Prescription Sleep Aids

Prescription sleep aids and sedatives are among the most widely used of all medicines. They work by depressing the central nervous system and may be helpful for occasional sleep problems, reducing anxiety and muscle tension.

It is always good to know what is causing sleep difficulties and try to solve the underlying problem first. However, when people face unexpected life changes which cannot be easily solved they often tend to reach for over the counter or prescription sleep aids.

Prescription Sleep Aids include:

• Older hypnotics - barbiturates, glutethimide (doriden), chloral hydrate (noctec),
  are rarely used today. There were many problems with those drugs including high frequency of side effects, risk of physical and psychological dependence, developing tolerance, lethal overdoses and many drug interactions.


• Benzodiazepines - long acting and short acting, both are useful for sleep problems and daytime anxiety or early morning awakenings. Although safer than early hypnotics they have many similar side effects and drug interactions. In addition they have a tendency to develop psychological dependence.


• Non-diazepine - newer and safer hypnotics introduced in the 1990s include Ambien,Sonata, Lunesta and the Rozerem. They are metabolized fast, which helps reduce the risk of side effects. They also have a lower tolerance and abuse potential than older sleeping medicines.


• Sedative antidepressants - may be used in cases when insomnia is caused by depression or anxiety. Antidepressants used for insomnia include amitriptyline (Elavil), nortriptyline (Pamelor) and trazodone (Desyrel).

Hypnotics depress brain activity, which may be associated with many 
unpleasant side effects such as:

• daytime drowsiness and excessive sedation
• memory impairment
• decrease of mental alertness
• loss of coordination
• impaired concentration and ability to operate machinery
• dizziness

Hypnotics interact with many other drugs used to treat everything from stomach ulcers to hypertension and heart disease.

They may be especially hazardous for people who drink alcohol, because of the additive depressive effect on the central nervous system, which is similar for alcohol and hypnotics.  You should never mix alcohol and sleeping medicines.

Because of concerns associated with induction of tolerance and dependence, sleeping medications should always be used in the lowest effective dose and for the shortest possible time (not longer than 5-7 days).  They don’t have to be taken regularly like most other medicines, but only when needed to facilitate sleep and get some rest.

Learn about the medication you take as much as you can.  It will help you avoid potential problems associated with side effects and drug interactions.  Do not be afraid to ask your doctor or pharmacist questions.

You can find more information on sleeping medicines by going to the U.S. National Library website and browsing by the first letter of the medication’s name: http://www.nlm.nih.gov/medlineplus/druginformation.html

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