Tranquilisation, Sedatives & Hypnotics

Question 1

Traq, Sed, Hypno

Answer 1

Tranq- drugs, calm, reduce anx/agitation.

Sed- similar- drug in higher dose induce sleep.

Hypno- specifically induce sleeo. May be sed/tranq given in higher dose.

• -some drugs marketed induce sleep e.g. Z-drugs (Zopiclone/Zolpidem).
• -other drugs tranq/sed without inducing sleep- Haloperidol, Hypenthixol- actually stim (anti-psych)

Question 2

Behavioral control in psychiatry (3)

Answer 2

1- Phy restraints- strait jacket- doc safety, no remove IV. 2 & 4 point ties.

2- Sed/Hypno drugs.

• -earliest = Paraldehyde from 1880s.
• -1900 Barbiturates- barbital.
• -1940s Antihistamines
• -1960s Benzodiazepines- diazepam.

3- Antipsychotic/ Neuroleptic/ Major Tranq- demotivating/indiff. Stop responding to motives (ignore voices in head etc).

Question 3

Sleep

Answer 3

• bio need- if don’t become rapidly psychotic.
• many psych disorders sleep disruption- probs cause of psychosis in some.

Hyponotics- can used put them to sleep- often used in less severe situations.

• -began late 1800s –> Bromides–> Barbiturates.
• -1955 Meprobamate “Miltown”- mum’s lil helper- famous drug talked about.

Benzos- first Librium 1960s. -Diazepam if OD unlikely to die. —suppresses deep sleep (NREM) stages 3 & 4.

• sleep is shallower & less satisfying- same applies to Z-drugs.
• longer sleep & fall asleep faster not satisfying- worse for Z-drugs v Bzs.
• effects ware off repeat (tolerance) - when stop get rebound = worse insomnia/nightmares etc.

Question 4

Over counter sleeping aids

Answer 4

Antihistamines- in Nytol/Benylin.

• -Trimeprazine- vallergan.
• -hangover effects of sedation last into next day- drowsy/groggy.

Melatonin- hormone Pineal Gland- secreted naturally during sleep. high at night- only works in 50%.
–most natural sleep architecture.

-no amazing sleeping drugs yet.