- Partial 5-HT1A agonist

- Effective as monotherapy or with SSRIs

- Slower onset than BZDs, faster than ADs

- Hepatic metabolism

- No psychomotor impairment

- Well tolerated, non-sedative, no abuse potential

• 2nd or 1st line therapy
• Rapid onset of action, effective in acute panic
• Lipophilic, hepatic metabolism, active metabolites
• Rebound anxiety upon cessation 
• Ineffective by themselves against comorbid depression
• High therapeutic index bu HIGH potential for interactions
• Potentially fatal w/ other CNS depressants
• Adverse effects include sedation, ataxia & amnesia

• not subtype-selective
• decrease REM and SWS, increase stage 2 NREM
• REM sleep rebound after discontinuation
• Motor impairmnet, amnesia, residual sedation
• Therapy limited to 4 weeks
• Risk dependency & tolerance

• BZD binding site antagonist
• IV only
• For reversal of therapeutic effect of BZD overdose

Zolpidem - Ambien

Zaleplon - short T1/2; can be given up to 4 hours before waking

Eszopiclone - Lunesta; only drug approved for chronic use

- α1 selective

- Lack BZD structure but act at BZD site

- First-line therapy

- Minimal disruption of sleep architecture

- no REM sleep rebound

- Can cause motor impairment, amnesia and residual sedation

• MT1 agonist
• no effect on GABA
• no rebound
• no tolerance or dependence
• not a controlled substance
• circadian desynchrony
• short duration of action