Suvorexant is an orexin receptor antagonist, and as such it treats insomnia differently from existing agents (though lemborexant and daridorexant have since followed in its footsteps). 

Ramelteon is a melatonin receptor agonist.

Low-dose doxepin is effective for sleep maintenance insomnia and is generally well tolerated at hypnotic doses, with minimal anticholinergic effects compared to higher antidepressant doses.

Buspirone is a non-benzodiazepine anxiolytic that is not habit-forming and does not cause sedation, but it takes time to work and is less effective for acute anxiety.

Antihistamines can be very effective sleep aids for many patients, although some patients may experience too much grogginess (“hangover”) in the morning.

Ziprasidone has an appealing weight and metabolic profile, but many clinicians are overly cautious due to its reputation for QT interval prolongation.

Trifluoperazine, like thiothixene (Navane), is an effective older agent with similar potency to haloperidol or fluphenazine; however, given the wide range of antipsychotic options today, it is rarely used.

Thiothixene is one of the original high-potency first-generation antipsychotics (FGAs)—but most clinicians prefer fluphenazine or haloperidol due to greater familiarity and more formulation options (liquid, injectable, long-acting).

Thioridazine prolongs the cardiac QT interval more than any other antipsychotic, rendering it too risky for the majority of patients.

Quetiapine’s low risk for extrapyramidal symptoms and broad spectrum of efficacy make it an appealing first-choice agent. However, sedation, weight gain, and orthostasis may limit use.