Class, Drug

Starting Dose

Usual Dose

Half-Life

(hours)

Comments

Intermediate-acting benzodiazepines

Temazepam

7.5 mg

7.5–30 mg

8.8

Psychomotor impairment, increases risk of falls

Short-acting nonbenzodiazepines

Eszopiclone

1 mg

1–2 mg

6

Reportedly effective for long-term use in selected individuals; may be associated with unpleasant taste, headache; avoid administration with high-fat meal.

Zaleplon (a pyrazolopyrimidine)

5 mg

5–10 mg

1 (reported unchanged in elderly persons)

Reportedly little daytime carryover, tolerance, or rebound insomnia

Zolpidem (an imidazopyridine)

5 mg

5–10 mg

1.5–4.5 (3 in elderly persons, 10 in hepatic cirrhosis)

Reportedly little daytime carryover, tolerance, or rebound insomnia

Sedating antidepressants

Mirtazapine^OL

15 mg

5–45 mg

31–39 in older adults; 13–34 in younger adults; mean = 21

Increased appetite, weight gain, headache, dizziness, daytime carryover; used for insomnia with depression

Trazodone^OL

25–50 mg

25–150 mg

Reportedly 6 ± 2; prolonged in elderly and obese persons

Moderate orthostatic effects; reportedly effective for insomnia with depression; administration after food minimizes sedation and postural hypotension