In this occasional feature, members of the Psych Congress Steering Committee and faculty answer questions asked by attendees at Psych Congress meetings.
QUESTION: What would be a drug of choice for insomnia associated with dementia in older patients?
ANSWER: Unfortunately, there are no agents that have an indication or proven track record in this specific area. However, it would make clinical sense to utilize agents that are least likely to have daytime carry over effects, i.e., those that have shortest durations of action.
In addition, the agents that do not have GABA-ergic activity may be less problematic from a cognitive standpoint than those that act at the melatonin, histamine, and orexin receptors, although this notion has not been properly evaluated.
— Karl Doghramji, MD, Professor of Psychiatry, Neurology, and Medicine and Medical Director, Jefferson Sleep Disorders Center, Thomas Jefferson University, Philadelphia, Pennsylvania.