With benzodiazepine agonists, the main feature to consider when choosing this type of hypnotic drug is the duration of action of the drug. Short-acting drugs can be used to treat insomnia with difficulty falling asleep, but do not help to improve insomnia with sleep maintenance disorders. Long-acting drugs increase the risk of daytime sedation and other residual effects.
Melatonin receptor agonists, such as ramelteon, are contraindicated in patients using fluvoxamine (luvoxamine), as the antidepressant fluvoxamine can significantly increase blood levels of ramelteon.
Sedative antidepressants and antipsychotics, sedative antidepressants are widely used as hypnotic drugs, but the doses used for hypnotic purposes are lower than those required for antidepressant action.