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Darius A. Rastegar

and Michael I. Fingerhood

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date: 31 March 2020

Sedative-hypnotics or tranquilizers act on the gamma-aminobutyric acid (GABA) receptor, producing depressed cortical function and disinhibition. They include benzodiazepines and barbiturates. Sedative-hypnotics are used therapeutically for treatment of anxiety, panic disorder, and insomnia. They are also used nonmedically for their sedating effects. Overdose leads to slurred speech, impaired judgment, and unsteady gait; it may also lead to stupor, coma, respiratory depression, vasomotor collapse, and even death. Withdrawal symptoms include agitation, restlessness, insomnia, anxiety, and seizures. Cognitive impairment and increased risk of accidental injury and falls are the most common medical complications. Patients can be withdrawn with a taper of a long-acting benzodiazepine. Inpatient treatment may be required for high-dose use and can be managed using phenobarbital. There are few data on long-term treatment of sedative use disorders.

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