Anxiolytics, Sedatives, and Hypnotics

Clinical Uses of the Sedative-Hypnotic and Anxiolytic Drugs... 

Psychotic symptoms may also occur with the withdrawal of alcohol, sedatives, hypnotics, and anxiolytics The following symptoms may occur persecutory delusions, perceptual distortions, and vivid hallucinations in any modality, most classically visual and tactile hallucination of insects crawling under the skin (formication) Substance abuse history may be elicited from the history and confirmed by finding urinary metabolites Confirmation of schizophrenia can only be made if the psychotic symptoms persist for at least a month following drug withdrawal... 

Insomnia is a common comorbid condition with depression, and frequently is made worse by antidepressants, particularly the SSRIs. When insomnia persists despite adequate evaluation and attempts to reduce it by other approaches, it is often necessary to use a concomitant sedative-hypnotic, especially a short-acting nonbenzodiazepine with rapid onset such as zaleplon or zolpidem. At times a benzodiazepine sedative hypnotic such as triazolam or temazepam may be necessary. If anxiety persists during the day and cannot be otherwise managed, it may be necessary to add an anxiolytic benzodiazepine such as alprazolam or clonazepam. Use of sedative-hypnotics and anxiolytics should be short-term whenever possible. 

Kava originates from the root of the Piper methysticum (kava) plant that grows predominately in the South Pacific islands. This drug has been used for centuries by various local cultures because of its sedative and antianxiety effects. Kava has likewise gained popularity in western societies, and studies suggest that kava extracts can be used as an alternative to traditional sedative-hypnotic and anxiolytic drugs, such as benzodiazepines (see Chapter 6).21,39 Kava may also produce... 

Greenblatt DJ, von Moltke LL. Sedative-hypnotic and anxiolytic agents. In Levy RH, Thummel KE, Trager WF, et al. Metabolic Drug Interactions. Philadelphia Lippincott Williams and Wilkins, 2000 259-270. 

In the preceding discussion, the DSM-IV is very specific, as it is elsewhere, that Substance-Induced Dementia can occur in association with the following classes of substances alcohol inhalants sedatives, hypnotics, and anxiolytics (p. 169, emphasis added). 

III SEDATIVE, HYPNOTIC, AND ANXIOLYTIC DRUGS (TRANQUILIZERS AND SLEEPING PILLS)8... 

Dasuen ER-115 Euhypnos Euipnos Gelthix K-3917 Lenal Levanxene Levanxol Neodorm SP Nocturne Nomapam Norkotral Tema Normison Normitab Nortem Oxydiazepam Perdorm Ranum Pronenron T Remestan Restoril Ro-5-5354 Temador Temazep von ct Temazepam Temtabs Tenox Uvamin Retard Wy-3917. Used medically as a sedative/hypnotic and anxiolytic. Crystals mp = 119-121°. Hoffmann-LaRoche Inc. Sandoz Pharm. Cap. 

A generic term relating to psychological and/a physical dependence when one or mae psychoactive substances or classes of psychoaaive substances are abused (alcohol sedatives, hypnotics and anxiolytics cannabis opioids cocaine amphetamine and other sympathomimetics hallucinogens caffeine nicotine ... 

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