8 mg | Little negative effect on cognition, somnolence, motor coordination, or nausea; useful for problems falling asleep only. |
| Antihistamine | diphenhydramine (Benadryl) | 25–100 mg | Useful for problems falling asleep only; good side-effect profile. |
| hydroxyzine (Vistaril, Atarax) | 10–100 mg | Useful for problems falling asleep only; anticholinergic side effects. | |
| Tricyclic antidepressant | doxepin (Sinequan) | 10–25 mg | Lower doses used for treatment of primary insomnia when antidepressant effect not needed; risk of anticholinergic side effects and weight gain. |
| amitriptyline (Elavil) | 10–15 mg | Lower doses used for treatment of primary insomnia when antidepressant effect not needed; risk of anticholinergic side effects and weight gain. | |
| nortriptyline (Pamelor) | 10–50 mg | Risk of anticholinergic side effects and weight gain. | |
| Second-generation antidepressant | trazodone (Desyrel) | 25–200 mg | Risk of orthostatic hypotension and falls. |
| mirtazapine (Remeron) | 7.5–45 mg | If depression not a concern, 7.5–15 mg best for sleep, hot flashes, increased appetite, and less morning sedation. Be aware of fall risk. | |
| Antipsychotic | quetiapine (Seroquel) | 25–100 mg | Risk of weight gain, metabolic syndrome, abnormal/involuntary movements; possible cardiovascular effects (e.g., prolonged QT interval). |
| chlorpromazine (Thorazine) | 10–50 mg | Risk of weight gain, metabolic syndrome, abnormal/involuntary movements; possible cardiovascular effects (e.g., hypotension). | |
| Chloral derivative | chloral hydrate | 0.5–1.0 g | Used mainly for sleep maintenance; risk of gastric irritation; risk of dependence and withdrawal; lethal in overdose. |
