Hypnotics Versus the Alternatives

Special Article

Psychiatry Investigation 2007;4(2):57-60.

Daniel F. Kripke, MD

Department of Psychiatry, University of California, San Diego, and The Scripps Clinic Sleep Center, La Jolla, California, USA

Abstract

<p class="MsoPlainText" style="word-spacing: 1; line-height: 150%; margin-top: 0; margin-bottom: 0" align="left"><font face="HY중고딕" size="2">When patients ask for hypnotics (sleeping pills), what should physicians advise? This review considers cognitive-behavioral therapy and hypnotics as alternative treatments. The effectiveness of cognitive-behavioral therapy for insomnia has been demonstrated. No appreciable risks have been reported. The risks of hypnotics include impairments of cognition and function, depression, cancer, and early mortality, but the newest hypnotics have surprisingly little objective benefit. The physician can help patients best by persuading them of the benefits of cognitive-behavioral approaches.

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Key words Hypnotics;Insomnia;Cognitive behavior therapy;Cancer;Depression;Mortality.