Overdose of sleeping pills
Medications that have a hypnotic effect, are widely used. Most of them have a strong psychotropic effect, that is, the ability to influence the human psyche. For this reason, potent sleeping pills are sold in pharmacies only by prescription. Is it possible to die from a sleeping pill overdose? Yes, according to experts, poisoning caused by various groups of drugs with hypnotic effects are not uncommon. This happens when the wrong drug intake, suicidal attempts, in cases of inadvertent overdose.
It is not recommended to use hypnotics on their own. The causes of sleep disorders are many, therefore specialist consultation is required. He will select the desired drug. We will not dwell on the benefits and dangers of drugs, talk about the appropriateness of their use. In this article, we will look at the main types of sleeping pills, find out how they work and what will happen from the overdose of sleeping pills of each individual pharmacological group.
Group of sleeping pills
In pharmacology, do not allocate hypnotic drugs in a separate group. Different drugs have this effect, respectively, they will have a different mechanism of action and their side effects.
Relatively harmless sleeping pills that are available without a prescription - herbal preparations and combined herbal remedies. These include:
- Valerian tincture;
- motherwort tincture.
These drugs are prescribed for sleep disorders due to increased anxiety, irritability, nervousness. Their action is mild, based on a sedative effect.
Next, we present a modern classification of hypnotic drugs that are not so harmless in their side effects.
- GABA antagonists are agents that act on the benzodiazepine receptors in the brain. This group includes benzodiazepines themselves (Librium, Fenazepam, Diazepam, Nozepam, etc.) and preparations of various chemical structures - Zaleplon, Zolpidem, Zopiclone.
- Barbiturates: phenobarbital, sodium etaminal.
- Means for anesthesia: chloral hydrate, sodium hydroxybutyrate.
- Histamine receptor blockers: diphenhydramine, doxylamine.
- Analogs of the sleep hormone: melatonin ("Melaxen") or melatonin receptor antagonists ("ramelteon", "Tasimelteon").
There is also a conditional division of drugs into the first-generation hypnotic drugs (barbiturates, bromides, antihistamines), the second (benzodiazepines) and the third (melatonin drugs, new drugs from different groups).
It should be noted that mankind has not yet invented the “ideal sleeping pill”, so doctors are forced in each case to select the drug with the maximum benefit for the patient and minimal side effects.
Let us dwell on the frequently used or dangerous representatives of the “hypnotic kingdom”.
Overdose with barbiturates
The sad first place in the number of deaths is an overdose of sleeping pills from the group of barbiturates:
- Barbital Sodium;
- "Ethanol sodium";
Barbiturates disrupt the activity of nerve cells, resulting in a depressing effect on the central nervous system. They slow down not only the mental activity of the brain, causing drowsiness, reducing the level of anxiety, but also have anticonvulsant properties, cause muscle relaxation.
Sleep caused by barbiturates is different from the natural. Often patients are haunted by nightmares, the structure of sleep itself changes - the ratio of fast and slow phases.
Common side effects of using barbiturates include:
- daytime sleepiness;
- retarded reaction;
- visual impairment;
- muscle twitching;
In high doses, the drug causes respiratory depression and cardiovascular activity, which leads to the risk of death. The lethal dose of sleeping pills from the group of barbiturates is only ten times higher than the therapeutic one. But when providing timely medical care there are good chances to save the patient and with a hundredfold overdose.
Acute poisoning with barbiturates is classified into four stages.
Easy form of poisoning. Within 10–15 hours, the victim is found to have drowsiness, weakness, impaired coordination, incoherence of speech, and excessive salivation.
- Stage superficial coma. Deep sleep, pupillary and tendon reflexes are reduced. Breathing is impaired, the tongue may fall, increased saliva is noted. The victim does not regain consciousness. This stage lasts for 1–2 days.
- At a severe stage, a deep coma develops, the pupils do not react to light, the skin becomes cold, breathing is disturbed, the pressure decreases and the body temperature drops. Possible stop breathing, pulmonary edema, brain. This period can last 3-5 days.
- The fourth stage - postcomatosis. Characterized by depression, mental disorders, impaired coordination.
Benzodiazepines are similar in their mechanism of action to barbiturates - they also act on GABA receptors. They also disrupt the normal sleep architecture and have several side effects:
- mental disorder.
Poisoning by hypnotic drugs of this drug group often occurs when attempting suicide. The difference from a therapeutic dose to a fatal dose is quite large - even exceeding a single dose dozens of times entails not very severe poisoning. The toxic effect is enhanced when taken together with alcohol.
The most acute reaction occurs when an overdose of the following drugs:
“Midazolam” and “Zolpidem” can be attributed to this group, as they have similar characteristics.
When benzodiazepine poisoning develops:
- slurred speech;
- reduced reflexes;
- constriction of the pupils;
- heart palpitations;
- drop in blood pressure;
- lowering body temperature.
Coma and difficulty breathing are rarely encountered mainly when the effect of hypnotic drugs is increased by the use of alcohol or other drugs that depress the central nervous system.
This group of sleeping pills include:
- sodium or potassium bromide.
These drugs enhance the process of inhibition in the cerebral cortex, have a calming effect.
Among the side effects noted:
- speech impairment;
- With prolonged use, bromism appears - runny nose, cough, conjunctivitis, general weakness, skin rash.
An overdose of sleeping pills from the bromide group is accompanied by impaired coordination of movements, dilated pupils, and increased heart rate.
Poisoning with sleeping pills "Bromizoval", possibly due to its ingestion in the amount of 20 grams. A strong inhibition of the central nervous system develops, the respiratory center is inhibited. Blood circulation is disturbed, the level of oxygen in the blood falls. Intestinal paresis, damage to the kidneys and lungs may occur.
Overdose with antihistamines
Drugs belonging to this group block histamine receptors. As a result, histamine, which is a “wakefulness mediator,” loses its ability to act on the central nervous system. This group includes first-generation antihistamines:
- "Dimedrol" (diphenhydramine);
- Donormil (doxylamine);
These drugs are available at the pharmacy without a prescription. Promote rapid sleep, but the duration of sleep does not increase. Of the side effects observed drowsiness and daytime inhibition.
In case of an overdose of sleeping pills, this group of consequences can be expressed in dizziness, dry mouth, muscle tremors, visual impairment, nausea, and increased sensitivity to light.
The new generation of sleeping pills
Currently, to normalize sleep, it is preferable to use new-generation drugs developed at the end of the 20th century. These include:
- derivatives of cyclopirrolone - "Zopiclone" (imovan);
- imidazopyridine derivatives (Zolpidem);
- pyrazolopyrimidine derivatives ("Zaleplon").
Practically harmless sleeping pills - "Melaxen" (melatonin). This drug is able to normalize the stage of falling asleep, and the duration of sleep is regulated by the natural production of melatonin. It does not adversely affect the structure of sleep, keeping all phases in a natural ratio. During the day, it does not affect the state of health, as it is rapidly excreted from the body. Even a significant overdose of Melaxen does not lead to any serious consequences.
Indications for use of sleeping pills
Why do we need sleeping pills? They are prescribed for sleep disorders. There are two main varieties:
- violation of sleep;
- violation of the duration of sleep, frequent waking.
The answer to the question: "Is the sleeping pill harmful or not?" Can only be given by the attending physician. Of course, by themselves, these drugs have a lot of negative points - addiction, impaired brain activity, residual effects. According to WHO recommendations for the normalization of sleep, it is desirable to use non-drug methods - normalization of mental activity, anxiety removal, work with a psychologist. But there are cases when the use of drugs is simply necessary and the harm from sleeping pills is insignificant, and the benefits are enormous.