ABSTRACT
Insomnia is a common symptom encountered in primary care and in psychiatric practice. Various psychiatric problems, including anxiety disorders, mood disorders, psychotic disorders, or situational stress can cause insomnia. Combinations of various hypnotics have complimentary and synergistic effects and hence may be used together for treating severe insomnia. The sedating effects of tricyclic antidepressants (TCAs) may be exploited for the treatment of insomnia, especially if loss of appetite and weight loss are of concern. Risperidone can occasionally cause insomnia, requiring additional medications. Medications with a low risk of abuse and addiction are preferred for treating insomnia in patients at risk for substance abuse. Most patients who have somatoform disorders are antagonistic to the idea that their condition has a psychiatric basis. Successful treatment of the psychiatric condition should improve energy level, motivation, concentration, and emotional control, thereby improving job functioning; whereas, untreated disorders can lead to deterioration in personal, social, and occupational functioning.
