Sedative-hypnotic agents antipsychotics

Taper off antipsychotics, benzodiazepines or sedative-hypnotic agents if possible... 

Use in combination with other drugs (e.g., antipsychotics, lithium, valproate) for the acute treatment of mania or mixed episodes. Use as a short-term adjunctive sedative-hypnotic agent. 

IV. Diagnosis Is usually based on the history of Ingestion or recent Injection. The differential diagnosis should Include other sedative-hypnotic agents, antidepressants, antipsychotics, and narcotics. Coma and small pupils do not respond to naloxone but will reverse with administration of flumazenil (see below). 

Other classes of drugs not included in Figure 22-3 that may exert sedative effects include most antipsychotic and many antidepressant drugs and certain antihistaminic agents (eg, hydroxyzine, promethazine). As discussed in other chapters, these agents differ from conventional sedative-hypnotics in both their effects and their major therapeutic uses. Since they commonly exert marked effects on the peripheral autonomic nervous system, they are sometimes referred to as "sedative-autonomic" drugs. Certain antihistaminics with sedative effects are available in over-the-counter sleep aids. Their autonomic properties and their long durations of action can result in adverse effects. 

Uremia Antihistamines Antiparkinsonian agents Antispasmodics Ophthalmic preparations OTC sleep/allergy medications Tricyclic antidepressants Other medications Analgesics/NS AIDs Anticonvulsants Corticosteroids (high dose) Digoxin H2 blockers Insulin Muscle relaxants Narcotics Psychotropics (anxiolytic, antidepressant, antipsychotic) Sedative/hypnotic Sulfonylurea... 

Introduction During 1966, several new types of chemical structures were reported to have central nervous system depressant activity, and further studies were described of compounds previously classified in this area. The problem of defining further the type of activity to predict whether a given depressant will be of clinical application as an antipsychotic, anti-anxiety agent, sedative, hypnotic, anti-convulsant or anesthetic continues to occupy the attention of many investigators. 

Antidepressants Antipsychotic Agents Sedatives, Hypnotics, and Tranquilizers Anticonvulsants. 

Introduction - Although an effort has been made in this chapter to exclude depressants classified in other chapters as antipsychotic and antianxiety agents, certain benzodiazepines will be considered here because of the number of compounds in this series which have been found clinically to possess sedative-hypnotic and anticonvulsant activity. In most cases, compounds with more than preliminary pharmacological data or representatives of new structural types were selected for inclusion in this chapter. 

Antipsychotic drugs have inconsistent effects on sleep patterns but tend to normalize sleep disturbances characteristic of many psychoses and mania. The capacity to prolong and enhance the effect of opioid and hypnotic drugs appears to parallel the sedative, rather than the neuroleptic, potency of a particular agent thus, potent, less-sedating antipsychotics do not enhance sleep. 

---