Which of the following medications is the safest to administer to adults needing assistance in falling asleep?
A. Sedatives
B. Hypnotics
C. Benzodiazepines
D. Anti-anxiety agents
Correct Answer: C. Benzodiazepines
The group of drugs that are the safest is benzodiazepines. They facilitate the action of the neurons in the central nervous system (CNS) that suppress responsiveness to stimulation, therefore decreasing levels of arousal. Benzodiazepines bind to GABA and GABAA receptors, acting as agonists. They have less risk of overdose and abuse potential than barbiturates. Benzodiazepines increase sleep time and improve sleep quality by reducing sleep-onset latency and wakefulness after sleep onset and by increasing sleep efficiency
Option A: In the last 30 years, although the drugs for the treatment of insomnia have become safer, the number of sedatives and hypnotics prescribed in the United States has declined. This decrease most likely reflects the public’s and the medical community’s increasing understanding of the side effects and limitations of the available hypnotic drugs.
Option B: Historically, sedative/hypnotics have been some of the most commonly prescribed drugs. Chloral hydrate was the original “Mickey Finn” slipped into the drinks of unsuspecting marks for the purposes of criminal activity. Unfortunately, the median lethal dose (LD50) for chloral hydrate is quite close to the therapeutic dose, and murders rather than robberies were often the result.
Option D: Benzodiazepines are a group of structurally related compounds that reduce anxiety when given at low doses and induce sleep at higher doses. Clinical guidelines generally recommend prescribing benzodiazepines to treat anxiety or insomnia that is severe, disabling, and causing extreme distress.
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