Side effects and drug interactions
The side effects of tranquilizers are manifold and each group of drugs has its own side effects. Therefore, the package insert of the drug should be studied carefully and the doctor or pharmacist should be consulted. In general, the side effects depend on the dose of the sedative taken and the duration of treatment.
Other factors such as the patient’s age and drug interactions also play a role. Especially the latter plays an important role and possible drug interactions should be clarified with the doctor before taking sedatives and thus avoided. Sedatives trigger physical and mental side effects.
Common side effects on the psychological level are drowsiness, listlessness and fatigue. At the same time the sleep structure is disturbed, especially the deep sleep phases are shortened. In addition, attention and the ability to concentrate are restricted.
Memory disorders occur. The slowing down also prolongs the ability to react, which can have dramatic consequences in road traffic. For this reason, patients taking strong sedatives should not participate in road traffic alone.
The physical side effects are just as varied: disorders of appetite and weight gain, sexual disorders, headaches, palpitations and sensory disturbances. At the same time, a relaxation of the musculature occurs, which, together with mental confusion, is accompanied by insecurity in walking and an increased risk of falling, which can end dangerously, especially for old patients. An important and dangerous side effect of tranquilizers is the possible respiratory and circulatory depression, which can occur especially in the case of an overdose. Especially in old patients or children, there is a risk that the effect of the drugs will be reversed (paradoxical reaction) and anxiety and fear reactions will occur more frequently.
More detailed information on different tranquilizers
Benzodiazepines are the largest and most important group of tranquillisers. Benzodiazepines are divided into three groups according to their duration of action. Group 1 includes the short-acting benzodiazepines (2 – 8 hours), such as midazolam (trade name Dormicum®), which have a particularly high risk of addiction and confusion or aggression.
The drugs in this group are mainly used for sleep disorders and to induce anaesthesia. In group 2, there are active substances with medium-length effects (5 – 20 hours), which are mainly used for sleep disorders. Lorazepam (Tavor®) or Oxazepam (Adumbran®) belong to this group.
The benzodiazepines in group 3 have a duration of action of 20-100 hours, and as these drugs are broken down, metabolites are produced which remain active. Clonazepam (Rivotril®), diazepam (Valium®) or flurazepam (Dalmadorm®) are active ingredients in this group and their side effects are mainly daytime fatigue. In addition, the ability to react is greatly reduced and the substances (especially Rohypnol®) are often misused in the drug scene or there is a dependency.
In order to avoid dependency, tablets should be taken as briefly as possible and interrupted by breaks. In addition, the drug should be discontinued slowly after a longer period of use. Barbiturates (methohexital, phenobarbital, thiopental) are more potent than benzodiazepines and therefore often have even more fatal consequences than benzodiazepines in cases of overdose.
Since their effects cannot be reversed directly, they cause fatal respiratory and cardiac arrest. In addition, patients quickly develop tolerance. Due to the numerous disadvantages of barbiturates, they are now only used for anaesthetic induction and epilepsy.
The drug options for antidepressant therapy are enormously diverse and use a wide range of different modes of action. Many antidepressive drugs have a sedative and psychomotoric damping effect on the patient. In particular, the tricyclic antidepressant antidepressant drugs (TCA, above all amitriptyline, clomipramine, doxepin, trimipramine and Opipramol®) and selective serotonin reuptake inhibitors (SSRI, e.g. citalopram, sertraline) are also used in the treatment of obsessive-compulsive disorders or anxiety disorders in addition to depression.
In the latter case, however, they are given in higher doses than in depression. Neuroleptics are mainly used in the therapy of schizophrenia and psychotic disorders, but are also used in personality disorders or psychoses involving restlessness, manic disorders or aggression. Neuroleptics are also used in anaesthetic premedication.
By inhibiting histamine receptors, they also have a sedative effect. Opioids are the most powerful painkillers available with serious side effects. The therapeutic effects of opioids are analgesia (painkillers) and suppression of the coughing stimulus (antitussives).
Side effects include dependence and addiction, respiratory depression, nausea and vomiting, constipation and low blood pressure. However, the sedative effect is also among the side effects: Opioids sedate and induce sleep. However, patients can be awakened from opioid-induced sleep, which is not possible with barbiturates or benzodiazepines.
The sedative effect of opioids is exploited by using highly effective opioids such as fentanyl, sufentanil or remifentanil as narcotics. These drugs are used to treat allergic reactions such as hay fever. Their mechanism of action inhibits histamine receptors, which mediate a reaction that triggers alertness.
Consequently, the inhibition of these histamine receptors therefore results in significant sedation. This original side effect of antihistamines, has been used as a desirable effect and there are different sleeping pills (doxylamine, diphenhydramine) or anxiolytics (hydroxyzine) based on an antihistamine. These drugs are available without a prescription in pharmacies, as they are generally only perceived as “light” sleeping pills.
There are a number of herbal preparations that have been shown in some studies to have a similar effect to histamine receptor blockers when taken in sufficient doses. A well-known herbal sedative is valerian, or more precisely the essential oils extracted from the valerian root. Valerian has a calming effect, as well as promoting falling asleep and sleep through.
The effect does not occur immediately after the first intake, rather it is necessary to take it for at least two weeks until the effects become noticeable. Valerian can help especially with mild sleep disorders or anxiety states. It is often used in combination with other medicinal herbs.
Melissa leaves and their essential oil also have a calming and anxiety-relieving effect. Lavender and passion flower have a similar effect. The medicinal herbs valerian, lemon balm, lavender and passion flower are often used together to relieve anxiety.
Peppermint, i.e. tea or essential oil, also has a relaxing and calming effect. A beer (no excessive consumption) can also act as a sedative. Hops are an important ingredient of beer and have a sleep-inducing effect. The Californian poppy seed is also used. It is used in herbal medicine mainly as a sleeping aid and sedative for mild mental stress.
