Depression The primary use of<unk>  is the treatment of unipolar major depression with or without anxiety. Data from open and double-blind trials suggest the antidepressant efficacy of<unk>  is comparable to that of amitriptyline, doxepin, and mianserin. Also,<unk>  showed anxiolytic properties, low cardiotoxicity, and relatively mild side effects. Because<unk>  has minimal anticholinergic activity, it was especially welcomed as a treatment for geriatric patients with depression when it first became available. Three double-blind studies reported<unk>  has antidepressant efficacy similar to that of other antidepressants in geriatric patients. However, a side effect of<unk> , orthostatic hypotension, which may cause dizziness and increase the risk of falling, can have devastating consequences for elderly patients; thus, this side effect, along with sedation, often makes<unk>  less acceptable for this population, compared with newer compounds that share its lack of anticholinergic activity but not the rest of its side-effect profile. Still,<unk>  is often helpful for geriatric patients with depression who have severe agitation and insomnia.<unk>  is usually used at a dosage of 150 to 300mg/day for the treatment of depression. Lower doses have also been used to augment other antidepressants, or when initiating therapy. Higher doses up to 600mg/day have been used in more severe cases of depression, for instance in hospitalized patients.<unk>  is usually administered multiple times per day, but once-daily administration may be similarly effective. Anxiety disorders<unk>  is often used in the treatment of anxiety disorders such as generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), and obsessive–compulsive disorder (OCD). However, use of<unk>  in anxiety disorders is off-label and evidence of its effectiveness for these indications is variable and limited. Benefits for OCD appear to be mild. Besides anxiety,<unk>  has been used to treat sleep disturbances and nightmares in PTSD.<unk>  is often used as an alternative to benzodiazepines in the treatment of anxiety disorders. Insomnia Low-dose<unk>  is used off-label in the treatment of insomnia and is considered to be effective and safe for this indication. It may also be used to treat antidepressant-related insomnia.<unk>  was the second-most prescribed agent for insomnia in the early 2000s, though most studies of<unk>  for treatment of sleep disturbances have been in depressed individuals. Systematic reviews and meta-analyses published in the late 2010s, including a Cochrane review, found low-dose<unk>  to be a significantly effective medication for short-term treatment of insomnia, both in depressed and non-depressed individuals.<unk>  slightly improves subjective sleep quality ( = –0.34 to –0.41) and reduces number of nighttime awakenings ( = –0.31, = –0.51). Conversely, it does not appear to affect sleep onset, total sleep time, time awake after sleep onset, or sleep efficiency. It appears to increase deep sleep, in contrast to certain other hypnotics. The quality of evidence of<unk>  for short-term treatment of insomnia was rated as low to moderate. There is no evidence available at present to inform long-term use of<unk>  in the treatment of insomnia. The benefits of<unk>  for insomnia must be weighed against potential adverse effects such as morning grogginess, daytime sleepiness, cognitive and motor impairment, and postural hypotension, among others. Quality safety data on use of<unk>  as a sleep aid are currently lacking.<unk>  is used at low doses in the range of 25 to 150mg/day for insomnia. Higher doses of 200 to 600mg/day have also been studied. The American Academy of Sleep Medicine's 2017 clinical practice guidelines recommended against the use of<unk>  in the treatment of insomnia due to inadequate evidence and due to harms potentially outweighing benefits. Combination with other antidepressants<unk>  is often used in combination with other antidepressants such as selective serotonin reuptake inhibitors in order to augment their antidepressant and anxiolytic effects and to reduce side effects such as sexual dysfunction, anxiety, and insomnia. Available forms<unk>  is provided as the hydrochloride salt and is available in the form of 50mg, 100mg, 150mg, and 300mg oral tablets. An extended-release oral tablet formulation at doses of 150mg and 300mg is also available.
Trazodone
Hydrocodone
Vilazodone
Oxycodone
Nefazodone
Norhydrocodone
Guanfacine
Amitriptyline