Kevin Leehey, M.D.
1980 E. Ft. Lowell Road, Suite 150 Tucson, Arizona 85719 (520) 296-4280 Fax: (520) 296-3835

MEDICATIONS FOR ANXIETY AND SLEEP

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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
0.5, 1, 2, 3mg

Niravam
(dissolve oral)
0.25, 0.5, 1, 2mg

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)
0.125mg
0.25mg
0.5mg
1mg
2mg

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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