Hypnotic
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]
Overview
Hypnotic drugs are a class of drugs that induce sleep (which differentiates them from the sedative category), used in the treatment of insomnia and in surgical anesthesia. Often the treatment of insomnia will not begin with drugs at all. Because many hypnotic drugs are habit-forming, a physician will usually recommend alternative sleeping patterns and exercise before prescribing medication for sleep. This is due to a large number of factors known to disturb the human sleep pattern.
These drugs include barbiturates, opioids, benzodiazepines (not all, hypnotic benzodiazepines are usually more powerful than the others in their group), zolpidem, zaleplon, zopiclone, eszopiclone, chloral hydrate, chlormethiazole or the antihistamines doxylamine, promethazine, and diphenhydramine. Alcohol is also used as a hypnotic drug.
Hypnotic Withdrawal
Differential Diagnosis
- Alcohol withdrawal
- Anxiety disorders
- Essential tremor
- Hypoglycemia
- Diabetic ketoacidosis
- Seizure due to infections, head injury, poisonings[1]
DSM-V Diagnostic Criteria for Sedative, Hypnotic, or Anxiolytic Withdrawal[1]
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AND
AND C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. AND D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance. Specify if:
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Hypnotic Intoxication
Differential Diagnosis
DSM-V Diagnostic Criteria for Sedative, Hypnotic, or Anxiolytic Intoxication[1]
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AND
AND
1. Slurred speech. 2. Incoordination. 3. Unsteady gait. 4. Nystagmus. 5. Impairment in cognition (e.g., attention, memory). 6. Stupor or coma. AND
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Hypnotic Use Disorder
Differential Diagnosis
- Alcohol use disorder
- Clinically appropriate use of the medication
- Generalized anxiety disorder
- Multiple sclerosis
- Subdural hematoma[1]
Epidemiology and Demographics of Sedative, Hypnotic, or Anxiolytic Use Disorder
Prevalence
The 12 month prevalence of hypnotic or anxiolytic use disorder is:
- 300 per 100,000 (0.3%) among adults 12-17 years old
- 200 per 100,000 among adults 18 years and older[1]
Risk Factors
- Availability of the substances
- Alcohol use disorder
- Environmental factors
- Early onset of use
- Genetic predisposition
- Peer use of the substance[1]
DSM-V Diagnostic Criteria for Sedative, Hypnotic, or Anxiolytic Use Disorder[1]
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Note: This criterion is not considered to be met for individuals taking sedatives, hypnotics, or anxiolytics under medical supervision.
Note: This criterion is not considered to be met for individuals taking sedatives, hypnotics, or anxiolytics under medical supervision.
Specify if:
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