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

MEDICATIONS FOR SLEEP, ATYPICAL DEPRESSION,
AND ANXIETY

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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
Antihistamine
(sleep)
Benadryl
(Diphenhydramine)
Tablet
12.5mg
25mg
50mg

typically only as needed 25-100mg Typical antihistamine effects: sedation, dryness. A few get agitation instead. Benadryl, available over the counter.

May provide calming and help with sleep anxiety.
Not to be used regularly for more than a few days or weeks without M.D. supervision.
Altarax
Vistaril
(Hydroxyzine)
Tablet
25mg
50mg
Liquid
12.5-50mg
MAOI
Monoamine
Oxidase
Inhibitors

(atypical depression and anxiety)
Nardil
(Phenelzine)

 

Parnate
(Tranylcypromine)

 

Emsam
(Seligiline skin patch)


Tablet
15mg

 

Tablet
10mg

 

Patch
6, 9, or 12 mg/24h

 


2-3 times a day

 

 


change patch daily


Adoles:30-60mg
Adults:30-90mg

 


Adoles:20-40mg
Adults:20-60mg

 

 

6, 9, or 12 mg/24h

 

Sedation, agitation


Hypertensive crisis may be dangerous if Tyramine containing medicine or food is ingested.

6 mg patch avoids diet and medicine interactions.  Occasionally bothers sleep; patch may irritate skin

May help atypical cases that other medicines do not. Requires special diet. Requires med-free period before and after.

Often SRI's also help atypical cases and are far easier for most people to take.

Infrequently prescribed due to potentially dangerous interactions.

Food, alcohol, and several medication interactions.
Melatonin
(sleep)
Melatonin 1mg
3mg
evening 1-12mg Sedation Mild, over the counter sleep aid. Helps restore natural sleep cycle. Cost and reliability of dose may be problem as not regulated by FDA. Claims beyond sleep help are unproven and likely untrue.
Azapirones
(anxiety)
BuSpar
(Buspirone)
Tablets
5mg
10mg
15mg
30mg
2-3 times a day Child:5-30mg
Adoles:15-60mg
Adult:15-60mg
max 100mg
Mild sedation. Occasional brief mild dizzy or energy.
Non-benzodiazipenine thus no habit forming potential. Very little side effects, or interactions.

Helps anxiety primarily. Good as a
depression or anxiety booster. Generic available.
Effectiveness often moderate.

Effect needs 1-3 weeks to build up. Not an as needed medicine.

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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