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Hypnotic

History of Hypnotic Drugs: – Hypnotica, a class of somniferous drugs, was tested in medicine in the 1890s. – Treatment for insomnia dates back to […]

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History of Hypnotic Drugs:
– Hypnotica, a class of somniferous drugs, was tested in medicine in the 1890s.
– Treatment for insomnia dates back to 1869 with chloral hydrate.
– Barbiturates were the first drugs for insomnia in the early 1900s.
– Quinazolinones and benzodiazepines replaced barbiturates in the 1970s.
– Nonbenzodiazepines are the most recent development since the 1990s.

Types of Hypnotic Drugs:
– Barbiturates act as CNS depressants with various effects.
– Barbiturates have been mostly replaced by benzodiazepines.
– Barbiturates are still used in general anesthesia and epilepsy.
– Quinazolinones are another class of drugs with hypnotic effects.

Barbiturates:
– Barbiturates modulate GABA receptors.
– Barbiturates have been replaced by benzodiazepines in medical practice.
– Barbiturates are still used in general anesthesia and epilepsy.
– Barbiturates have physical and psychological dependence.

Quinazolinones:
– Quinazolinones function as hypnotic/sedatives.
– Quinazolinones contain a 4-quinazolinone core.
– Quinazolinones have been proposed for cancer treatment.
– Quinazolinones have sedative effects.

Benzodiazepines:
– Benzodiazepines are useful for short-term insomnia treatment.
– Long-term use of benzodiazepines is not recommended due to dependence risk.
– Benzodiazepines improve sleep by reducing wakefulness.
– Benzodiazepines should be taken intermittently and at low doses.

Hypnotic (Wikipedia)

Hypnotic (from Greek Hypnos, sleep), or soporific drugs, commonly known as sleeping pills, are a class of (and umbrella term for) psychoactive drugs whose primary function is to induce sleep (or surgical anesthesia) and to treat insomnia (sleeplessness).

refer to caption
Zolpidem tartrate, a common but potent sedative–hypnotic drug. Used for severe insomnia.

This group of drugs is related to sedatives. Whereas the term sedative describes drugs that serve to calm or relieve anxiety, the term hypnotic generally describes drugs whose main purpose is to initiate, sustain, or lengthen sleep. Because these two functions frequently overlap, and because drugs in this class generally produce dose-dependent effects (ranging from anxiolysis to loss of consciousness), they are often referred to collectively as sedative–hypnotic drugs.

Hypnotic drugs are regularly prescribed for insomnia and other sleep disorders, with over 95% of insomnia patients being prescribed hypnotics in some countries. Many hypnotic drugs are habit-forming and—due to many factors known to disturb the human sleep pattern—a physician may instead recommend changes in the environment before and during sleep, better sleep hygiene, the avoidance of caffeine and alcohol or other stimulating substances, or behavioral interventions such as cognitive behavioral therapy for insomnia (CBT-I), before prescribing medication for sleep. When prescribed, hypnotic medication should be used for the shortest period of time necessary.

Among individuals with sleep disorders, 13.7% are taking or prescribed nonbenzodiazepines, while 10.8% are taking benzodiazepines, as of 2010, in the USA. Early classes of drugs, such as barbiturates, have fallen out of use in most practices but are still prescribed for some patients. In children, prescribing hypnotics is not yet acceptable—unless used to treat night terrors or sleepwalking. Elderly people are more sensitive to potential side effects of daytime fatigue and cognitive impairments, and a meta-analysis found that the risks generally outweigh any marginal benefits of hypnotics in the elderly. A review of the literature regarding benzodiazepine hypnotics and Z-drugs concluded that these drugs can have adverse effects, such as dependence and accidents, and that optimal treatment uses the lowest effective dose for the shortest therapeutic time period, with gradual discontinuation in order to improve health without worsening of sleep.

Falling outside the above-mentioned categories, the neurohormone melatonin and its analogues (such as ramelteon) serve a hypnotic function.


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