One small study of normal volunteers suggested that venlafaxine may be associated with an increase in restless legs syndrome symptoms and periodic limb movements.
Sertraline, fluoxetine, and amitriptyline appear to increase periodic limb movements that do not disrupt sleep and are thus unlikely to be clinically significant.
The decision to treat, the treatment choice, and when to end treatment are based on risk/benefit ratios (including the risk of not treating). In general, it is optimal when trying to identify the best treatment for a patient, to start with medications that have the lowest-risk profile, before moving to those with a greater potential for side effects.
Food and Drug Administration (FDA)-approved drugs, many medications are used “off-label” to treat insomnia.
An inability to sleep, insomnia, or excessive oversleeping called "hypersomnia" can be one of the signs of depression.
It's the first approved drug in a class called orexin receptor antagonists.
And while some of the insomnia drugs are classified by the FDA as controlled substances that require doctors and pharmacists to take additional steps before they're prescribed or dispensed; trazodone is not a controlled substance, so doctors can prescribe it without those constraints.
In addition, many physicians apparently believe that trazodone is safer than other frequently prescribed sleep medications.
The current evidence is limited by poor study design, inadequate use of standardized questionnaires, and heterogeneous populations studied for variable lengths of time.
Future research should attempt to remedy these shortcomings.