Substance-Related Disorders
Sedatives, Hypnotics and Anxiolytics
- Important Facts
- Symptoms of Intoxication
- Symptoms of Abuse
- Symptoms of Withdrawal
- Prenatal Effects
- Treatment
Important Facts
- Definitions:
- Sedatives – are used to treat agitation, reduce daytime activity, temper excitement and have a calming effect with little impact on motor or mental functions.
- Hypnotics – produce drowsiness and facilitate the onset and maintenance of sleep. Hypnotics cause a more pronounced depression of the central nervous system than do sedatives.
- Anxiolytics – reduce anxiety.
- Common sedatives, hypnotics and anxiolytics include Valium, Xanax, Ativan, Tranxene, Dalamine, Restotril, Seconal, Phenopbarbital, Nembutal, Buspirone, Zolpidem and Halcion.
- Common side effects include drowsiness, poor coordination, depression and light-headedness.
- The sedative, hypnotic and anxiolytic (anti-anxiety) substances include the benzodiazepines, carbamates, barbiturates, anti-histamines, beta-blockers and the barbiturate-like hypnotics. These substances include all prescription sleeping medications and almost all prescription anti-anxiety medications.
- These agents are brain depressants that slow the central nervous system.
- At high doses, these agents can be lethal, especially when mixed with alcohol.
- Substances with rapid onset and/or short to intermediate lengths of action may be especially vulnerable to abuse.
- These agents act to slow the body and cause drowsiness and a reduction of symptoms including anxiety, sadness, jitteriness, shaking and worrying.
- These agents are used in the treatment of anxiety, depression, insomnia and epilepsy.
- These agents create an euphoric state often accompanied by slowed speech and loss of coordination.
- These agents reduce tension and induce a state of relaxation, drowsiness and sleep while decreasing alertness.
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Symptoms of Intoxication
- Anterograde amnesia (inability to form new memories)
- Impaired judgement
- Impaired social or occupational functioning
- Inappropriate sexual or aggressive behavior
- Lack of coordination
- Maladaptive behavioral or psychological changes
- Memory or attentional problems
- Mood swings
- Slurred speech
- Unsteady gait
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Symptoms of Abuse
- Coma
- Death (fatal overdose, fatal reaction to sudden withdrawal)
- Dependence
- Drowsiness
- Impaired judgement
- Impaired social or occupational functioning
- Rapid mood changes
- Respiratory difficulties
- Sleeplessness
- Slurred speech
- Stupor
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Symptoms of Withdrawal
- Anxiety
- Autonomic hyperactivity
- Changes in sleeping pattern, insomnia
- Delirium
- Headache
- Hypotension
- Irritability
- Muscle twitching
- Nausea or vomiting
- Physical and psychological discomfort
- Psychomotor agitation
- Rapid heart rate
- Rapid pulse
- Restlessness
- Seizures
- Sweating
- Temporary auditory, visual, or tactile hallucinations or illusions
- Tremors of the hands, tongue and eyelids
- Weakness
- In rare instances, death.
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Prenatal Effects
- Infants may be born addicted
- Birth defects
- Children exposed to these drugs before birth may develop behavioral problems.
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Treatment
- Drugs should be tapered gradually because sudden withdrawal can lead to seizures, and in rare cases, death.
- Initial detoxification may need to take place in a hospital under the supervision of medical staff.
- Physicians may prescribe a longer acting, less addictive drug to decrease withdrawal symptoms.
- Residential treatment programs that emphasize intense group therapy are typically successful.
- Twelve-step programs can be helpful.
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