Medication | Starting dose | Usual effective dose range | Common side effects | Rare but serious side effects |
Sodium oxybate¶ | Doses are administered twice nightly, at bedtime and 2.5 to 4 hours later Recommended starting dose by weight:
| 2 to 9 grams in 2 divided doses at night Maximum recommended total night dose by weight:
| Morning sedation, nausea, weight loss, dizziness, enuresis, sleepwalking, tremor, worsening of OSA | Confusion, severe sedation, central sleep apnea, coma, diversion or misuse¶ |
Mixed oxybate salts (calcium, magnesium, potassium, and sodium oxybates)¶ | Same as for sodium oxybate | Same as for sodium oxybate | Same as for sodium oxybate | Same as for sodium oxybate |
Tricyclic antidepressants | ||||
ClomipramineΔ | 25 mg at bedtime | 25 to 100 mg/day at bedtime | Dry mouth, constipation, sweating, blurry vision, somnolence, weight gain, orthostatic hypotension | Cardiotoxicity, seizures, suicidal ideation, bone marrow suppression, serotonin syndrome |
Imipramine | 25 mg once daily | 25 to 75 mg/day in 1 to 2 divided doses | ||
ProtriptylineΔ | 5 mg once daily | 5 to 10 mg/day in 1 to 2 divided doses | ||
Selective serotonin reuptake inhibitors | ||||
Fluoxetine | 5 to 10 mg once daily | 10 to 30 mg once daily | Nausea, insomnia, tremor | Suicidal ideation, prolongation of QT interval, serotonin syndrome |
Sertraline | 12.5 to 25 mg once daily | 25 to 200 mg once daily | ||
Citalopram | 10 mg once daily | 10 to 40 mg once daily | ||
Serotonin norepinephrine reuptake inhibitors | ||||
Venlafaxine | 25 mg once daily | 37.5 to 75 mg once daily | Nausea, weight loss, dizziness, headache, constipation, insomnia, somnolence, tremor | Suicidal ideation, prolongation of QT interval, serotonin syndrome |