Table 4 Sedatives - Agents Used To Induce Sleep And Sedation With Significant Next Day Sleepiness After Used Based On Pharmacodynamics, Clinical Trials, And/Or Performance Testing
CLASS (DRUG) [Neuromodulator Effected] | 1/2 LIFE | Next Day Sleepiness [Clinical Trials] | Next Day Effects On Performance & Driving Tests | Toxicity And/Or Significant Side Effects |
|---|---|---|---|---|
Antidepressants - tricyclics (amitriptyline etc.) [serotonin] | 10–20 HR. | Significant | Significant With Minimal Study | Anticholinergic, Respiratory suppression in overdose |
- Atypicals (trazadone, mirtazapine) [serotonin] | traza- done (8 h) mirtaza-pin 20–40 HR. | Significant | Significant With Minimal Study | Respiratory Suppression In Overdose |
H1 antihistamine Diphinhydramine, hydroxyzine, triprolidine) [histamine] | 2–12 HR. | Significant | Significant - Multiple studies | Confusion [Black Boxed For The Elderly] |
Antipsychotic - Olanzapine [histamine] | 6–8 HR. | Significant | Significant with minimal study | Potentially persistent extra-pyramidal Side effects |
- Doxepin [histamine, orexin] | 1/2–15 h. (dose based) active metabolite | Significant | Significant With Minimal Study | Potentially persistent extrapyramidal Side effects |
Gaba agonists - medium ½ life benzodiazepi-nes (estalolam, clonazepam, temezepam, etc.) [GABA] | 7–10 HR. | Significant | Significant Multiple studies | Disinhibition |
- Long ½ life benzodiazepi- nes (flurezepam, diazepam, etc.) [GABA] | Up To 11 Days | Significant | Significant Multiple studies | Disinhibition Falls in the elderly |
Orexin antagonists (suvorexant) [orexin] | 10–22 HR. | Significant | Significant | Unknown New agent |