노인 불면증의 약물치료

• 영문명: Pharmacotherapy for Insomnia of the Elderly
• 발행기관: 대한노인정신의학회
• 저자명: 강승걸(Seung-Gul Kang)
• 간행물 정보: 『노인정신의학』노인정신의학 제26권 제1호, 1~7쪽, 전체 7쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2022.04.30

영문 초록

Insomnia is a common disease in the elderly. It is caused by various etiologies and their combinations. Therefore, treatment should be tailored to the individual. Cognitive-behavioral therapy for insomnia (CBT-I) is the treatment of choice for chronic insomnia; however, hypnotics are commonly used as a primary treatment in the clinical practice. The hypnotics approved for insomnia management in Korea include zolpidem, eszopiclone, triazolam, doxepin, prolonged-release melatonin, and flurazepam. Although not approved, sedative antidepressants and antipsychotics are also frequently used. When prescribing hypnotics to elderly patients, the side effects and limitations of pharmacotherapy should be explained in advance, and the lowest effective dose and “as needed” prescription should be employed. Moreover, the adverse effects should be considered, including dependence, in the elderly. When reducing the medication dose, gradual tapering is safe and realistic considering the withdrawal symptoms. Even in long-term pharmacotherapy, the combination of sleep hygiene education and CBT-I should be considered to increase the effectiveness of and satisfaction from the insomnia treatment, and minimize the medication dose.

키워드

Cognitive behavior therapy Elderly Hypnotics Insomnia Drug side effects