Page 40 - Demo

CONTINUING PROFESSIONAL DEVELOPMENT
COUNSELLING IN PRACTICE
Insomnia and selective serotonin re-uptake inhibitors
BY ELISE APOLLONI MPS
What are my treatment options for insomnia?
Insomnia is a medical condition characterised by a person struggling to get
to sleep (taking more than 30 minutes) or stay asleep (waking for more than 30–45 minutes throughout the night). People experiencing insomnia may also report early wakening and/or their sleep does not refresh them for the following day.1,2 While some people experience acute insomnia, others may suffer from chronic insomnia (i.e. duration is greater than 30 days) associated with other conditions such as pain, mental illness, or medicines.3
Treatment options for insomnia can be non-pharmacological or pharmacological.3 Non-pharmacological treatment options can include implementation of sleep hygiene measures (including stimulus control), sleep restriction techniques, light therapy and cognitive behavioural therapy (to address anxieties around sleep). Pharmacological treatment options for adults are ideal for short-term use and include benzodiazepines (e.g. temazepam)
and ‘z-drugs’. Elderly people experiencing insomnia should explore non- pharmacological treatment options as first-line treatment.3 Alternative medicinal options include prolonged-release melatonin 2 mg (Circadin) or compounded preparations, sedating antihistamines (e.g. doxylamine) and herbal medicines (e.g. valerian, passionflower, and lavender).4
Elise Apolloni is a Canberra-based community pharmacist, mental health first aid trainer and Lifeline Australia Telephone Crisis Supporter and volunteer telephone counsellor for the Pharmacists’ Support Service.
LEARNING OBJECTIVES
After reading this article, pharmacists should be able to:
• Identify pharmacological and non-pharmacological treatment
options for insomnia
• Recognise the correlation between optimal dose timing of
selective serotonin re-uptake inhibitors (SSRIs) and insomnia
• Assess patient needs and refer patients with insomnia to a general
practitioner (GP) if necessary.
Competencies addressed: 1.3.1, 1.3.2, 1.4.1, 2.1.1, 2.1.3, 2.1.4, 6.1.1, 6.1.2, 6.1.3, 6.2.1, 6.2.2, 6.2.3, 6.3.3, 7.1.1, 7.1.2, 7.1.3, 7.1.4, 7.3.1, 7.3.2, 7.3.3.
Accreditation number: CAP1701A
38 Australian Pharmacist January 2017 I ©Pharmaceutical Society of Australia Ltd.
This article has been independently researched and peer reviewed.