Drugs that contribute to immersion in a strong, prolonged sleep are called sleeping pills. Their scientific name is hypnotics. Pharmacology distinguishes several classes of such drugs. Depending on the principle of action, the pharmacokinetics, indications and contraindications for administration, possible side effects and their frequency of development are also different.
For what reasons sleep problems develop
There is an opinion that insomnia is the inability to fall asleep, and this condition is more common for older people. This opinion is erroneous. Insomnia is characterized not only by the inability to plunge into a sound sleep, but also by frequent awakenings in the middle of the night. This problem can affect a person of any age and any gender. Early waking (if the total duration of sleep is less than five hours) is a type of insomnia.
According to the classification of sleeping pills, in pharmacology there are two large groups of drugs: with narcotic action and without it. They, in turn, are divided into other subgroups.
Hypnotics and drugs are available in various forms: tablets, capsules, syrups, ampoules with a solution for injection. Of course, tablets are the most popular among patients.
What exactly causes sleep problems:
- chronic fatigue, constant physical and psycho-emotional overstrain;
- work in night shifts (doctors, police, military personnel) disrupts the sequence of sleep phases, and as a result, people in these professions suffer from chronic sleep problems;
- some endocrine disorders (thyroid disease);
- organic brain damage;
- consequences of traumatic brain injuries and concussions;
- cerebrovascular accident;
- depressive and anxiety disorders;
- taking psychotropic drugs;
- premenstrual syndrome in women;
- hypochondria and obsessive-compulsive disorder;
- withdrawal syndrome in addicted people.
Which doctor prescribes a prescription for hypnotics?
Most sleeping pills of pharmacology can not be purchased without a prescription from a doctor, since they are included in the list of potent drugs. Where to go to a simple person suffering from sleep problems to get such a document?
First you need to take a coupon for an appointment with a local therapist. Describe his condition to him. It is possible that the therapist will advise the drug and even write a prescription. In some cases, if the symptoms described by a sick person are quite serious, they give him a referral for a consultation with a neurologist or psychiatrist. They can prescribe potent hypnotics. Hypnotics in pharmacology stand apart: in terms of action, they belong to psychotropic drugs. Often, their appointment is associated with the need for constant monitoring of the patient's condition in the IPA.
As a rule, a neurologist takes in a regional clinic, but a psychiatrist consults patients in IPA, which is located in a separate building in most cities and keeps separate records of patients seeking help.
Non-narcotic sleeping pills: classification
Pharmacology distinguishes many groups of hypnotics. Each of them has several drugs. They all differ in mechanisms of action on the human body.
There are several large groups of non-narcotic, that is, not causing physical and psychological dependence, drugs:
- benzodiazepines;
- non-benzodiazepines;
- histamine receptor blockers;
- derivatives of GABA (gamma-aminobutyric acid).
All drugs of these groups have sleeping pills, anti-anxiety, sedative effect. Some of them can increase appetite, others are toxic to the liver. Each group of hypnotics will be described in detail later in the article.
Narcotic hypnotics: features of application
These drugs are strictly prescription drugs, as they can cause physical and psychological dependence. If the patient without them fell asleep with difficulty, then taking such pills, he sleeps soundly and for a long time. But a month later, tolerance develops, and a sick person needs an increasing dose of sleeping pills.
Pharmacology is gradually moving away from the production of such drugs, as they often do more harm than good. Nevertheless, large pharmacological concerns continue to produce narcotic hypnotics for profit.
This group of drugs is called barbiturates. They have a powerful sleeping pill. Only a person after taking the pill does not fall asleep in a healthy sleep, but falls into a real coma as a result of paralysis of the nervous system.
Benzodiazepines: principle of action and list of drugs
Medicines from this group are prescribed for patients suffering from constant anxiety, sleep problems, phobias. At one time, benzodiazepine derivatives made a breakthrough in neurology. In the treatment of anxiety, panic attacks, neurosis, obsessive-compulsive disorders and nervous tics, now no neurologist or psychiatrist can do without prescribing a patient from the benzodiazepine series. These drugs are one of the most popular drugs in pharmacology.
According to the classification of sleeping pills and the description, we can conclude that benzodiazepines are drugs with a more gentle effect on the body. With prolonged use, however, the patient may experience physical dependence and addiction. The principle of action is based on the effect on GABA receptors.
Benzodiazepines are not recommended for the treatment of acute psychotic conditions, delirium tremens and intoxicated. They can be used as a means of normalizing sleep during the period of withdrawal syndrome.
List of popular and commonly prescribed benzodiazepines
The following benzodiazepines are classified as sleeping pills:
- Gidazepam. It has a mild tranquilizing effect and anticonvulsant effect. In pharmacies, they are released strictly according to the prescription. Release form - white tablets of 30 mg or 50 mg. Not only promotes rapid falling asleep, but also stops fear and a feeling of irritability, anxiety.
- Diazepam has a hypnotic effect. A neuropathologist prescribes a dosage, depending on which the drug can have both a stimulating and sedative effect.
- "Phenazepam" is a powerful sleeping pill. Release strictly according to the recipe. Release form - tablets. It also has a vasodilating and muscle relaxant effect. Helps patients in acute psychotic conditions.
