The most sedating
The older sedative-hypnotics that have a prolonged half-life increase the risk for next-day sedation and daytime psychomotor impairment and pose an increased risk for abuse and dependence.Other complications of benzodiazepine use include tolerance, withdrawal, abuse, and rebound insomnia.Medications used in the treatment of insomnia include nonbenzodiazepine receptor agonists, benzodiazepine receptor agonists, the selective melatonin receptor agonist ramelteon, and sedating antidepressants.All can be considered first-line agents for insomnia; agent choice is largely dictated by past trials, cost, side-effect profile, drug interactions, and patient preference.The representatives of this group are: Benzodiazepines are the most widely used group of sedative drugs.
Barbiturates are nonselective CNS depressants that used to be the mainstay of treatment to sedate patients or to induce and maintain sleep.In modern medicine they have been largely replaced by the benzodiazepines, primarily because they can induce tolerance, physical dependence and serious withdrawal symptoms.Nevertheless, certain barbiturates are still employed as anticonvulsants (phenobarbital) and to induce anesthesia (thiopental).Side effects: Nausea, insomnia, headaches, sexual dysfunction, jitteriness; possibly drowsiness, dry mouth, constipation.
It’s the worst one for weight gain, and among the worst for withdrawal symptoms (unless properly managed).The goal in such development is to produce agents that are more efficacious, safer and better tolerated than older medications. Although all SSRI drugs have the same mechanism of action, each SSRI has slightly different pharmacological and pharmacokinetic characteristics.This leads to differences among the SSRIs in their half-lives, clinical activity, side effects, and drug interactions.Sedative-hypnotics include nonbenzodiazepine receptor agonists (zaleplon, zolpidem, eszopiclone); short-acting benzodiazepine receptor agonists (triazolam); intermediate-acting benzodiazepine receptor agonists (estazolam, temazepam); and selective melatonin agonists (ramelteon).