Severe insomnia and nighttime psychomotor excitement associated with psychiatric disorders are challenges in psychiatric care and nursing. In clinical settings, psychotropic drugs with strong hypnotic sedative effects, such as antipsychotics or antidepressants, are frequently used in addition to hypnotics. Indeed, psychotropic drugs that have α₁, α₂, H₁, or 5-HT₂ blocking actions have been reported to exert hypnagogic effects, such as shortening of sleep latency, prolongation of total sleep time, and shortening of nocturnal awake time, on polysomnography and subjective evaluations. However, most of these findings were based on small-scale short-term clinical trials, sometimes using healthy volunteers, and there are few clinical trials that have examined the insomnia improvement effects and tolerability at mid-to long-term dosing in insomnia patients. Clinical data to clarify dosage, administration period, and safety are required for possible future use of hypnotic sedative psychotropic drugs as complementary therapy for refractory insomnia where ready-made hypnotics are ineffective.
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