Untested Drugs Being Used for Insomnia, Experts Warn

WASHINGTON -- Many Americans who suffer from chronic insomnia are being treated with prescription drugs that have not been proved safe or effective, a panel of researchers said Wednesday.

The panel called for more research on treatment of chronic insomnia, which they called a major public health problem that plagues tens of millions of adults in the United States.

Alan Leshner, chairman of the National Institutes of Health panel, and the university researchers spent two days grilling insomnia experts before issuing a state-of-the-science statement.

"Many of the medications now widely used to manage chronic insomnia have not been rigorously evaluated for long-term use," said Alan Leshner, CEO of the American Association for the Advancement of Science. "This is a critical issue, given the fact that many patients suffer from a form of insomnia that can persist for a very long time, decades and longer," he said.

Doctors can legally prescribe drugs "off label," meaning to treat conditions for which the drugs are not approved by the Food and Drug Administration.

Panelists said many doctors prescribe antidepressant drugs for insomnia, although it is not clear that patients can't sleep because they are depressed or become depressed because of lack of sleep.

Many medications, including over-the-counter drugs, can cause harmful side effects, the panel said.

They also said many insomnia sufferers are driven to self-medicate with alcohol, despite indications that alcohol actually impairs the quality of sleep.

The panel also said many non-pharmaceutical approaches are safe but have not been demonstrated to be effective in rigorous clinical trials.

An exception, the panel said, is a treatment called cognitive behavorial therapy, in which patients are taught to eliminate erroneous, anxiety-producing beliefs about sleep.

Although this therapy has been demonstrated to be effective, only a few hundred doctors in the country know how to administer it, the panel said. It recommended that more physicians be trained in using the technique.

"We found many gaps in the scientific literature that need to be filled," Leshner said. "That's why we believe our recommendations for a research agenda in many ways is more important than our report on the state of clinical practice as it exists."

The conference was sponsored by the Office of Medical Applications of Research and the National Institute of Mental Health.

Jeff Nesmith's e-mail address is jeffn@coxnews.com Editor Notes: