Address
341 State St.
Madison, WI
53703

Phone
608-251-3242 main
608-251-4454 rx
608-251-3304 fax
608-251-3853 rx fax
608-251-5339 tty

Store Hours
Mon-Fri 9-7
Sat 10-6
Sun Closed

Store map

5/13/10
News from the Dispensary: INSOMNIA
ARE MY MEDICATIONS CAUSING MY INSOMNIA?
Stimulants, other medications that cause insomnia, and what you can do about it.
STIMULANTS
- Methylphenidate: Ritalin®, Methylin®, Metadate®, Focalin®, Concerta®, and Daytrana® patch
- Dextroamphetamine: Dexedrine®, Dextrostat
- Amphetamine/Dextroamphetamine: Adderall®
Mechanism of Action: The mechanism of action for stimulants is somewhat unknown. Stimulants increase central nervous system activity (brain and spinal cord) by blocking the reuptake of two important neurotransmitters, norepinepherine and dopamine, in neuronal synapses. This increase in norepinepherine and dopamine in neuronal synapses is thought to cause an increase in attention span and concentration. On average, it takes the human body 12 hours to metabolize 50% of a stimulant medication.

Common Side Effects:
- Weight Loss (9% )
- Decrease in Appetite (26% )
- Loss of appetite (5% )
- Nausea (12% )
- Vomiting (10% )
- INSOMNIA (13%)*
- Headache (13%)
*Stimulants can cause insomnia because the increase in central nervous system activity makes it hard to sleep. This is especially true with afternoon and evening doses of stimulants as it typically takes the human body 12 hours to metabolize 50% of a stimulant medication.

OTHER MEDICATIONS THAT CAN CAUSE INSOMNIA:
- Central nervous system depressants (alcohol, benzodiazepines, Kava Kava, muscle relaxants, etc)
- Asthma medications
- Anti-depressants
- Steroids
- Caffeine
*This is a partial list of common medications that can cause insomnia. Ask your pharmacist at Community Pharmacy if any of the medications you are taking can cause insomnia.

MEDICATIONS COMMONLY USED TO TREAT INSOMNIA:
- Zolpidem (Ambien®)
- Lunesta®
- Benzodiazepines (for example, Ativan® = lorazepam)
- Melatonin
- Trazodone
- Mirtazapine (Remeron®)
- Amitriptyline
- Diphenhydramine (Benadryl® and most over the counter sleep aids)
- Chamomile
- 5-HTP and/or Tryptophan
- Kava Kava
* If you can avoid it, you do not want to treat the side effects of one medication with another medication. Talk to your Community Pharmacy pharmacist or herbalist today.

MEDICAL CONDITIONS ASSOCIATED WITH INSOMNIA:
- Post-traumatic stress disorder (PTSD)
- Anxiety
- Depression
- Substance abuse
- Migraine/headaches
- Chronic obstructive pulmonary disease (COPD)
- Fibromyalgia
- Chronic pain
- Nighttime urination
- Congestive heart failure
- Restless leg syndrome (RLS)
- Sleep apnea
- Brain injuries

WHAT YOU CAN DO ABOUT YOUR INSOMNIA:
1. Talk to your doctor about your insomnia and, if applicable, mention that you are also taking a stimulant medication(s).
2. If applicable, take your afternoon stimulant medication dose earlier than usual.
3. Avoid alcohol and other drugs; especially before bed.
4. Avoid eating three hours before bed.
5. Get a nighttime routine and stick to it. You will fall asleep easier if you stick to a routine.
6. Decrease your caffeine intake; especially in the afternoon and evening.
7. Try relaxation and meditation.
8. Try to decrease or eliminate stress in your life.

This informal brochure was created as part of my student internship. If you have any further questions or would like to know more, please contact the Community Pharmacy staff.
Tom Dilworth, DPH-4, 2010
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