Antipsychotics should not be routinely used to treat primary insomnia in children, adults, or the elderly, according to new recommendations issued by leading Canadian psychiatric organizations.

This and 12 other evidence-based recommendations were released by a joint working group of the Canadian Psychiatric Association (CPA), the Canadian Academy of Child and Adolescent Psychiatry (CACAP), and the Canadian Academy of Geriatric Psychiatry (CAGP) for the Choosing Wisely Canada (CWC) campaign.

Instead, the CWC psychiatry working group recommends thorough assessment to establish possible behavioral causes (eg, poor sleep-wake schedule, use of caffeine and nicotine), emotional causes (eg, stress), and psychiatric or physical causes (eg, pain, sleep apnea) of insomnia.

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