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Sedative preparations

A sedative or tranquilizer (or tranquillizer, see American and British English spelling differences) is a substance that induces sedation by reducing irritability or excitement.

At higher doses it may result in slurred speech, staggering gait poor judgment, and slow, uncertain reflexes. Doses of sedatives such as benzodiazepines, when used as a hypnotic to induce sleep, tend to be higher than amounts used to relieve anxiety, whereas only low doses are needed to provide a peaceful and calming sedative effect.

Sedatives can be misused to produce an overly-calming effect (alcohol being the classic and most common sedating drug). In the event of an overdose or if combined with another sedative, many of these drugs can cause unconsciousness (see hypnotic) and even death.

There is some overlap between the terms ''sedative'' and ''hypnotic''. The terms describe distinct effects, but medications that cause one of these effects often also cause the other.

Advances in pharmacology have permitted more specific targeting of receptors, and greater selectivity of agents, which necessitates greater precision when describing these agents and their effects:

· Anxiolytic refers specifically to the effect upon anxiety. (However, some benzodiazepines can be all three: sedatives, hypnotics, and anxiolytics).

· Tranquilizer can refer to anxiolytics or antipsychotics.

· Soporific and sleeping pill are near-synonyms for hypnotics.

Therapeutic use

Doctors often administer sedatives to patients in order to dull the patient's anxiety related to painful or anxiety-provoking procedures. Although sedatives do not relieve pain in themselves, they can be a useful adjunct to analgesics in preparing patients for surgery, and are commonly given to patients before they are anaesthetized, or before other highly uncomfortable and invasive procedures like cardiac catheterization, colonoscopy or MRI. They increase tractability and compliance of children or troublesome or demanding patients. Patients in intensive care units are almost always sedated (unless they are unconscious from their condition anyway).

Sedative dependence

Some sedatives can cause physiological and psychological dependence when taken regularly over a period of time, even at therapeutic doses.

Dependent users may get withdrawal symptoms ranging from restlessness and insomnia to convulsions and death. When users become psychologically dependent, they feel as if they need the drug to function, although physical dependence does not necessarily occur, particularly with a short course of use. In both types of dependences, finding and using the sedative becomes the focus in life. Both physical and psychological dependence can be treated with therapy

Dangers of combining sedatives and alcohol

Further information: Combined Drug Intoxication

Sedatives and alcohol are sometimes combined recreationally or carelessly.

Since alcohol is a strong depressant that slows brain function and depresses respiration, the two substances compound each other's actions and this combination can prove fatal.

Sedatives and amnesia

Sedatives can sometimes leave the patient with long-term or short-term amnesia. Lorazepam is one such pharmacological agent that can cause anterograde amnesia. Intensive care unit patients, who receive higher doses over longer periods, typically via IV drip, are more likely to experience such side effects.

Sedatives and crime

Sedatives - most commonly alcohol but also GHB, Flunitazepam (Rohypnol), and to a lesser extent, temazepam (Restoril), and midazolam (Versed)-are well known for their use as date rape drugs (also called a Mickey) and being administered to unsuspecting patrons in bars or guests at parties to reduce the intended victims' defenses. These drugs are also used for robbing people.

Statistical overviews suggest that the use of sedative-spiked drinks for robbing people is actually much more common than their use for rape. Cases of criminals taking rohypnol themselves before they commit crimes have also been reported, as the loss of inhibitions from the rug may increase their confidence to commit the offence, and the amnesia produced by the drug makes it difficult for police to interrogate them if they are caught.

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