Other Hypnotic Drugs

This section combines four medications that are used for insomnia.  There are two types of medications in this section. First, there are the GABA receptor agonists (zolpidem, zaleplon, and eszopiclone) that are specific to the BZ1 receptor type (benzodiazepines are non-specific GABA receptor agonists).  Second there is ramelteon, which is a melatonin receptor agonist that stimulates release of melatonin.  

Class Drugs

• Zolpidem

• Zaleplon

• Eszopiclone

• Ramelteon

Class Mechanism of Action

• Varies based on agent

Class Application

• Induction of sleep

Class Adverse Effects

• See individual drugs.

Drug Table

Drug Name	Application	Comments	Image
Zolpidem	Insomnia; -Little dependence or withdrawal; -Little tolerance; -Little rebound insomnia; -Effects last ~5 hours; -Does not alter sleep stages	Mechanism; Related to benzodiazepines; No muscle relaxing or anticonvulsant effects; Binds to receptor subtype BZ1; Adverse Effects; Nightmares; Anterograde amnesia; Drowsiness	"Z",  "Pie", and "Donkey"
Zaleplon	Insomnia; -Little dependence or withdrawal; -Little tolerance; -Little rebound insomnia; -Half-life 1 hour; -Does not alter sleep stages	Mechanism; Related to benzodiazepines; No muscle relaxing or anticonvulsant effects; Binds to receptor subtype BZ1; Adverse Effects (fewer than zolpidem); Nightmares; Anterograde amnesia; Drowsiness	"Sale" and "Pylon"
Eszopiclone	Insomnia; -Little dependence or withdrawal; -Little tolerance; -Little rebound insomnia; -Elimination half-life 6 hours; -Does not alter sleep stages	Mechanism; Related to benzodiazepines; No muscle relaxing or anticonvulsant effects; Binds to receptor subtype BZ1; Adverse Effects; Anxiety; Dry mouth; Peripheral edema; Somnolence	"EZ" "Pie" "Clone"
Ramelteon	Insomnia; Useful in patients with increased sleep latency; No dependence or withdrawal	Mechanism; Melatonin (MT1 & MT2) receptor agonist; Stimulates release of melatonin, which promotes sleep-wake cycle; Adverse Effects; Dizziness, fatigue, somnolence; May increase prolactin levels	"Ram" "Melting On"