The 8 most used types of hypnotic drugs

From clinical psychology, insomnia problems, whether they are related to conciliation or maintenance of sleep, are treated preferably through behavioral techniques such as stimulus control, sleep hygiene, and progressive muscle relaxation of Jacobson.

However, in cases of severe insomnia or resistant to psychological therapy, it may be necessary to combine it with the use of medications. In this article we will talk about the most widely used and known types of hypnotic drugs.

• Related article: "Types of psychotropic drugs: uses and side effects"

The most used hypnotic drugs

Below we will describe the most common groups of hypnotic drugs in the present and in the second half of the 20th century. Although nowadays benzodiazepine analogs are the drug treatment of choice for insomniaIn some places, classic hypnotics such as benzodiazepines and barbiturates are still used.

It is important to note that not all of these drugs are used to treat insomnia, but rather that some of them are very powerful and specific medications for the management of other alterations. We include these cases in the list because of the significance of the hypnotic effects associated with their use or their relevance in the history of sleeping pills.

1. Benzodiazepines

Benzodiazepines include some of the most commonly used drugs to treat insomnia symptoms, especially the short-lived variants. However, long-term use of these drugs leads to risk of dependence and withdrawal syndrome, as it acts similarly to alcohol, and just like this one ends up disturbing the dream.

The use of benzodiazepines as hypnotics has been in decline since the 1990s, a time when that benzodiazepine analogues were developed, which we will refer to in the section following. Currently, drugs in this class are used primarily to treat symptoms of anxiety and alcohol withdrawal for short periods of time.

• Related article: "Benzodiazepines (psychotropic): uses, effects and risks"

2. Benzodiazepine analogs (Z drugs)

Benzodiazepine analogs are drugs with properties very similar to those of benzodiazepines, although they cannot be classified in this group because they have a different chemical structure. In recent years they have become the most widely used hypnotics in many parts of the world since they have been attributed high security.

In this category, three main drugs stand out: zolpidem, zaleplon and eszopiclone. Another of the better known Z drugs, zopiclone, has been withdrawn in some countries because of its side effects, which are not very different from those of benzodiazepines.

3. Orexin receptor antagonists

Various recent medications thave antagonistic effects on receptors for the neuropeptide orexin or hypocretin, which is associated with alertness and wakefulness, as well as appetite. The degree of effectiveness of these drugs has yet to be assessed, although Suvorexant has been approved for use and research on Lemborexant is promising.

4. Barbiturates

Barbiturates were the most commonly used medications to treat insomnia until the advent of benzodiazepines, which cause fewer side effects. At present, different types of barbiturates are used as surgical anesthetics and as anticonvulsants in cases of epilepsy, but their application as hypnotics has become very unusual.

Continued use of these drugs carries a high risk of physical and psychological dependence, which in turn explains the intense withdrawal syndrome associated with barbiturates. Another factor contributing to the loss of popularity of these drugs was the worrying number of suicides due to overdose.

• You may be interested: "Barbiturates: effects, mechanisms of action and toxicity"

5. Quinazolinones

Quinazolinones are chemical compounds with diverse medical properties: they can have anti-inflammatory, analgesic, antibacterial, antifungal, and anticonvulsant effects. In addition, the anticancer properties of some quinazolinones, such as Idelalisib, have been investigated, although these studies have been abandoned because of side effects.

In the 1960s and 1970s it was very popular Methaqualone, better known by its trade name "Quaalude". This hypnotic drug was widely used as a recreational drug during this time, especially in nightclubs.

6. Anesthetics

Medications that are used as anesthetics are often considered members of the same category as hypnotics and sedatives. Within this group we find propofol, etomidate and the ketamine; the first two are frequently administered to people, while ketamine is more widely used in veterinary medicine.

7. Cannabinoids

Chemical compounds derived from cannabis, such as tetrahydrocannabinol and cannabidiol, are sometimes used as psychotropic drugs because of their sedative, hypnotic and painkillers. In recent years, drugs have been developed from marijuana that carry a relatively low risk of dependency.

• You may be interested: "Research reveals why marijuana can cause schizophrenia"

8. Melatonin

Melatonin is a hormone that is involved in the regulation of biological rhythms, especially in the sleep-wake cycle. Currently there are medicines based on melatonin that are used as an alternative treatment for insomnia; however, and despite the ease of access to these products, they must be used with a prescription.