Sedatives and Hypnotics

1. Sedatives and Hypnotics By Jessica Davies

2. What are sedatives and hypnotics? • Sedatives and Hypnotics are basically one in the same • They are Central Nervous System Depressants • The biggest difference is the dose • Lower doses of the drug are considered sedatives which create a calming effect • Higher doses of the drug are considered hypnotics and create a drowsy effect.

3. Short History • The most commonly prescribed sedatives are benzodiazepines, such as Valium • These drugs are also known as minor tranquilizers. • Before the development of benzodiazepines in the 1950s and 1960s, doctors most often prescribed barbiturates to cause sleep and sedation. • Because barbiturates have a high potential for abuse, doctors today rarely prescribe them. • However, the exception is phenobarbital (Luminal), which is still used as a sedative and as an anticonvulsant.

4. Types • Barbiturates >such as Luminal • Benzodiazepines >such as Valium, Restoril, and Xanax • “Z-drugs” sedatives >such as Lunesta and Ambien • Antihistamines >such as Benadryl Allergy, Dramamine • Herbal Sedatives >such as catnip and cannabis • Others such as alcohol or opioids

5. Benzodiazephines • Most well-known and most frequently-prescribed of the hypnotic medications • Effective short term, but a tolerance to this drug can be built up in 1-2 weeks • When used long term, withdrawal almost always occur • Dependency is far more dangerous than that of opiates and other drug classes because of the lethal withdrawal

6. Therapeutic Use • Often used in order to dull a patient’s anxiety that is related to a painful or anxiety-provoking procedure (such as surgery). • They do not relieve pain, but are a useful aide to analgesics in preparing a patient for surgery. • They help increase the compliance of children or troublesome patients. • Also patients in intensive care units are almost always sedated .

7. Dependence • Can cause physiological and psychological dependence when taken over a period of time on a regular basis, even at the therapeutic doses • Physiologically: Dependent users often experience withdrawal symptoms such as restlessness, insomnia, convulsions or even death • Psychologically: Dependent users often feel as if they need the drug to function • In both of these finding and using becomes primary focus in their lives.

8. Abuse • Barbiturates and benzodiapines are mostly responsible for the abuse when it comes to sedatives • These drugs are much more dangerous due to their widespread recreational and non-medical use. • Those who have difficulty dealing with stress, anxiety or sleeplessness can easily overuse • Heroin users, if they cannot get their main drug of choice, will use sedatives as a substitute. • Some just take them recreationally to relax and forget their worries

9. Abuse continued… • Barbiturate overdosing is a major factor in 1/3 of all reported drug related deaths, including suicide and accidental drug poisoning • Some accidental deaths occur when taken with alcohol or taking repeated doses • In 1998 a total of 70,982 cases of exposure were called into U.S. poison control centers. • 2,310 resulted in major toxicity and 89 resulted in death • 50% of those admitted to ER as result of nonmedical use of sedatives have a legitimate prescription, but have usually taken an excessive dose.

10. Health Hazards • Most side effects are typical: staggering, blurred vision, impaired perception of time and space, slowed reflexes and breathing, reduced sensitivity to pain, impaired thinking, and slurred speech • Health Hazards though are more serious • They include: anemia, depression, impairment of liver function. • Babies of chronic users may have difficulty in breathing and feeding, disturbed sleep patterns, sweating, irritability and fever.

11. Conclusion • Sedative and Hypnotic help many people in many ways • They help relieve anxiety, stress and insomnia • Even though they can be a good thing, they also have their down falls • We can build a tolerance quickly which can result in a larger chance of abuse and a worse withdrawal stage. • Long term use is never advised especially with all the major health hazard that can occur.