Active Ingredient: Hydroxyzine
Nighttime drug use can produce drowsiness severe enough to affect next day performance and driving tests Gango et al.
Sedation is infrequent with H 2 antagonists e. Sedation is a common side effect of the traditional antipsychotics, with chlorpromazine and thioridazine somewhat more sedating than haloperidol.
The sedation associated with these agents is most likely associated with their known effects on histaminic receptors. Doxepin, a sedating psychotropic agent with pronounced histamine H-1 receptor antagonism exerts at least part of its effects by antagonizing orexin Krystal et al.
Suvorexant, is an orexin antagonist designed to lower waking arousal Norman and Anderson. Currently, it is being heavily marketed as a hypnotic Rhyne and Anderson.
As based on performance and driving tests, this agent is known to produce a dose-related next day increase in somnolence for all age groupings tested Farkus. Clinically these agents are sometimes used off-label for their sedative effects.
Among antihypertensives in wide use, the complaints of tiredness, fatigue and daytime sleepiness are commonly associated with drugs having antagonistic effects at the norepinephrine neuroreceptor Dimsdale 1992. The complaints of tiredness, fatigue and daytime sleepiness 2—4.
Beta-blocking drugs with vasodilating properties e. Alpha-1 antagonists e.
Prazosin, a norepinephine antagonist, has demonstrated value in treating insomnia associated with PTSD nightmares Raskind et al. The neurochemical basis for the sedation induced by many of these agents remains poorly defined except for those agents know to have GABA agonist effects e.
In individuals being treated with such medications for seizure disorders, the clinical differential between medication effects and sedation secondary to recurrent seizures can be difficult to determine Manni and Tartara.
Almost all drugs with CNS activity induce sleepiness as a side effect in some patients Bittencourt et al.
The sedative side effects of some of these agents are clinically utilized in specific situations. However, sleepiness is a common and often-unwanted side effect for many types of prescription medications including commonly used antitussives, skeletal muscle relaxants, antiemetics, antidiarrheal agents, genitourinary smooth muscle relaxants, and others Table 1.
These sedative side effects can limit the use of these agents in patients in which the level of persistent daytime sleepiness affects waking.
All sedating agents can contribute to an increased risk for motor vehicular accidents. The prescription and OTC medications known to increase the risk of sleepiness-related crashes include longer acting benzodiazepine anxiolytics, sedating antihistamines H 1 class, and tricyclic antidepressants TCAs.
The risks are higher with higher drug doses and for people taking more than one sedating drug simultaneously Ceutel 1995; Gengo and Manning 1990; Van Laar et al.
Since a high percentage of the population uses drugs of abuse as well as medications for underlying illness, the use of multiple sedating drugs use has increasingly become a problem. In 1993, about one in eight drivers were using more than one drug, but by, it was closer to one in five.