In treating insomnia, which agent has the lowest risk of addiction and dependence?

Doxepin is an appropriate choice for treating insomnia, particularly because it has a lower risk of addiction and dependence compared to other options such as flurazepam, zolpidem, and alprazolam. Doxepin is a tricyclic antidepressant that has sedative properties at low doses. Unlike benzodiazepines or other sleep medications, it does not lead to the development of tolerance, which is a common issue with agents that act on the central nervous system, thereby reducing the risk of dependence.

Flurazepam, zolpidem, and alprazolam are primarily used for their sedative or anxiolytic effects but come with a higher potential for misuse and addiction due to their rapid onset of action and effects on the GABA receptors. Benzodiazepines like flurazepam and alprazolam can also cause withdrawal symptoms upon discontinuation after prolonged use. Zolpidem, although non-benzodiazepine, still carries a risk of dependence due to its sedative properties.

In contrast, doxepin's mechanism of action is more suited for long-term management of insomnia without the significant risks that accompany the other medications listed. This makes it a safer choice for individuals who may