Friday 21 October 2016

ARE SLEEP MEDICINES SAFE? ARE THEY ADDICTIVE?

Hi friends,        

Medicines for sleep or ‘sleeping pills’ are viewed by different people in different ways. For a lot of people, sleeping pills mean tablets that are addictive and damage one’s organs such as kidney and liver. For others, taking them is a habit even though it may be harmful. Still others discount the presence of any harmful effects and use it. Yet another group of people might feel it as safe as long as it is prescribed and supervised by a qualified expert. So what is the reality? We shall discuss this today.

While the term ‘sleeping pill’ is often used to refer to any medicine that can put one to sleep, they are chemically very different and have different properties. The first thing to understand here is that medicines that induce sleep often have additional properties, which may be beneficial, or viewed as side effects. Depending upon these properties, certain medications may be primarily used for sleep while others, although inducing sleep, have primary effects that are used for some other purpose. Another way of looking at these medicines is to divide them in to two groups – addictive or habit-forming, and, non-addictive or non habit-forming.

Many classes of medicines can be classified under the heading of sleeping pills that are addictive. Usually, these medicines have additional actions like anti-anxiety and muscle relaxant effects. Some of the newer ones have an almost exclusive sleep effect. The duration of effect of these medicines varies from couple of hours to an entire day or even longer, facilitating selection based on the exact need. The older medicines were very dangerous in overdose, but the newer ones are far less so. But they are all addictive, some more and some less. This means that the following things are likely to happen on regular use: need to increase the dose periodically because of inadequate effect at the previous dose (tolerance); anxiety, sleeplessness and seizures (fits) on abrupt stoppage (withdrawal symptoms). Daytime sedation may lead to dulling of intellectual functioning, errors at work, accidents and falls, with their attendant implications. Because of this risk, these medicines should not ordinarily be used unless benefits clearly outweigh the risks. When they do need to be used, they are not recommended for more than 4-6 weeks.

Many medicines can be used for the purposes of inducing/ improving sleep and are not addictive. These medicines include certain antidepressants, antipsychotics and miscellaneous agents such as anti-histaminics (often used in the treatment of allergy/ common cold). They are often used in much lower doses than in cases of treatment of depression/ psychosis and must be used with caution, under the supervision of a qualified psychiatrist. They can also have certain side effects which can be minimized/ abolished with an expert prescription and supervision. Their biggest advantage is that they are not addictive and their additional antidepressant properties can be a boon, as sleep disturbances are often associated with stress.

Irrespective of the kind of medicine, they should only be used when their use is clearly warranted and the benefits clearly outweigh the risks. For most situations where sleep disturbance is temporary, medicines must not be used. In any case sleep hygiene measures (http://drsathyaprakash.blogspot.in/2016/06/how-to-get-good-nights-sleep.html) must first be instituted before medicines are tried.

So going back to the original question? Are medicines for sleep addictive? Some are, some are not. Are they safe? If they are properly prescribed and monitored, they are safe, but it is best to avoid the addictive ones as far as possible.

So that was the discussion for this week friends. Hope you liked it!

Please let me know if you want me to discuss any specific issue by typing in the comments section below.



So until next time, STAY HAPPY!


Dr. Sathya Prakash, MD, Dip. CBT

Consultant Psychiatrist, Psychotherapist and Behavioural Sciences Expert




2 comments:

  1. I want to quit clonazepam 0.5mg i am taking this medicine for last 5 months please help me to quit this medicine cz my carrier family all spoiling cz lots of sudden changes happens my personality change all blurry

    ReplyDelete
  2. Dear Robert,
    The dosage and duration of taking clonazepam suggests that an addictive process has probably set in. However, both the dose and duration are quite less when compared to a lot of other people who have gotten better. So there is really nothing to be alarmed about. But I must say that this is a complex scenario and addressing this here may not be appropriate. This is best addressed after a detailed evaluation. I suggest you meet a good psychiatrist in your area. Good luck and take care!

    ReplyDelete

About Me

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Dr. Prakash is a highly accomplished mental health expert with qualifications from both Indian and western universities. He is a gold medalist from the prestigious All India Institute of Medical Sciences, New Delhi. He is a winner of several national and international awards. Besides treating patients he has a keen research interest and has published over 50 research papers in national and international journals. He is frequently present at scientific conferences in India and overseas where he has made numerous presentations. LYBRATE.COM/DR.SATHYAPRAKASH