Treatment of resistant depression in adults
Only 40 percent of patients in primary care respond to the first choice of antidepressant medication. Approximately 20 percent stop the medication due to side effects, and 30 percent have no response.
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Three newer non-benzodiazepine hypnotic agents have been developed and FDA-approved for the treatment of insomnia. Zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta) are rapid-onset, short duration of action drugs that act on GABAA receptors. Their mechanism of action is not completely understood, but they can be conceptualized as benzodiazepine receptor agonists. This new generation of drugs may offer advantages over benzodiazepines in terms of safety (less tolerance and dependence). They have largely replaced the benzodiazepines as hypnotic medicines of choice, although they lack the anxiolytic, anticonvulsant, and muscle-relaxant properties of the benzodiazepines.
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