Section outline

  • Introduction

    Hypnotics are a group of psychotropic drugs that help induce sleep and are primarily used to treat severe insomnia. These drugs vary in their mechanisms of action, duration of effect, and side effects, making it crucial to carefully select the appropriate type for each case.


    First: Definition of Hypnotics and Indications for Use

    Hypnotics are drugs that affect the central nervous system and promote sleep. They are usually prescribed for:

    Chronic or acute insomnia.

    Sleep disorders caused by anxiety or depression.

    Improving sleep quality in patients with other psychological disorders.


    Second: Types of Hypnotics and Their Pharmaceutical Forms

    Hypnotics can be classified into several types based on their chemical composition and mechanism of action:


    Benzodiazepines:

    Among the most commonly used hypnotics due to their effectiveness and relatively few drug interactions.

    Used only for severe, disabling insomnia as they may lead to dependence and addiction.

    They act quickly, so they should be taken about 20 minutes before bedtime.

    Examples include Triazolam (Halcion), Flunitrazepam (Rohypnol), and Nitrazepam (Mogadon).

    Pharmaceutical Forms: Available as oral tablets and, in some cases, injectable solutions for severe cases.


    Barbiturates:

    Used only for extreme cases of insomnia.

    Misuse can lead to drug tolerance (Tolérance), which causes addiction.

    Have a narrow safety margin, making overdose dangerous and potentially fatal, especially when combined with alcohol.

    Pharmaceutical Forms: Available as tablets, capsules, or injectable ampoules for intravenous administration.


    Z-Drugs (Z-Hypnotics):

    Act similarly to benzodiazepines but have a shorter duration of effect.

    They work quickly and are designed to be eliminated from the body rapidly.

    Examples include:

    Zopiclone – marketed as “Imovane” and “Zimovane.”

    Zolpidem – sold under the brand name “Stilnox.”

    Zaleplon.

    Pharmaceutical Forms: Available as fast-dissolving tablets and, in some cases, capsules.


    Other Hypnotics:

    Some anxiolytics and antidepressants possess sedative properties, such as:

    Amitriptyline.

    Atarax.

    Tranxene.

    Phenergan.

    Theralene.


    Pharmaceutical Forms: Available as tablets, syrups, and sometimes intramuscular injections.


    Third: Side Effects and Risks

    Although hypnotics are effective for treating insomnia, they carry certain risks and side effects, including:

    Reduced alertness, affecting activities that require high concentration, such as driving.

    Daytime drowsiness and dizziness.

    Memory disturbances, particularly with long-term use.

    Physical or psychological dependence, making withdrawal difficult without medical supervision.

    Drug interactions with other medications, potentially leading to serious complications.


    Fourth: Contraindications

    Hypnotics are contraindicated in some cases, such as:

    Allergy to benzodiazepines or their derivatives.

    Acute respiratory insufficiency.

    Certain liver and kidney disorders affecting drug metabolism.

    Pregnancy and breastfeeding, due to potential harm to the fetus or infant.


    Conclusion

    Hypnotics are effective treatments for insomnia and sleep disorders, but they require careful use under medical supervision. Awareness of their risks is essential, and alternative treatments, such as Cognitive Behavioral Therapy for Insomnia (CBT-I), should be considered for improving sleep quality in a safer manner.