- Nitrazepam is a tablet preparation that effectively fights seizures and insomnia. Psychiatrists and neurologists are prescribed as sleeping pills. Sell strictly with a prescription. Incorrect dosage can contribute to the development of motor anxiety and have a toxic effect on neurons.
Side effects of benzodiazepines:
- in the first week of admission from the nervous system: drowsiness, sweating, feeling tired, decreased motor activity;
- from the gastrointestinal tract: constipation, decreased intestinal motility, bloating;
- from the cardiovascular system: lowering blood pressure, pulse disturbances, tachycardia, angina pectoris.
Histamine receptor blockers
Drugs with antihistamine activity prevent and eliminate spasm of smooth muscles, reduce capillary wall permeability, and have anti-edematous and anti-inflammatory effects. Some of them have a pronounced sedative effect on the central nervous system, block cholinergic receptors of autonomic nodes. This effect allows the use of these drugs as sleeping pills. Their pharmacology is well studied. Subject to proper dosing, they do not cause drug dependence.
Official medicine rarely uses these drugs to troubleshoot sleep problems. More often they are prescribed to patients with allergies of various origins.
Hypnotic drugs acting by blocking histamine receptors:
- Diphenhydramine. They are produced in the form of tablets and ampoules with a solution for injection. It has a strong hypnotic and sedative effect. No prescription is allowed.
- "Suprastin", "Tavegil" - used most often with allergies. They have a pronounced hypnotic effect.
Possible side effects of histamine receptor blockers:
- toxic effects on the liver and kidneys;
- blurred vision;
- headache;
- digestive upset;
- urticaria, dermatitis, eczema.
GABA derivatives
GABA (gamma-aminobutyric acid) is an organic compound that affects the processes in the brain and central nervous system. There are many sleeping pills in pharmacology that act not due to the pure GABA in the composition, but its derivatives. Thanks to the combination with other components, for example, with nicotinic acid in Picamilon, pharmacists have achieved not only sleeping pills, but also nootropic, which is very popular in modern pharmacology.
The mechanism of action of hypnotics based on GABA is simple: the acid is not just a inhibitory mediator, but a mediator responsible for synchronizing large groups of neurons on slow waves. This allows not only to normalize the phases of sleep while taking the drug, but also to achieve long-term improvements even after drug withdrawal.
List of drugs derived from GABA
List of the most popular drugs from the group of sleeping pills - derivatives of GABA:
- Phenibut The drug was originally created as a medicine for astronauts. It is sold only by prescription. It is a nootropic with a mild tranquilizing effect. Depending on the dosage, Phenibut may also have a stimulating effect on the nervous system. It gives an excellent effect during the period of withdrawal syndrome. Assign to children with a delay in psycho-speech development.
- "Piracetam". Sell in the form of dragees. It is one of the first synthesized nootropics with a sedative, hypnotic, calming effect. The effect of sleeping pills (derivatives of GABA) is ambiguous: with an increase in dosage, they can provoke hyperactivity and insomnia. So with the dosage of "Piracetam" should be careful. It is worth starting the dose with the minimum allowable doses.
- "Picamilon" is a nicotinic acid preparation with gamma-aminobutyric acid. It has a mild sedative and nootropic effect. Restores the order and normalizes the duration of the phases of sleep. Often prescribed for children with mental illness (RDA, hyperactivity, developmental delay) and adults with insomnia, anxiety, depressive disorders, low working capacity.
- "Baclofen." In France, it is used as a drug for alcoholism. In our country, this remedy is prescribed for problems with sleep. With prolonged use, Baclofen can cause psychological and physical dependence, although none of the doctors usually focuses on this.
- "Aminalon" is one of the first drugs with sleeping pills among the derivatives of GABA. The drug is still actively prescribed in neurology. It is a precursor to growth hormone, has a generally positive and strengthening effect on the body and nervous system, stabilizing the duration of sleep phases. Today "Aminalon" is one of the safest sleeping pills with a sedative effect and a minimum of side effects.
Barbiturates: principle of action, side effects
This is a fairly large group of drugs in pharmacology. The mechanism of action of sleeping pills based on barbituric acid is based on the fact that their active components penetrate neurons (cells of the nervous system) and have a depressing effect on some receptors, blocking their work. Barbiturates not only have sleeping pills, they also have analgesic and anticonvulsant effects.
Barbiturates are potent substances. In a number of countries, they are completely banned from free sale and equated with drugs.
In our country, these drugs can still be purchased at the pharmacy. For example, the well-known Corvalol, which grandmothers love so much, contains phenobarbital, which is a barbiturate. Corvalol owes him a strong sedative effect.
People who do not have a medical education believe that Corvalol gives you good sleep and peace because of the mint it contains. In fact, this effect is due to a barbiturate called phenobarbital in the composition, which provokes paralysis of the nervous system.
In the Soviet years, barbiturates were prescribed for patients with mental disorders and hyperactivity, as well as for insomnia. Very often they are used now, but only in a hospital if anesthesia is necessary.
Side effects when taking sleeping pills based on barbituric acid:
- unwanted myocardial contractions, which can trigger the development of heart failure;
- delayed response to external stimuli;
- toxic effects on the liver and kidneys;
- toxic effects on neurons;
- tremors and cramps of limbs;
- coma and death.