What is the drug of choice for insomnia?

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Doxepin is FDA-approved to treat sleep disorders characterized by difficulty maintaining sleep. However, other sedative TCAs (such as amitriptyline, nortriptyline, and imipramine) have not been approved to treat patients with sleep disorders. Mirtazapine is currently only approved for the treatment of major depressive disorders. Sedation is achieved due to the strong antagonistic effects of the drug on histamine (H) receptors. The Centers for Disease Control and Prevention further classifies sleep disorders as episodic (lasting at least one month but less than three months lasting), persistent (three months or longer), or recurrent (two or more episodes within one year).

Because the drug can be addictive and abusive, doctors do not recommend it as a long-term treatment for sleep disorders.

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