4.1. Hypnotics and anxiolytics
4.1.1.1. Hypnotics for acute insomnia
Prescribing Notes:
Before a hypnotic is prescribed, the cause of the insomnia should be established and underlying factors should be addressed and non-drug management, such as sleep hygiene considered. If a hypnotic is essential, it should be prescribed at the lowest effective dose as a short course (preferably one week) and the choice of agent based on the patient’s medication and medical history and evaluation of the consequences of supplying a potential drug of abuse.
Prescribing Notes:
Before a hypnotic is prescribed, the cause of the insomnia should be established and underlying factors should be addressed and non-drug management, such as sleep hygiene considered. If a hypnotic is essential, it should be prescribed at the lowest effective dose as a short course (preferably one week) and the choice of agent based on the patient’s medication and medical history and evaluation of the consequences of supplying a potential drug of abuse.
4.1.1.2. Hypnotics for chronic insomnia
Restrictions:
Restricted to use in patients where sleep hygiene advice has been unsuccessful and the use of cognitive behavioural therapy for insomnia (CBT-I) has failed or for whom CBT-I is unsuitable or unavailable.
Prescribing Notes:
- For the treatment of adult patients with chronic insomnia characterised by symptoms present for at least 3 months and considerable impact on daytime functioning.
- Sleepio® is a six-week programme based on CBT-I. Sleepio® is used to treat insomnia and is available free on the NHS. For more information visit Sleep | NHS inform
4.1.2. Anxiolytics
Prescribing Notes:
Only beta-blocker licensed for anxiety with symptoms such as palpitation, sweating and tremor. It is not included in the Preferred List for hypertension, angina and heart failure