Overdose sleeping pills
Drugs that have a hypnotic effect are used quite widely. Most of them have a strong psychotropic effect, that is, the ability to influence the human psyche. For this reason, potent sleeping pills are dispensed in pharmacies only on prescription. Can I die from an overdose of sleeping pills? Yes, as specialists note, poisoning caused by various groups of drugs with hypnotic action is not uncommon. This occurs with improper administration of the drug, with suicidal attempts, in cases of unintentional overdose.
It is not recommended to use sleeping pills alone. The causes of sleep disturbance are many, therefore, a specialist consultation is required. He will pick up the right drug. We will not dwell on the benefits and harms of drugs, talk about the advisability of their use. In this article we will look at the main types of hypnotics, find out how they work and what will happen from an overdose of hypnotics of each individual pharmacological group.
Groups of sleeping pills
In pharmacology do not allocate hypnotics in a separate group. This effect has different drugs, respectively, they will have a different mechanism of action and their side effects.
Relatively harmless sleeping pills, which are dispensed 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. They have a soft effect, based on a sedative effect.
Next, we present a modern classification of hypnotics, far less harmless in their side effects.
- GABA antagonists are agents that affect the benzodiazepine receptors in the brain. This group includes the actual benzodiazepines (Librium, Fenazepam, Diazepam, Nosepam and others) and preparations of various chemical structures - Zaleplon, Zolpidem, Zopiclone.
- Barbiturates: phenobarbital, ethaminal sodium.
- Means for anesthesia: chloral hydrate, sodium oxybutyrate.
- Blockers of histamine receptors: "Dimedrol", "Doxylamine".
- Sleep hormone analogues: melatonin (Melaxen) or melatonin receptor antagonists (Ramelteon, Tasimelteon).
There is also a conditional division of drugs into hypnotics of the first generation (barbiturates, bromides, antihistamines), the second (benzodiazepines) and the third (melatonin drugs, new drugs of different groups).
It should be noted that mankind has not yet invented the "ideal sleeping pills", therefore doctors are compelled in each case to select the drug with the maximum benefit for the patient and minimal side effect.
Let us dwell in more detail on the frequently used or dangerous representatives of the "hypnotic kingdom".
Overdose with barbiturates
A sad first place in the number of deaths is overdosed with sleeping pills from the barbiturates:
- "Barbital 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 possess anticonvulsant properties, cause muscle relaxation.
Sleep caused by barbiturates is different from the natural. Often patients are haunted by nightmares, the structure of the sleep itself changes - the ratio of fast and slow phases.
The frequent side effects of barbiturates include:
- daytime sleepiness;
- inhibited reaction;
- impaired vision;
- muscle twitching;
In high doses, the drug causes respiratory depression and cardiovascular activity, which leads to the risk of death. The lethal dose of a sleeping pill from the barbiturate group is only ten times higher than the therapeutic dose. But with the provision of timely medical care there is a good chance to save the patient and with a hundredfold overdose.
Acute poisoning with barbiturates is classified into four stages.
An easy form of poisoning. Within 10-15 hours, the victim is diagnosed with drowsiness, weakness, impaired coordination, incoherent speech, increased salivation.
- Stage of superficial coma. Deep sleep, pupillary and tendon reflexes are reduced. Violated breathing, can sink tongue, there is an increased separation of saliva. The victim does not come to 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 colder, breathing is disrupted, the pressure decreases and the body temperature decreases. Possible stopping of breathing, edema of the lungs, brain. This period can last 3-5 days.
- The fourth stage is post-coma. Characteristic of depression, mental disorders, impaired coordination.
Benzodiazepines are similar in their mechanism of action to barbiturates - they also affect GABA receptors. They also disrupt the normal sleep architecture and have a number of side effects:
- violation of the psyche.
Poisoning with hypnotics of this drug group often occurs when attempting suicide. The difference from the therapeutic dose to the fatal dose is quite high - even exceeding the single dose does not cause a very serious poisoning. Toxic effect is enhanced by joint acceptance with alcohol.
The most acute reaction occurs when an overdose of the following drugs:
To the same group can be attributed to "Midazolam" and "Zolpidem", since they have similar characteristics.
When benzodiazepines are poisoned:
- slurred speech;
- disturbance of balance;
- decreased reflexes;
- narrowing of the pupils;
- increased heart rate;
- drop in blood pressure;
- lowering of body temperature.
Coma and difficulty breathing are rarely found primarily in the intensification of the effects of sleeping pills with alcohol or other drugs that depress the central nervous system.
Overdose of bromides
This group of hypnotics includes:
- sodium or potassium bromide.
These drugs enhance the inhibition processes in the cerebral cortex, have a calming effect.
Among the side effects noted:
- speech impairment;
- with prolonged use, there are phenomena of bromism - runny nose, cough, conjunctivitis, general weakness, skin rash.
Overdose of sleeping pills from the group of bromides is accompanied by a violation of coordination of movements, dilated pupils, palpitations.
Poisoning with sleeping pills "Brominated", perhaps because of its intake of 20 grams. A strong inhibition of the central nervous system develops, the respiratory center is depressed. Violated blood circulation, the level of oxygen in the blood drops. There may come paresis of the intestine, damage to the kidneys and lungs.
Overdose of antihistamines
Drugs belonging to this group block histamine receptors. As a result, histamine, which is a "mediator of wakefulness," loses its ability to affect the central nervous system. This group includes first-generation antihistamines:
- "Diphenhydramine" (diphenhydramine);
- "Donormil" (doxylamine);
These medicines are dispensed in a pharmacy without a prescription. They promote fast falling asleep, but the duration of sleep does not increase. Of the side effects, drowsiness and daytime inhibition are noted.
In case of an overdose of sleeping pills, this group of consequences can be expressed in dizziness, dry mouth, muscle trembling, visual impairment, nausea and increased sensitivity to light.
A new generation of hypnotics
Currently, for the normalization of sleep, the use of new-generation drugs developed at the end of the 20th century is preferable. These include:
- derivatives of cyclopyrrolons - Zopiclone (imovan);
- derivatives of imidazopyridines ("Zolpidem");
- derivatives of pyrazolopyrimidines ("Zaleplon").
Virtually harmless hypnotics - "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 well-being, as it is quickly excreted from the body. Even a significant overdose of "Melaxen" does not lead to any serious consequences.
Indications for the use of sleeping pills
Why do I need hypnotic drugs? They are prescribed for sleep disorders. There are two main varieties:
- violation of falling asleep;
- disturbance of the duration of sleep, frequent waking up.
The answer to the question: "is hypnotic harmful or not?" Can be given only by the attending physician. Of course, these medications themselves have many negative aspects - addiction, impaired brain activity, residual phenomena. According to WHO recommendations for normalization of sleep it is desirable to use non-drug methods - normalization of mental activity, withdrawal of anxiety, 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.