#93 - Sleeping Pills and their Alternatives with Dr. Ranji Varghese

Matt Walker welcomes Dr. Ranji Varghese back to the podcast today to complete the whole sleeping pill story by discussing newer sleeping pills, beyond benzos and Z-drugs. Together, they explore Melatonin receptor agonists (like Ramelteon) that signal sleep preparation, unlike sedating GABAergics. They also detail how DORAs inhibit the wakefulness-promoting orexin, how off-label options (ex. trazodone, low-dose doxepin) affect histamine, the risks and benefits of each. Dr. Varghese goes ...