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Dearborn, MI
A 36-year-old male asked:

For sleep aid, patient with severe insomnia you dr. had to choose between prescribing amitriptyline or trazadone or flexeril, (cyclobenzaprine hcl) which one would you choose? and how would you monitor it?

2 doctor answers7 doctors weighed in
Dr. Bryan Treacy
Gynecology 35 years experience
Variable: I use trazodone frequently for insomnia since it is scored two different ways on the tablet. It gives a variety of doses to try from a 150 mg dose. In other words, you can try 50-75-100-125-1150 mg at bedtime for a sleep aid. Flexeril (cyclobenzaprine hcl) is also a reasonable attempt at sleep aid. I monitor by early morning feelings more than anything.
Dr. Erica Bial
Specializes in Pain Management
Adjunct,side effects: It all depends on the situation. The bigger question to me is "why does the patient have insomnia?" and then deal with that piece. You mentioned that you're on methotrexate, but not why. Similarly, you've had a cardiac catheterization, but don't state the reason. The choice of drug when treating insomnia, if a drug therapy is required at all, depends strongly on the other conditions.
Dr. Bryan Treacy
Gynecology 35 years experience
Good point. I didn't see the MTX or cardiac cath issues in this question for some reason.
Aug 11, 2015

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Last updated Jun 24, 2018

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