04.03.2014
According to National Sleep Foundation, insomnia is difficulty falling asleep or staying asleep, even when a person has the chance to do so.
Insomnia may be caused by depression and stress but it may also be caused by the imbalances in the neurotransmitters as a result of long term use of drugs of pleasure. From the foregoing discussion, it follows that the causes of insomnia usually fall into one of three types: 1) medical and psychiatric, 2) iatrogenic, and 3) psychosocial (TABLE 1). It is imperative that pharmacists conduct a brief medical history when counseling patients with insomnia, asking specifically about diagnosed medical disorders, medications, herbs and supplements, caffeine, alcohol, tobacco, and sleep hygiene.
Attention to the underlying causes of sleeplessness is critical to alleviating both short-term and long-term insomnia.
Once underlying medical, psychosocial, or iatrogenic causes have been addressed and appropriate sleep hygiene has been initiated, OTC sleep aids may be considered. The recommended dose of valerian for insomnia is 300 mg to 600 mg standardized to 0.8% to 1% valerenic acid per dose at bedtime. Pharmacist-to-Patient Counseling Tips: Owing to the widespread availability and marketing of the aforementioned nutraceuticals for insomnia to the general public, their use often is not supervised by pharmacists. The use of herbs and supplements for chronic insomnia that is not medically supervised should be discouraged because an underlying, treatable cause of insomnia may otherwise be masked. Benzodiazepines: The currently marketed benzodiazepines and their respective usual doses for insomnia are listed in TABLE 4. Nonbenzodiazepine Hypnotics: Zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata) are nonbenzodiazepine sedative-hypnotic drugs approved for the short-term treatment of insomnia.
Insomnia that worsens or persists beyond 3 weeks may signal an underlying medical, psychiatric, iatrogenic, or psychosocial disorder. People with insomnia can feel dissatisfied with their sleep and usually experience the symptoms of poor sleep that may deter them from enjoying healthy lifestyles. John’s wort has been found to be very effective in treatment of depression that might cause difficulty in sleep and this is owed to its effects on serotonin may be primarily responsible for its antidepressant activity.


However there are also medical approaches to treating drug induced Insomnia but of all these going the natural way is much better since it has less side effects and is more effective.  We at AWAREmed health and wellness center are dedicated to finding the best natural solutions to health problems. Because of their access to the general public and expertise in drug therapy, pharmacists are uniquely qualified to assist patients with insomnia. Comorbidities such as physical disability, respiratory problems, medication use, depressive symptoms, environmental factors, poor living conditions, and loss of a spouse, close friend, or relative have all been associated with higher rates of insomnia in individuals over the age of 65.1 Conditions such as depression, anxiety, asthma, chronic obstructive pulmonary disease, congestive heart failure, thyroid disease, gastroesophageal reflux disease, pain, sleep apnea, and neurologic disorders also are linked to the development of insomnia. The pharmacist may be the initial point of contact for patients with insomnia, and they can provide referrals to physicians. Diphenhydramine may cause confusion and sedation and is not recommended for use as a hypnotic agent in the elderly.11 Diphenhydramine and doxylamine may cause dizziness, sedation, confusion, dry mouth, constipation, and urinary retention, effects that are more pronounced in elderly patients.
The pharmacist should first address sleep hygiene and other nonmedical or psychiatric causes of insomnia before recommending these supplements. The use of benzodiazepines for insomnia is somewhat controversial because of their potential to produce euphoria and their potential association with withdrawal symptoms after prolonged use.
Commonly reported withdrawal symptoms are anxiety and insomnia; others include tinnitus, involuntary movements, perceptual changes, confusion, and depersonalization. Ramelteon (Rozerem) is a melatonin receptor agonist approved for the treatment of insomnia characterized by difficulty initiating sleep onset. Although these medications are utilized to help relieve insomnia in patients with depression, they should be used with extreme caution in older patients.
Apart from these two causes, a person may also have a family history of depression and so predisposed to depression a case which makes it rather complicated for the brain to produce the neurotransmitters in required amounts. Anxiety beckons insomnia and so should be avoided to help you sleep soundly and reap huge health benefits from it. Pharmacists can give patients and their physicians important feedback whenever treatable or reversible underlying causes of insomnia are suspected. The pharmacist may wish to consider providing feedback to a patient's physician whenever treatable or reversible causes of insomnia are suspected, especially in drug-induced cases.


Patients with chronic insomnia may be advised to contact national organizations that provide free support materials to people suffering from insomnia (TABLE 5). Clinical evaluation of diphenhydramine hydrochloride for the treatment of insomnia in psychiatric patients: a double-blind study. Melatonin in medically ill patients with insomnia: a double-blind, placebo-controlled study.
Doxepin in the treatment of primary insomnia: a placebo-controlled, double-blind, polysomnographic study.
Diseases like cancer, arthritis, heart disease, stroke, Alzheimer’s disease and even Parkinson’s disease have been linked to insomnia. Chronic insomnia is usually associated with medical, psychiatric, psychological, or substance-use disorders. Changes in the circadian rhythm caused by the normal aging process dictate patterns of falling asleep and waking up earlier in the older population. Antidepressants should not be used in patients with urinary retention or chronic constipation. Finally, the pharmacist should promote principles of good sleep hygiene and take a thorough medication history to rule out any iatrogenic causes of the insomnia. Primary insomnia is not caused by a health problem; it is a sleep disturbance that cannot be attributed to a medical, psychiatric, or environmental cause. Secondary insomnia, on the other hand, is caused by an underlying medical condition or a medication.
This herb has been found to be very useful in treatment of conditions that are caused as a result of imbalances in the neurotransmitters.




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