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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

From: Treating insomnia with medications

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
  1. Key: the term “Significant” indicates comparison to placebo or hypnotics