List of Sedative-Hypnotic Drugs (Sleeping Pills)
- Non-Benzodiazepines
- Melatonin receptor agonists
- Orexin receptor antagonists
- Benzodiazepines
- Sedating antidepressants
- Barbiturates
- Over-the-Counter sleep aids
- "Off-label" sleeping pills
Based on "Sleep Disorders Medicine"
written by Dr. Sudhansu Chokroverty, MD
Several different classes of medications are used to treat insomnia. This list includes both prescription and over-the-counter sedative-hypnotic medications.
Non-Benzodiazepine hypnotics (Z-Drugs)
Z-drugs are structurally unrelated to each other. These medications have largely replaced traditional benzodiazepines in the treatment of insomnia.
| Generic | Brand Name |
|---|---|
| Eszopiclone | Lunesta |
| Zaleplon | Sonata |
| Zolpidem | Ambien, Intermezzo, Zolpimist |
| Zopiclone * | Zimovane |
| * NOT approved in the US | |
Melatonin receptor agonists
Ramelteon is currently the only FDA-approved melatonin receptor agonist. Ramelteon is used for sleep onset insomnia and has little value for maintaining sleep.
| Generic | Brand Name |
|---|---|
| Ramelteon | Rozerem |
Orexin receptor antagonists
Orexin-receptor antagonists is a novel pharmacologic class of hypnotics. The first - and by far the only - member of this class was approved in 2014.
| Generic | Brand Name |
|---|---|
| Suvorexant | Belsomra |
Benzodiazepines
Benzodiazepine hypnotics are used for the short-term treatment of insomnia. Benzodiazepines produce sedative, hypnotic, anxiolytic, and muscle relaxant effects.
Benzodiazepines shorten sleep latency and reduce the number of awakenings and the time spent in stage of wakefulness.
All benzodiazepines are controlled substances in schedule IV.
| Generic | Brand Name |
|---|---|
| Hypnotics | |
| Brotizolam * | Lendormin |
| Estazolam | Prosom |
| Flurazepam | Dalmane |
| Loprazolam* | Dormonoct, Havlane, Sonin, Somnovit |
| Lormetazepam* | Loramet, Noctamid |
| Nitrazepam* | Cerson, Mogadon, Nitrazadon, Radedorm |
| Quazepam | Doral |
| Temazepam | Restoril |
| Triazolam | Halcion |
| * NOT approved in the US | |
| Anxiolytics (not approved as hypnotics) | |
| Alprazolam | Xanax |
| Bromazepam | Lexotan |
| Chlordiazepoxide | Librium |
| Clorazepate dipotassium | Tranxene, Gen-Xene |
| Clonazepam | Klonopin |
| Diazepam | Valium |
| Lorazepam | Ativan |
| Midazolam | Versed |
| Oxazepam | Serax |
Sedating antidepressants
Sedating antidepressants are widely used for insomnia, but are not officially licensed for this indication. Currently doxepin is the only antidepressant approved by the U.S. FDA for the treatment of insomnia.
| Generic | Brand Name |
|---|---|
| Amitriptyline* | Elavil, Endep, Vanatrip |
| Doxepin | Silenor, Sinequan, Adapin |
| Mirtazapine* | Remeron |
| Trazodone* | Desyrel, Oleptro, Trittico |
| * NOT FDA approved for insomnia | |
Barbiturates
Currently barbiturates are not recommended for routine use for insomnia due to high incidence of tolerance and dependence.
| Generic | Brand Name |
|---|---|
| Amobarbital | Amytal Sodium |
| Butabarbital | Butisol |
| Pentobarbital | Nembutal |
| Phenobarbital | |
| Secobarbital | Seconal Sodium |
Other sedative-hypnotic agents
| Generic/Class | Brand Name |
|---|---|
| Chloral hydrate (sedative, hypnotic) |
Somnote, Noctec, Aquachloral |
| Dexmedetomidine | Precedex, Dexdor, Dexdomitor |
| Ethchlorvynol | Placidyl |
Over-the-counter sleep aids
Most of the over-the-counter sleep aids contain sedating antihistamine (histamine type 1 receptor blocker).
| Generic | Brand Name |
|---|---|
| Diphenhydramine | Benadryl |
| Doxylamine | Unisom SleepTabs, Good Sense Sleep Aid |
Dietary supplements, herbal products
| Name | Class |
|---|---|
| Melatonin | hormone secreted by the pineal gland, available as dietary supplement |
| Kava | herbal product |
| Passion flower | herbal product |
| St. John's wort | herbal product |
| Valerian | herbal product |
"Off-label" Sleep Aids
| Generic | Brand Name |
|---|---|
| Atypical antipsychotics | |
| Olanzapine 5 | Zyprexa |
| Quetiapine 6 | Seroquel, Seroquel XR |
| Anticonvulants | |
| Gabapentin7 | Neurontin |
| Tiagabine8 | Gabitril |
| Antihistamines | |
| Chlorpheniramine 3 | Antagonate, Chlor-Trimeton, Kloromin, Phenetron, Pyridamal 100, Teldrin |
| Hydroxyzine and its combinations2 | Vistaril, Atarax |
| Promethazine 3 | Phenergan, Remsed |
| Trimeprazine 4 | Temaril, Vallergan |
Resources
- 1. New FDA Approved Drugs CenterWatch
- 2. Spahr L, Coeytaux A, Giostra E, Hadengue A, Annoni JM. Histamine H1 blocker hydroxyzine improves sleep in patients with cirrhosis and minimal hepatic encephalopathy: a randomized controlled pilot trial. Am J Gastroenterol. 2007 Apr;102(4):744-53. PubMed
- 3. Saitou K, Kaneko Y, Sugimoto Y, Chen Z, Kamei C. Slow wave sleep-inducing effects of first generation H1-antagonists. Biol Pharm Bull. 1999 Oct;22(10):1079-82. PubMed
- 4. Mohammadi R, Gaudoneix-Taieb M, Armand-Branger S, Beauverie P, Poisson N. Value of trimeprazine among hypnotics in a psychiatric facility. Encephale. 2000 Sep-Oct;26(5):75-80. PubMed
- 5. Khazaie H, Rezaie L, Darvishi F, Najafi F, Avis K. Treatment of paradoxical insomnia with atypical antipsychotic drugs. Neurosciences (Riyadh). 2013 Jan;18(1):64-9. PubMed
- 6. Anderson SL, Vande Griend JP. Quetiapine for insomnia: A review of the literature. Am J Health Syst Pharm. 2014 Mar 1;71(5):394-402. PubMed
- 7. Lo HS, Yang CM, Lo HG, Lee CY, Ting H, Tzang BS. Treatment effects of gabapentin for primary insomnia. Clin Neuropharmacol. 2010 Mar-Apr;33(2):84-90. PubMed
- 8. Walsh JK, Zammit G, Schweitzer PK, Ondrasik J, Roth T. Tiagabine enhances slow wave sleep and sleep maintenance in primary insomnia. Sleep Med. 2006 Mar;7(2):155-61. PubMed
Created: December, 2015
Last reviewed: February 18, 2019
