Miya Pearson
Sleeping pills are not narcotics, but they do carry similar dangers and can produce many of the same adverse effects. Sleeping pills are typically used to treat insomnia by making the user feel drowsy and relaxed, and can be obtained over the counter or by prescription. Prescription sleeping pills are stronger than over-the-counter pills and are typically only prescribed for short-term relief due to the risk of dependence and addiction. Some of the strongest sleeping pills include doxepin (Silenor), daridorexant, lemborexant, and benzodiazepines such as quetiapine (Seroquel) and olanzapine (Zyprexa).
| Characteristics | Values |
|---|---|
| Name | Daridorexant or Lemborexant |
| Type | Sleeping pill/sleep aid |
| Availability | Prescription medication |
| Use case | Short-term treatment of insomnia |
| Effectiveness | May offer sustained benefits with a potentially lower risk of dependence compared to older drugs |
| Side effects | May cause drowsiness during the day, confusion, parasomnia, CNS depression, hallucinations, mood changes, memory loss, complex sleep behaviors, liver function impairment, worsening of depression or suicidal thoughts |
| Precautions | Not recommended for long-term use due to risk of dependence and addiction; may cause adverse reactions at higher doses; not suitable for pregnant or nursing individuals, children, or those with glaucoma or urinary retention without consulting a doctor; should not be taken within 3 hours of a meal |
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What You'll Learn
Zolpidem (Ambien, Intermezzo, Zolpimist)
Zolpidem, also known by the brand names Ambien, Intermezzo, Zolpimist, Edluar, and Ambien CR, is a sedative-hypnotic medication used for the short-term treatment of insomnia. It is not a benzodiazepine, but it works similarly by enhancing the effects of the inhibitory neurotransmitter GABA in the brain. Zolpidem is available in various forms, including tablets, extended-release tablets, sublingual tablets, and oral sprays. It is important to note that Zolpidem is intended for short-term use and should ideally not be taken for more than seven to ten days.
After taking Zolpidem, individuals typically become very sleepy and should plan to go to bed right away. They should also remain in bed for 7 to 8 hours afterward. If one wakes up in the middle of the night after taking Zolpidem, they should not take another Zolpidem sublingual tablet (Intermezzo) or any other sleeping pill. It is crucial to avoid consuming alcohol or herbal products like St. John's wort when taking Zolpidem, as interactions may occur.
Zolpidem has been associated with serious and potentially life-threatening side effects. Some individuals have engaged in activities such as driving, preparing food, or even sleepwalking while not fully awake, and later having no memory of these actions. Therefore, it is essential to consult a doctor immediately if one experiences unusual sleep behaviors while taking Zolpidem. Additionally, Zolpidem can cause drowsiness, memory problems, and issues with alertness or coordination if one gets up too soon after taking the medication.
Although Zolpidem is not as habit-forming as benzodiazepines, it can still lead to physical dependence within a couple of weeks, even when taken at recommended dosages. As such, it is crucial to discuss the use of Zolpidem with a healthcare provider before starting the medication and to inform them of any history of substance use or alcohol consumption. While Zolpidem can be effective in treating insomnia, it should be used with caution and under medical supervision to ensure safe and appropriate use.
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Zaleplon (Sonata)
Zaleplon, previously sold under the brand name Sonata, is a prescription sleep medication for adults. It is used to treat insomnia or trouble falling asleep. It is a type of sedative-hypnotic called a non-benzodiazepine, or "z-drug". Zaleplon is a controlled substance due to its risk of misuse and dependence. It is available in capsule form and should be taken by mouth right before bed or when one is already in bed and cannot fall asleep. It is important to note that Zaleplon should only be taken if one can get at least 7 hours of sleep after taking it.
Zaleplon works by activating proteins in the brain called gamma-aminobutyric acid-A (GABA-A) receptors, which help calm the brain and make it easier to fall asleep. It belongs to the group of medicines called central nervous system (CNS) depressants, which slow down the nervous system.
There are several side effects associated with Zaleplon. It can cause sleepwalking, memory loss, next-day drowsiness, dizziness, and an increased risk of falling, especially for older adults. It can also cause abnormal thoughts or behaviours and may worsen depression and cause suicidal thoughts or actions in a small number of people. Zaleplon should not be taken with alcohol or other medications that cause drowsiness, as this can increase the risk of side effects.
