Sedative-Hypnotic Agents

These may be used to induce sleep or depress the central nervous system in areas of mental and physical response, awareness, sleep, and pain.
Sedative hypnotic medications are generally used for sleep disorders or any other time where sleep is necessary.  It creates a state of decreased mental and physical responsiveness, decreased awareness and diminished pain.

Usually sedative-hypnotics are used for insomnia or difficulty sleeping.  Ideally these medications should be used for brief periods of time-less than three weeks total.  Insomnia is usually caused by poor sleeping habits, jet lag, stress, certain medications, disease, and depressive disorders.  If a person has chronic insomnia lasting longer the three weeks, the doctor must decide if it is worth it to put the patient on a potentially addictive medication for sleep.  The doctor should do a complete history, including getting a list of medications and a substance abuse history.

These hypnotic medications work by increasing the abilities of gamma-aminobutyric acid or GABA to work in the central nervous system.  GABA is a neurotransmitter in the brain that, when activated, produces drowsiness, facilitates sleep and helps you maintain sleep.

Sedative-hypnotics can be used for insomnia that happens in the middle of the night or for helping people with Parkinson’s disease have less motor movement while getting to sleep.  Different sedative-hypnotics have different half-lives and cause varying amounts of grogginess in the morning.  The half-lives of drugs determine how long the drug is in effect. With long acting sedative hypnotic medications, the drug can build up in the system causing daytime drowsiness. Thought and motor skills are impaired during the day and this can be dangerous.

Sedative hypnotic drugs can interact with other drugs which is another reason for using a short-acting medication.  The carry-over of these drugs is minimal and the propensity for drug-drug interactions is less.

Sedative hypnotic medications don’t come in a single class.  They are simply listed together because they can be used for insomnia.  Some of these drugs include the following:
Butisol sodium (butabarbital sodium)-a barbiturate medication
Ambien or Ambien CR (zolpidem tartrate)
Dalmane (flurazepam hydrochloride)-a benzodiazepine medication
Carbtrital (pentobarbital and carbromal)-a barbiturate medication
Edluar (zolpidem tartrate)
Doral (quazepam)-a benzodiazepine medication
Halcion (triazolam)-a benzodiazepine medication
Lunesta (eszopiclone)
Intermezzo (zolpidem)
Prosom (estazolam)-a benzodiazepine medication
Placidyl (ethchlorvynol)
Restoril (temazepam)-a benzodiazepine medication
Seconal (secobarbital sodium)-a barbiturate medication
Rozerem (ramelteon)
Zolpimist (zolpidem tartrate)
Silenor (doxepin hydrochloride)-an antidepressant medication
Sonata (zaleplon)

There are a couple of over-the-counter medications available in different forms and mixed with a variety of other medications:
Unisom (doxylamine)
Benadryl (diphenhydramine)

Unfortunately there are a lot of side effects associated with sedative hypnotic medications and some of these interfere with their use.  These include nervousness, headache, nausea, apprehension, talkativeness, apprehension, confusion, irritability, relaxation, euphoria, tremor, weakness, poor concentration, depression, incoordination, nightmares, depression, palpitations, insomnia, rapid heart rate, chest pains, heartburn, vomiting, nausea, constipation, diarrhea, pain in the abdomen, alteration in taste, loss of appetite, excessive salivation, and dry mouth.

Sedative hypnotic medication comes in such a variety of classes and half-lives that if one fails to work or has an excess of side effects, it is easy to try another one.
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