Brief Answer:
Detailed answer and explanations given below

Detailed Answer:
Hello,

Sleeping problems also called insomnia is a complex diagnosis and needs good evaluation and follow up of the patient so it is crucial for patients to be checked and monitored by a physician. Meanwhile i am giving you some medications commonly used in patients with chronic insomnia and that do not interact with the drugs that you are taking. These medications would be: Ramelteon, Zolpidem, Mirtazapine,

There are other classes of drugs used for insomnia but many of them are not recommended due to interactions with amiodarone and causing problems with the conduction in the heart so please be cautious and do not use any sleeping drugs without the doctor's recommendation.

A very effective class of drugs for short term insomnia are benzodiazepines (diazepam or lorazepam) but due to dependance they are not recommended to be taken regularly or for periods longer then a week (this is very important as patients end up with less effect with time and very high doses due to dependence).

If you have a chronic condition that is causing you insomnia (pain, depression, anxiety, sleeping apnea, etc) you will need to first treat the causing agent to be effective in treating insomnia.

Other drugs that have been used as over the counter and sleeping aids are sedating antihistamines (diphenhydramine, chlorpheniramine), taken only at night. They don't interact with the drugs you are using and is safe to be taken but there primary use is for allergy and drowsiness is a side effect. So it is not recommended to be taken for prolonged periods as they may cause drowsiness during the day and risk for accidents.

There are nonpharcologial treatment of insomnia: behavioral therapy is found to be very effective to treat chronic insomnia, please talk to your doctor to see the chance of having one or a few of the behavioral therapy techniques to help.
Good sleep hygiene is crucial to help with insomnia: going to bed and getting up at the same time each day, avoiding sleep during the day, avoiding stimulant drinks (coffee, energy Drinks, cola), avoiding cigarette and alcohol use, regular exercises during the day (not in the evening)... etc.

To conclude i would say:
- insomnia needs careful evaluation by a doctor, there is information provided on drugs for insomnia that can be used together with amiodarone and toprol but is safer for you to discuss these with your doctor.
- treatment of other chronic conditions that might be causing the insomnia is very important
- there are nonpharmachological treatments for insomnia that are very effective, talk to your doctor on how to access these
- try to avoid regular use of benzodiazepines due to dependence and also some drugs for insomnia when taken with amiodarone can effect the electric condition in the heart so discuss with your doctor before taking anything for insomnia.
- safe drugs to take for insomnia while you are on amiodarone and toprol are Zolpidem, Ramelteon, Mirtazapine, etc.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj,
General & Family Physician

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