Drug-use pattern of Chinese herbal medicines in insomnia: a 4-year survey in Taiwan.

BACKGROUND AND OBJECTIVE: Insomnia is a common complaint in the general population. Interest in the use of alternative treatments for insomnia is increasing exponentially and is fairly common in Taiwan. We undertook a survey to define the drug utilization patterns of Chinese herbal medicines (CM) for insomnia in Taiwan. METHODS: The survey was conducted over a period of 4 years, from January 2003 to December 2006. Outpatients with primary insomnia and being treated with CM were studied. Core drug-use indicators were the number of CM items per prescription, the dosing frequency and duration of CM prescriptions, the most common prescribed CM herbs and CM formulae used. RESULTS: Six thousand eight hundred and sixty patients, using 37,046 CM herb items, were screened during the study period. The average CM items per prescription was 5.40. Most of prescriptions (95.23%) were prescribed for administration three times a day. The most often prescribed Chinese herbal products were Hong-Hwa (Carthamus tinctorius) and Jia-Wey-Shiau-Yau-San, which includes Angelica sinensis, Atractylodes macrocephala, Paeonia lactiflora, Bupleurum chinense, and Poria coco. CONCLUSION: This is the first extensive survey examining the drug utilization patterns of Chinese herbal medicines in the treatment of insomnia. Although the data were generated in Taiwan, the herbs and practices identified are likely to be widely generalizable wherever Chinese herbal remedies are used for insomnia. Multiple herbs and complex formulae were commonly used. The baseline data generated should be of use in informing subsequent studies, including those aimed at a thorough evaluation of the herbs' effectiveness.