There are many medications that cause insomnia. With any new symptoms, we must first rule out the possibility of medication adverse effects. Here’s 3 classic examples of the prescribing cascade due to drug induced insomnia.
- Corticosteroids. They are used for so many different conditions. Inflammatory disorders, pain, allergic reactions, and respiratory problems are a few examples where a steroid “burst” would be used for a period of a few days to a few weeks. It is incredibly important to ask patients who start a new medication for insomnia whether they have been on a steroid recently.
- Systemic decongestants. Pseudoephedrine can be very effective at relieving nasal decongestion. Keep an eye out for patients who newly start this medication during cough and cold season, or possibly allergy season. Pseudoephedrine can definitely cause insomnia and contribute to polypharmacy.
- Stimulants. Commonly used for attention disorders, stimulants like methylphenidate or amphetamine salts very commonly cause insomnia. Be sure you understand what type of stimulant the patient is taking and what time of the day they are taking it. Taking long acting stimulants midday or later can cause significant insomnia. Many providers writing orders will recommend not taking any more stimulants after early afternoon to avoid insomnia.
What other medications have you seen cause insomnia?
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How about select antidepressants, Wellbutrin for one and theophylline (relative of caffeine)
In with the stimulants, I often see patients who are on weight loss medications such as Phentermine or Phendametrizine prescribed Zolpidem. Counseling helps educate the patients as to the ‘why’ the insomnia is occurring and then allows the patient to decide if the weight loss medication’s benefits exceed the negative consequences of insomnia and side effects of zolpidem.
SSRIs, like Fluoxetine
Would love if you could add a “older post/newer post” button to blog posts…easier to catch up on the recent ones, vs. clicking through archives! Thanks!
Hey Sonia, thanks for the question/comment – if you click on the blog tab at the top of the page, that should give them to you in chronological order. Is that helpful? – Thanks, Eric
Wellbutrin