Drugs that promote deep, prolonged sleep are called sleeping pills. Their scientific name is hypnotics. Pharmacology distinguishes several classes of such drugs. Depending on the principle of action, pharmacokinetics, indications and contraindications for admission, possible side effects and the frequency of their development also differ.
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. Such an opinion is erroneous. Insomnia is characterized not only by the inability to fall into a deep sleep, but also by frequent awakenings in the middle of the night. This problem can affect a person of any age and any gender. Waking up early (if the total sleep duration is less than five hours) is a type of insomnia.
According toclassification of hypnotics, in pharmacology there are two large groups of drugs: with and without narcotic action. They, in turn, are divided into other subgroups.
Sleeping pills and preparations are produced in various forms: tablets, capsules, syrups, ampoules with a solution for injection. Of course, pills are the most popular among patients.
What causes sleep problems:
- chronic fatigue, constant physical and psycho-emotional overstrain;
- night shift work (doctors, police, military) disrupts sleep phases and as a result people in these occupations suffer from chronic sleep problems;
- certain endocrine disorders (thyroid disease);
- organic brain damage;
- consequences of head injuries and concussions;
- impaired circulation of the brain;
- depressive and anxiety disorders;
- taking psychotropic drugs;
- premenstrual syndrome in women;
- hypochondria and obsessive-compulsive disorder;
- withdrawal syndrome in addicted people.
Which doctor writes a prescription for hypnotics?
Most hypnotic pharmacology drugs cannot be purchased without a prescription from a doctor, as they are on the list of potent drugs. Where can a simple person suffering from sleep problems go to get such a document?
ForFirst you need to take a coupon for an appointment with a local therapist. Describe your 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, he is given a referral for a consultation with a neurologist or psychiatrist. They can write a prescription for powerful hypnotics. Sleeping pills in pharmacology stand apart: by their action they are classified as psychotropic drugs. Often their appointment is associated with the need for constant monitoring of the patient's condition in the IPA.
A neuropathologist, as a rule, sees in the district clinic, but a psychiatrist consults patients in the PND, which in most cities is located in a separate building and keeps a separate record of patients seeking help.
Non-narcotic hypnotics: classification
Pharmacology distinguishes many groups of hypnotics. Each of them has several drugs. All of them differ in the mechanisms of action on the human body.
Several large groups of non-narcotic, that is, not causing physical and psychological dependence, drugs can be distinguished:
- benzodiazepines;
- nonbenzodiazepines;
- histamine receptor blockers;
- GABA (gamma-aminobutyric acid) derivatives.
All drugs of these groups have hypnotic, anti-anxiety, sedative effects. Some of them can increase appetite, others are toxic to the liver. About each group of hypnoticswill be detailed later in the article.
Narcotic hypnotics: application features
These drugs are strictly prescription drugs, as they can cause physical and psychological dependence. If the patient had difficulty falling asleep without them, then taking such pills, he sleeps soundly and for a long time. But after a month, tolerance develops, and the 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. And yet, large pharmacological concerns continue to produce narcotic hypnotics for profit.
This group of medicines is called barbiturates. They have a strong hypnotic effect. Only a person after taking a pill does not fall asleep with a he althy sleep, but falls into a real coma as a result of paralysis of the nervous system.
Benzodiazepines: principle of action and list of drugs
Drugs from this group are prescribed to 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, neuroses, obsessive-compulsive disorders and nervous tics, now not a single neurologist or psychiatrist can do without prescribing a drug from the benzodiazepine series to the patient. These drugs are one of the most popular drugs in pharmacology.
According to the classification of sleeping pills and description, you canconclude 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 pathological intoxication. They can be used as a means of normalizing sleep during withdrawal symptoms.
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 by prescription. Release form - white tablets of 30 mg or 50 mg. Not only helps to fall asleep quickly, but also relieves fear and feelings of irritability, anxiety.
- "Diazepam" has a hypnosedative effect. A neurologist prescribes a dosage depending on which the drug can have both a stimulating and a sedative effect.
- "Phenazepam" is a powerful sleeping pill. Released strictly according to the recipe. Release form - tablets. It also has a vasodilating and muscle relaxant effect. Helps patients in acute psychotic states.
- "Nitrazepam" is a tablet drug that effectively fights convulsions and insomnia. Assign psychiatrists and neurologists as a sleeping pill. Sold strictly according to the recipe. Atimproper dosage can contribute to the development of restlessness and have a toxic effect on neurons.
