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Drug Classes and Therapy

Drug therapy, when combined with good sleep hygiene, may be helpful for the short-term management of insomnia.

Benzodiazepines are commonly used for the management of sleep disorders. Shorter-acting benzodiazepines are less likely than long-acting benzodiazepines to be associated with drowsiness or sluggishness the next morning.

Other drugs used in the short-term management of insomnia include a unique agent called Ambien (zolpidem), barbiturates, sedating antihistamines, and a new drug called Sonata.

Drug classes used to treat Sleep Disorders

Barbiturates: Barbiturates slow down central nervous system function, heart rate, and respiration. People who use them continually may become tolerant to the effects of barbiturates, which also produce potentially serious side effects.

Drugs in the class

• Amobarbital (Amytal)
• Butabarbital (Butalan Elixir, Butisol, Sarisol No.2)
• Pentobarbital Oral (Nembutal)
• Phenobarbital (Bellatol, Solfoton)
• Secobarbital (Seconal)
• Pentobarbital Injection (Nembutal Injection)
  

Benzodiazepines

Benzodiazepines are drugs that relieve anxiety by acting on the limbic system, an area deep inside the brain that appears to be involved in primitive emotional responses.

Benzodiazepines work at the level of the nerve cells in the brain. They enhance the effects of a chemical messenger called gamma aminobutyric acid (GABA) that slows down the activity of the nerve cell. When GABA binds to the nerve cell, a channel is widened allowing more chloride ions to move into the nerve cell. This makes the cell less active. When benzodiazepines bind to GABA receptors, the effects are enhanced.

Benzodiazepines enhance the sedating effect of GABA by allowing chloride ions (Cl-) into the nerve cells, slowing the activity of the neuron.

Drugs in the Class

• Alprazolam (Xanax)
• Chlordiazepoxide (Libritabs, Librium, Mitran, Reposans-10, Sereen)
• Clonazepam (Klonopin)
• Clorazepate (ClorazeCaps, ClorazeTabs, GenENE, Tranxene, Tranxene-SD)
• Diazepam (Valium, Valrelease)
• Estazolam (ProSom)
• Flurazepam (Dalmane)
• Lorazepam (Ativan)
• Oxazepam (Serax)
• Temazepam (Restoril)
• Triazolam (Halcion)
• Lorazepam Injection (Ativan Injection)
  

Miscellaneous Sedatives and Hypnotics

Sonata is a newer drug, released in 1999 for the treatment of short-term insomnia. It is not a benzodiazepine or a barbiturate. This hypnotic's main advantage is that it is associated with less next morning drowsiness.

Ambien is not a benzodiazepine or a barbiturate, but it slows down the brain's normal function, in a way that is not harmful but that promotes sleep. It works relatively quickly and has fewer side effects than some of the other sleep-inducing medications.

Drugs in the class

• Chloral Hydrate
• Zolpidem (Ambien)
• Zaleplon (Sonata)
• Chloral Hydrate Rectal (Aquachloral Supprettes)
• Ethchlorvynol (Placidyl)
• Glutethimide (Doriden)

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