A review of suvorexant, doxepin, ramelteon, and tasimelteon for the treatment of insomnia in geriatric patients

Geriatric patients often experience insomnia because of physiological and neurological changes that occur during the aging process. Use of benzodiazepines, nonbenzodiazepine hypnotics, and diphenhydramine for the treatment of insomnia pose an increased risk of cognitive impairment, falls, and fractures in this patient population. Therapeutic alternatives approved by the Food and Drug Administration include suvorexant, doxepin, ramelteon, and tasimelteon, which have shown effcacy and safety in various studies. This paper explores and outlines the available safety and effcacy data associated with these medications and reviews their potential place in therapy in treating insomnia in the geriatric population.