Insomnia meds for psych patients?

i like ambien (i actually take it myself as well). I worry about temazepam and etc benzos and their addictive qualities. Ambien can be addictive as well, but people are less likely to take it during the daytime. I'm curious to other people's opinions.

other than benzos and benadryl, the only other sleep med I've given since my last floor job was ambien and trazadone; ambien's ok, but as mentioned, folks can become dependent on it; the other problem with ambien is that you really need to be able to devote a block of 8 or so hrs. to sleep, which is pretty much impossible in a hospital, regardless of floor; another problem is that I've seen people wake up in the middle of the night displaying bizarre behaviors, which doesn't go well with someone who already is psychotic; trazadone's, IMHO is a decent option

since my last floor job, the CR version of ambien has come out as well as lunesta; I'm not familiar with either in terms of effectiveness, unfortunately

don't forget about seroquel. we give out anything and everything for sleep. how well it works and what type of med we give depends on the person. seroquel, lunesta, ambien, trazodone, benadryl, vistaril, temazepam, mirtazepine, risperdal, haldol, thorazine (last few of course not sleep meds but helpful when already ordered as a prn for anxiety/agitation and patient is up and agitated at 10pm or 2am).

The most poplular drug of choice for our pts. seems to be Seroquel and if something else needed....all of the above....

In outpatient we generally are prescribing Lunesta and Rozerem (getting Rozerem covered on state insurance is a NIGHTMARE though)...for patients at low risk of drug abuse the NPs will SOMETIMES use benzos, but not too much...we also use Benadryl, Seroquel, Trazodone, and Remeron.

how do your pts. like lunesta? is rozerem new? how is it?

Remeron (mirtazapine) is not just for underweight insomniacs (as far as the off-label uses). Even when used as an antidepressant, many users find it to be more effective than Zoloft w/ less ADR's (adverse drug reactions).

A bit off topic but, I had a guy the other night with psych issues and dementia. had PRN ambien ordered and he asked me for a sleeping pill when I was passing her HS meds. Well, I gave him the 10mg of Ambien and he fell asleep. 2hrs later, I hear this cry from his room. He is standing next to her roommate's bed yelling "Cant you see!! he is bleeding to death. he is stuck between the rails. Someone help him.". The poor room mate was lying in the bed looking so freaked out. Turns out my patient was having major nightmares from the ambien. Definitely made me want to second guess myself everytime I want to give an ambien.