sedativer

Sedativer, or sedatives, are medicines that depress the central nervous system to produce calmness, reduce anxiety, or induce sleep. They are used to treat insomnia, anxiety disorders, and to facilitate medical procedures. They vary in potency, duration, and mechanism of action.

Most sedatives are prescription drugs that act on the GABA neurotransmitter system. The largest group are benzodiazepines (for example diazepam, lorazepam, temazepam) which enhance GABA activity at the GABA-A receptor and have anxiolytic, sedative, anticonvulsant, and muscle-relaxant properties. Barbiturates (such as phenobarbital) were once common but are now used less due to narrow safety margins. Non-benzodiazepine hypnotics, often called Z-drugs (zolpidem, zaleplon, eszopiclone), target the same receptor but with different subunit selectivity and are commonly used for short-term insomnia.

Over-the-counter sedating agents include certain antihistamines like diphenhydramine and doxylamine, which can cause next-day drowsiness and cognitive impairment.

Risks and safety: Sedatives can cause dependence and tolerance with long-term use. Withdrawal can be dangerous; they can cause cognitive and motor impairment, especially in older adults. They interact with alcohol and other central nervous system depressants to increase respiratory depression and sedation. They should be used at the lowest effective dose for the shortest possible time, and patients should be monitored by a healthcare professional. In pregnancy and lactation, many sedatives carry risks and require medical advice.

Regulation varies by country; most sedatives are prescription medications. When possible, non-pharmacological treatments, such as sleep hygiene or cognitive behavioral therapy for insomnia, are preferred for chronic conditions.