From the Guidelines
For a patient who has tried trazodone, Belsomra, and Quviviq without success and dislikes Ambien's effects, consider prescribing low-dose doxepin (3-6mg) or ramelteon (8mg) at bedtime, as recommended by the American College of Physicians 1. These medications work differently than Ambien - doxepin is a tricyclic with strong H1 antagonism at low doses that improves sleep maintenance with minimal side effects, while ramelteon is a melatonin receptor agonist that helps with sleep onset and has no risk of dependence or morning grogginess, as supported by studies 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Alternative Options for Insomnia Treatment
The patient has already tried trazodone, belsomra, and quviviq for her insomnia, and the only thing that works is ambien, but she doesn't like its side effects. Other options could be non-benzodiazepine receptor agonists, such as zolpidem, zaleplon, or eszopiclone, which have been shown to be effective in treating insomnia with reduced side effects and less concern about addiction 2, 3, 4. These medications have a lower risk of tolerance, dependence, abuse, and residual effects compared to benzodiazepines, and may be a suitable alternative for the patient 4, 5.