The use of ramelteon for secondary insomnia due to mental illness

Insomnia and nonrestorative sleep are common symptoms associated with many different forms of mental disorder. Patients suffering from major depressive disorder, bipolar disorder, and anxiety disorders often suffer from insomnia due to their illness or even due to the medications that are prescribed for their illness. Pharmacologic treatment for insomnia in this scenario typically includes either a benzodiazepine sedative or an antihistamine, Recently, ramelteon was approved for the treatment of primary insomnia. The agent utilizes a novel mechanism of action whereby it stimulates melatonin receptors. This article reports on a case series of a heterogeneous group of psychiatrically ill patients who used ramelteon 8-16 mg at bedtime to treat secondary insomnia. Patients had a wide range of response with ramelteon and found it to be well tolerated.