Ramelteon, as a selective melatonin receptor agonist, has significant therapeutic effects on insomnia with difficulty falling asleep. Its discontinuation process should follow regulations to avoid rebound insomnia. The following provides a detailed explanation from two aspects: treatment effectiveness and precautions for discontinuing medication.

1. Therapeutic effect

(1) Clinical efficacy: By activating MT1/MT2 receptors to regulate circadian rhythm, it can shorten the latency period to sleep and improve sleep quality, especially suitable for patients with primary insomnia.

(2) Effective time: Rapid absorption after oral administration, with a peak time of about 0.5-1.5 hours. It is recommended to take it 30 minutes before bedtime to match the physiological sleep cycle.

(3) Safety features: As an unregulated prescription drug, the risk of dependence and withdrawal reactions is low, and common adverse reactions are mild dizziness or drowsiness.

2. Precautions for discontinuation of medication

(1) Discontinuation principle: It is recommended to gradually reduce the dosage instead of suddenly stopping the medication. The medication can be administered every other day for 1-2 weeks to reduce the risk of rebound insomnia.

(2) Monitoring points: During the discontinuation of medication, changes in sleep quality should be observed. If persistent insomnia worsens, a doctor should be consulted to adjust the plan.

(3) Special population: People with liver dysfunction have slowed metabolism and need to extend the medication reduction period; Older people have increased drug sensitivity, and the reduction in dosage should be more cautious.

3. Auxiliary management measures

(1) Behavioral intervention: During the cessation of medication, cooperate with sleep hygiene education, maintain regular sleep patterns, and avoid napping and caffeine intake.

(2) Alternative therapy: For long-term medication users, transitioning to non pharmacological interventions such as cognitive-behavioral therapy can be considered to maintain efficacy.

(3) Follow up requirement: It is recommended to follow up for one month after discontinuing the medication to assess whether the sleep condition is stable.