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The effectiveness of insomnia medication

We know that many of you dislike taking medication for insomnia (you've told us). We recently read that an insomnia drug, approved by the FDA, barely got through the approval process and in one trial it failed to reduce the number of patients with insomnia.

The issue here is this: drugs either get approved or they don't. As consumers, we aren't given any additional information on how well drugs did in trials or how easily they won approval.

Is this right? Should we be seeing drugs receive scores, or should we simply accept that a drug is effective if it has been approved by the FDA? We'd like to know your thoughts.

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Last updated: April 30, 2010

This Article Was Written By

Martin Reed

Leave a Comment

  • A. Marina Fournier
    November 18, 2010, 6:20 am

    I did as much research as I could, given that, mostly all I had were a bunch of names in a given geographical area.

    I just checked to see what I could find on a search, and she gets glowing reviews. She was one of only two, out of the dozen or more pdocs my insurance would cover, that I called after I’d been properly dx’d with bipolar disorder (I’m in the NOS category). For people who thought they were only depressed (and boy, was I!), getting an accurate dx is hard if you don’t talk about the times when you’re not depressed, as there is no easy diagnostic test for the bipolar disorder. The average delay is 15 years.

    I had had two detested pdocs in Santa Cruz County who simply didn’t listen. Serial Insomniac has had more than her share of those, alas. During a clinical trial for a non-invasive device for treatment-resistant depression, at Stanford Medicine, through the Psych department, I discovered that pdocs didn’t have to be hidebound like those two. The Stanford pdocs were great–caring, funny, interested in your feedback (then again, it *was* a clinical study).

    I decided I’d try pdocs in Santa Clara county, and there sure were more to choose from. Apparently most of the ones I called had no room in their practice. I’d left a lengthy message, giving her background info on what I needed, and she was glad that I’d answered in advance, the questions she was going to have asked me. I liked the initial feel I got over the phone and set up an appointment. We met, and I told her how I approached the rapport we were going to build, and there was simply never any problem betweeen us.

    The drive from Santa Cruz to Half Moon Bay is pretty, and I’d give myself 90 min. to get there, depending on how many slow-around-the-curves, won’t-pull-overs there were in front of me. The drive from here isn’t as pretty, and I still try to have 90 min. to get there, because once you’re off the fwy, going the little winding road to the coast also depends on the larger “slows”–trucks.

    She is so worth it.

    Reply
  • Martin Reed
    November 17, 2010, 4:58 pm

    It sounds like you have the ideal relationship with your doctor, Marina! Did you get lucky, or did you do your research before selecting her?

    Reply
  • A. Marina Fournier
    November 15, 2010, 8:48 pm

    I think we should have a way to learn the protocols of the trial and how they performed, with details as to the affected populations.

    I reluctantly trusted a doctor’s judgement to my detriment, and couldn’t get him to listen to factual evidence that Serzone was actually keeping me awake, as I seem to have an idiosyncratic reaction to benzodiazepines. Serzone isn’t one (I think, as it’s specifically for depressed people with accompanying insomnia, not the reverse), but working on the same principle.

    For the patient well-educated in their own experience of insomnia, this is flawed thinking. WE know our body’s reactions to what we’ve tried, and our physicians should listen to us, especially when we can cite research to back us up.

    Thank goodness my pdoc is happy to engage me in judging what’s good for me in her area of expertise. We discuss advances in treatment for bipolars, debate over whether a new med is worth trying, encourages me to participate in clinical trials where I fit the protocol, if it doesn’t entail me going off the meds that are working for me. She trusts my judgement, and I trust hers.

    Reply
  • Martin Reed
    November 24, 2009, 10:26 am

    Thanks for your comment, Serial Insomniac! I think you make a good point – drugs that have been on the market for longer typically have more of a ‘track record’ – which allows us to make more informed decisions. However, this isn’t the case for new drugs – so perhaps we should be given more information on just how well these new drugs performed in clinical trials.

    On the other side of the argument, some will still say we should just trust our doctor’s judgement, and having access to additional information when it comes to prescription medication is not in the consumer’s interest; particularly when they have no medical education or training.

    It’s an interesting issue, that’s for sure.

    Reply
  • Serial Insomniac
    November 23, 2009, 1:17 pm

    In cases where a drug is newly available, I would want to know about its effectiveness in clinical trials. I would want to ensure it was likely to work for me, especially as I am notoriously resistant to medication.

    Where the drug is older and established, I trust my GP enough to simply leave the decision to him (reviewing as necessary). He’ll have had enough experience of the medication and he knows me well enough to know how it’d work for me. But nevertheless, the figures should still be available; not everyone has a good relationship with the doctor, and in any case knowledge is power.

    I personally don’t see the problem with taking sleeping pills, so long as it is under medical supervision to prevent addiction. I am fairly certain I would have killed myself but for Zopiclone. Sleep, however it has been induced, makes my life less bad.

    Reply