It is important to consult a doctor before taking Zaleplon, especially if one has a history of drug abuse or dependence, asthma, sleep apnea, or liver disease. Zaleplon should be used with caution in these cases, as it may worsen the conditions. It is also important to disclose all medications one is taking to ensure safe usage.
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Doxepin (Silenor)
Doxepin, also known by its trademarked name Silenor, is a tricyclic antidepressant (TCA) medication that helps treat insomnia in people who have trouble staying asleep. It is available in the form of a tablet, capsule, or liquid, and is taken orally. Doxepin is a prescription medication, meaning it can only be obtained with a doctor's prescription. It is typically taken once daily, within 30 minutes of bedtime, and users are advised to follow the directions on their prescription labels carefully. It is important to note that Doxepin should not be taken within 3 hours of a meal.
Doxepin works by slowing down brain activity, allowing those with insomnia to sleep. It is also used to treat anxiety and depression by increasing certain chemical levels in the brain. However, it is not recommended for children below 12 years old, as studies have not been conducted on its effects in this age group. Similarly, it is advised that elderly patients exercise caution when taking Doxepin due to an increased risk of side effects.
The medication may cause drowsiness and sleep-related behaviours such as sleepwalking, sleep-driving, or preparing and eating food while asleep. As such, it is important to refrain from activities that require alertness after taking the medication. Doxepin may also interact with other medications, including monoamine oxidase (MAO) inhibitors, and users are advised to consult their doctor or pharmacist about potential interactions before taking Doxepin.
Doxepin is available as a brand name drug, Silenor, and as an authorized generic version. The generic version is priced at $99 or less, while the brand name version is priced at $115 or less.
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Suvorexant (Belsomra)
Suvorexant, sold under the brand name Belsomra, is a medication used to treat insomnia in adults. It is produced by Merck & Co. and is available by prescription in the United States, Canada, Australia, Russia, and Japan. Suvorexant is a dual orexin receptor antagonist (DORA), which means it acts on the orexin OX1 and OX2 receptors in the brain. It does not interact with GABA receptors, which sets it apart from benzodiazepines and Z-drugs, two other types of sleep aids.
The medication is taken orally and has been shown to reduce the time it takes to fall asleep, decrease middle-of-the-night wakefulness, and increase total sleep time. Its effectiveness is considered modest and similar to that of other orexin antagonists, but lower than benzodiazepines and Z-drugs. A 2017 systematic review and meta-analysis of randomized controlled trials found that suvorexant improved sleep onset, total sleep time, and sleep quality when assessed after one to three months of treatment.
The recommended dose of suvorexant is 15 to 20 mg, and it has an intermediate elimination half-life of 12 hours, with a time to peak of about 2 to 3 hours. Side effects may include somnolence, excessive daytime sleepiness, headache, dizziness, abnormal dreams, dry mouth, and impaired next-day driving ability. Rarely, sleep paralysis, sleep-related hallucinations, sleepwalking, and suicidal ideation may occur.
It is important to note that suvorexant is a controlled substance in some countries, such as the United States, where it is classified as a Schedule IV drug, indicating a modest potential for misuse. In Australia, it is not a controlled drug but is still prescription-only medicine. Suvorexant does not appear to be available in the United Kingdom or other European countries, except for Russia.
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Lemborexant
Side effects of lemborexant include somnolence, fatigue, headache, and abnormal dreams. Less common side effects include sleep paralysis. The medication may also increase the effects of alcohol and other CNS depressants. It is important to consult a doctor before taking lemborexant, especially if one has a history of drug abuse or dependence, breathing or lung problems, cataplexy, mental illness, or liver disease.
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Frequently asked questions
Sleeping pills are not narcotics, but they do carry similar dangers and side effects. Sleeping pills are classed as sedative-hypnotics, most of which require a prescription. The newest prescription sleeping pills on the market include daridorexant and lemborexant, which may be better at treating chronic insomnia with a lower risk of dependence.
Sleeping pills can cause drowsiness during the day, confusion, and parasomnia (sleepwalking or eating). They can also cause rising tolerance levels and physical dependence, which can lead to addiction.
Yes, sleeping pills can be addictive as they alter the brain's chemical pathways and change its structural makeup over time. This can lead to a psychological dependence on the drug.
Alternatives to sleeping pills include natural sleep aids such as melatonin and valerian supplements. Cognitive behavioural therapy (CBT) may also be more effective at improving sleep.
Sleeping pills treat insomnia by making you feel drowsy and relaxed. They slow down the brain's electrical activity, which induces sleep.