Side effects of benzodiazepines:
- in the first week of taking from the nervous system: drowsiness, sweating, feeling tired, decreased motor activity;
- from the gastrointestinal tract: constipation, decreased intestinal motility, bloating;
- from the side of the cardiovascular system: lowering blood pressure, pulse disorders, tachycardia, angina pectoris.
Histamine receptor blockers
Preparations with antihistamine activity prevent and eliminate spasm of smooth muscles, reduce capillary wall permeability, 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 hypnotics. Their pharmacology is well studied. With proper dosing, they do not cause drug dependence.
Official medicine rarely uses these drugs to eliminate sleep problems. More often they are prescribed to patients with allergies of various origins.
Sleeping drugs that act by blocking histamine receptors:
- "Dimedrol". Released in the form of tablets and ampoules with a solution for injection. Possessesstrong hypnotic and sedative effect. They don't sell without a prescription.
- "Suprastin", "Tavegil" - used most often for allergies. They have a pronounced hypnotic effect.
Possible side effects of histamine receptor blockers:
- toxic effects on the liver and kidneys;
- decrease in clarity of vision;
- headache;
- indigestion;
- urticaria, dermatitis, eczema.
GABA derivatives
GABA (gamma-aminobutyric acid) is an organic compound that affects the processes occurring in the brain and central nervous system. There are many hypnotic drugs in pharmacology that do not act due to 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 a hypnotic effect, but also a nootropic, which is very much in demand in modern pharmacology.
The mechanism of action of GABA-based hypnotics is simple: acid is not just an inhibitory neurotransmitter, but a mediator responsible for synchronizing large groups of neurons on slow waves. This allows not only to normalize sleep phases while taking the drug, but also to achieve long-term improvements even after stopping the drug.
List of GABA drugs
List of the most popular drugs from the group of sleeping pills - GABA derivatives:
- "Phenibut". The drug was originally created as a medicine for astronauts. It is sold by prescription only. It is a nootropic with a mild tranquilizing effect. Depending on the dosage, Phenibut can also have a stimulating effect on the nervous system. Gives excellent effect in the period of withdrawal syndrome. Assign to children with delayed psychoverbal development.
- "Piracetam". Sold in the form of dragees. It is one of the first synthesized nootropics with a sedative, hypnotic, sedative effect. The effect of hypnotics (GABA derivatives) is ambiguous: with an increase in dosage, they can provoke hyperactivity and insomnia. So with the dosage of "Piracetam" you should be careful. It is worth starting with the minimum allowable doses.
- "Pikamilon" is a preparation of nicotinic acid with gamma-aminobutyric acid. It has a mild sedative and nootropic effect. Restores order and normalizes the duration of sleep phases. Often prescribed for children with mental illness (RDA, hyperactivity, developmental delay) and adults with insomnia, anxiety, depressive disorders, low performance.
- "Baclofen". In France, it is used as a drug for alcoholism. In our country, this remedy is prescribed for sleep problems. With prolonged use, Baclofen can cause psychological and physical dependence, although none of the doctors usually focuses on this.
- "Aminalon" is one ofthe first hypnotic drugs among GABA derivatives. The drug is still actively prescribed in neurology. It is a precursor of growth hormone, has a generally positive and strengthening effect on the body and nervous system, stabilizing the duration of sleep phases. To date, "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 hypnotics based on barbituric acid is based on the fact that their active ingredients penetrate neurons (cells of the nervous system) and have a depressing effect on some receptors, blocking their work. Barbiturates not only have a hypnotic effect, they also have analgesic and anticonvulsant effects.
Barbiturates are potent substances. In a number of countries, they are completely prohibited from free sale and equated to 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. It is to him that Corvalol owes a strong sedative effect.
People who do not have a medical education believe that Corvalol gives sound sleep and peace of mind due tothe mint it contains. In fact, this effect is due to a barbiturate called phenobarbital in the composition, which provokes paralysis of the nervous system.
Barbiturates were prescribed in the Soviet years to patients with mental disorders and hyperactivity, as well as insomnia. Very often they are used now, but only in a hospital if anesthesia is necessary.
Side effects of taking barbituric acid sleeping pills:
- unwanted myocardial contractions, which can trigger the development of heart failure;
- slow response to external stimuli;
- toxic effects on the liver and kidneys;
- toxic effects on neurons;
- tremor and leg cramps;
- coma and death.
