For Sleep, Atypical Depression and Anxiety

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.
Antihistamine (sleep)	Altarax Vistaril (Hydroxyzine)	Tablet 25mg 50mg Liquid 12.5-50mg	typically only as needed	25-100mg
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		Mild sedation or energy	Non-benzodiazipenine thus no habit forming potential. Very little side effects, or interactions. Helps anxiety primarily. Good as a booster. Generic available.	Effectiveness often moderate. Effect needs 1-3 weeks to build up. Not a PRN med.

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.