Treating insomnia

Beware of the DTC advertising on sleep agents, such as Ambien:

Although initially promoted as superior to benzodiazepines in terms of daytime sedation, dependence, and withdrawal, the Z drugs (ed note – aka Zolpidem (Ambien)) have not delivered on several fronts. On the quality of evidence, of the 17 randomised trials with a total of 1284 patients, all were industry funded, outcomes were poorly and often selectively reported in favour of positive findings, comparators were suboptimal, durations were very short (maximum six weeks), and surrogate markers (generally sleep variables) were highlighted.7 On the risk-benefit front, no consistent difference was found between the Z drugs and benzodiazepines for either effectiveness or safety.7 On the economic front, since the Z drugs are each several times the cost of older benzodiazepines, without evidence of superior effectiveness, they cannot be considered cost effective.

The guidelines can be found here.