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Related Concept Videos

Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

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Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
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Sedatives and Hypnotics Drugs: Benzodiazepines01:19

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Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
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Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

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Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
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CNS Depressants: Barbiturates and Benzodiazepines01:14

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CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
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Depressants01:28

Depressants

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Depressant drugs, including alcohol and sedative-hypnotics, diminish central nervous system activity by enhancing the action of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces brain activity and promotes relaxation. These substances can have various therapeutic uses but also pose significant risks, especially when misused or combined.
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
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Related Experiment Video

Updated: Apr 1, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Cognitive Effects and Sedation.

Lara Dhingra1, Ebtesam Ahmed1,2, Jae Shin3

  • 1MJHS Institute for Innovation in Palliative Care, New York, New York, USA.

Pain Medicine (Malden, Mass.)
|October 14, 2015
PubMed
Summary

Opioid therapy for chronic pain can cause cognitive effects and sedation (CES), leading to discontinuation. Management includes dose adjustment, rotation, or non-pharmacological therapies to mitigate these common side effects.

Keywords:
Adverse EventsChronic PainCognitive ImpairmentOpioid TherapyPsychomotor DysfunctionSedation

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Pain Management

Background:

  • Cognitive effects and sedation (CES) are common in patients with chronic nonmalignant pain on long-term opioid therapy.
  • CES is a primary reason for patients discontinuing opioid treatment.

Purpose of the Study:

  • To review the phenomenology, epidemiology, mechanisms, assessment, and management of opioid-related CES.
  • To synthesize current knowledge on cognitive and sedative effects associated with long-term opioid use in chronic pain.

Main Methods:

  • A narrative review of empirical and theoretical literature.
  • Focused on studies of long-term opioid therapy (≥ 3 months) in chronic nonmalignant pain populations.

Main Results:

  • CES includes inattention, memory deficits, psychomotor dysfunction, somnolence, and lethargy.
  • Causes can be unrelieved pain, opioid therapy, or combined factors.
  • Mechanisms involve CNS effects, including direct neuronal toxicity and impaired processing.

Conclusions:

  • Memory deficits (73-81%), sleep disturbance (35-57%), and fatigue (10%) are prevalent CES.
  • Severe CES can lead to delirium or coma.
  • Comorbidities and treatments can exacerbate CES, especially in the elderly.