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.
Restrictions:
Restricted to short term use (less than two weeks) in adults initiated by a specialist for severe insomnia, when insomnia is interfering with daily life and other therapies have failed.
As per Scottish Government guidance, is of limited clinical value. Please consider deprescribing where safe and appropriate. Continued prescribing should be subject to regular review.
Restrictions:
Restricted to initiation as recommended by secondary care and in concordance with the NHSGGC 'Melatonin for acute and chronic insomnia in adults' treatment guideline.
Melatonin should be prescribed in generic form. Approved medicinal forms include:
- Melatonin 2mg modified-release tablets
- Melatonin 3mg immediate-release tablets
- Melatonin 1mg in 1ml oral solution
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.