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The Secret Dangers of Off-Label Sleep Aids

There are at least half a dozen prescription sleep aids sold in the us alone. On top of that, doctors are allowed to prescribe medications "off-label" - meaning they can prescribe a medication meant to solve one problem in order to solve a completely different ailment that it wasn't necessarily designed to treat.

People in the medical community have been questioning whether practicing this type of medicine is safe or healthy for patients. In truth, it's a bit of a grey area. Some of these off label prescriptions are perfectly safe and provide a real benefit to the patients who take them. On the other hand, there are off-label prescriptions out there which may be doing a lot more harm than good. This is an unfortunately common problem with drugs that are prescribed off-label to treat sleep problems. We'll discuss them below, and give you the information you need in order to make an informed decision about the medications you take.

Medications to Watch Out For

When a certain medication earns a reputation for producing and unexpected side effect in a statistically significant number of patients who take it, it may inspire some doctors to prescribe it for off-label uses. The drugs below are some of the most commonly prescribed off-label medications for sleep. They include:


Trazodone is an antidepressant medication sold all over the world. Trazodone is its generic name, but it goes by many different brand names depending on what country you live in. It has a few very specifically approved uses which include the treatment of major depressive disorder, anxiety, and even alcohol dependence. It has been around since the early 1980s, and sells for less than $5 for a one month supply in the United States.

When a pharmaceutical company develops a new drug which is found to be relatively safe - but they're not sure exactly what it's good for - they shop it around to different doctors' offices and encourage them to prescribe it for "investigational use". Although this sounds dangerous, it is also legal. Trazodone has some investigational uses of its own, potentially being an effective treatment for complex regional pain syndrome, OCD, erectile dysfunction, schizophrenia, and alcohol withdrawal. But regardless of why trazodone was prescribed to you, whether it be for insomnia or something else, there are still some dangerous symptoms that you should know about before you get it filled.

  • Priapism - an erection lasting for 4 hours or longer
  • Cardiac arrhythmia - A dangerous and potentially lethal irregular heartbeat
  • Hepatotoxicity - liver poisoning
  • Worsening depression, or thoughts of suicide
  • Next day grogginess
  • Orthostatic hypotension - A dramatic drop in blood pressure when sitting or standing up


Amitriptyline is another type of antidepressant the doctors prescribe off-label for insomnia. But they prescribe it for a number of other problems as well, both off-label and on. As an antidepressant, it is primarily given to patients who suffer from major depressive disorder, anxiety disorders, or bipolar disorder. Furthermore, it isn't uncommon for doctors to prescribe it to people who suffer from ADHD (attention deficit hyperactivity disorder). Some people even receive a prescription for amitriptyline because they suffer from fibromyalgia, posturepedic neuralgia, or some other type of neuropathic pain.

Like trazodone, amitriptyline has a number of investigational uses as well. Doctors have prescribed it for everything from eating disorders to bedwetting to chronic cough, and even migraines. There are some reports that it's a more effective antidepressant than most of the first line medications available today; however, most doctors are reluctant to prescribe it the first time a patient comes to them presenting symptoms. Apparently, it has a higher rate of toxicity than regular antidepressants, and its side effects are more frequent and less tolerable than SSRIs. Such side effects include:

  • Dizziness
  • Headache
  • Weight gain
  • Confusion
  • Anxiety/agitation
  • Orthostatic hypotension
  • Impotence
  • Loss of sexual desire
  • Drowsiness
  • Insomnia
  • More frequent nightmares


Mirtazapine is also known by the brand name Remeron. Unlike the other drugs on this list so far, Mirtazapine is an atypical antidepressant which doesn't exactly use the same mechanism of action as your typical SSRI, SNRI, or tricyclic antidepressant. Despite the uncertainty surrounding what this drug is and what it does, the main reason doctors prescribe it is, of course, to help people suffering from depression. It can also help people who are suffering from panic disorders, so it's not uncommon for a doctor to prescribe it to people suffering with anxiety as well.

Mirtazapine has some other interesting off label uses that are worth mentioning. Obviously, we wouldn't be talking about it in this article if it didn't induce drowsiness and help with symptoms of insomnia. But it can also be prescribed to those or suffering from uncontrollable nausea and vomiting. Furthermore, many patients report that it stimulates their appetite. It can even help someone gain weight if, for example, they're suffering from an eating disorder or a severe case of depression which leaves them without much of an appetite at all. Despite its myriad of uses, it still comes with some unnerving side effects:

  • Constipation
  • Dry mouth
  • Unwanted drowsiness
  • Unhealthy weight gain
  • Confusion
  • Dizziness
  • Peripheral edema - swelling of extremities
  • Elevated cholesterol and triglyceride levels

Safer Alternatives to Off-Label Sleep Aids

You don't have to resort to off-label medications - or even prescription sleep aids - in order to cure your sleeping problems. Obviously, you should try following the advice of your doctor first. But if that doesn't work, or if the cure is worse than your restless nights, there may be alternatives that you should try out. Avinol PM is a good one to start with. It contains safe, natural herbs and botanicals that don't come with the disastrous side effects that the drugs we've mentioned so far do. And you don't need to spend time and money getting a prescription for it. You can order it online right now from the comfort of your own home, and start getting healthy, restful sleep as soon as it arrives at your doorstep. Learn more.

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