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Miscellaneous anxiolytics, sedatives and hypnotics

Written on August 1, 2018 by C. Fookes, BPharm

Medically reviewed on August 1, 2018

What are Miscellaneous anxiolytics, sedatives and hypnotics?

Miscellaneous anxiolytics, sedatives, and hypnotics are those anxiolytics, sedatives, and hypnotics that are unique in their action and not comparable to any other anxiolytics, sedatives and hypnotics currently on the market, although their side effects may be similar. They do not resemble benzodiazepines or barbiturates in their structure.

Anxiolytics, sedatives, and hypnotics are medicines that are used to relieve anxiety, calm, or induce sleep.

What are miscellaneous anxiolytics, sedatives, and hypnotics used for?

Miscellaneous anxiolytics, sedatives, and hypnotics act in the brain to treat anxiety and insomnia and to induce calm. Apart from the “Z” drugs (zolpidem, eszopiclone, and zaleplon), most are older drugs that have been largely superseded by newer, less toxic agents. Some may be considered for the treatment of the following conditions when other agents have been ineffective or are not tolerated:

  • Alcohol withdrawal
  • Anxiety
  • Sleeplessness (insomnia)
  • To help calm patients before surgery or diagnostic procedures
  • To help control post-operative pain
  • To help with the withdrawal of opiates or barbiturates.

What are the differences between miscellaneous anxiolytics, sedatives, and hypnotics?

Miscellaneous anxiolytics, sedatives, and hypnotics are a diverse group of medicines with no consistent structural relationship. Many are older drugs and most have an unknown mechanism of action but work on the central nervous system to treat anxiety and insomnia.

Although diphenhydramine and doxylamine are listed here under miscellaneous anxiolytics, sedatives, and hypnotics; they both are antihistamines. Because one of their side effects is sedation, they may be used short-term to aid sleep.

Zolpidem, zopiclone (not available in the U.S.), eszopiclone, and zaleplon are commonly referred to as “Z” drugs. These drugs are not benzodiazepines, but they act in a similar way to benzodiazepines and have a similar risk of dependence with long-term use. "Z" drugs are structurally unrelated to each other.

Please refer to individual drug monographs for each drug's mechanism of action, route of administration, and antibiotic spectrum.

Generic name Brand name examples
buspirone Buspar
chloral hydrate Somnote
diphenhydramine Compoz Nighttime Sleep Aid, Tranquil
doxylamine NytolUnisom
eszopiclone Lunesta
melatonin Generic
meprobamate Generic
ramelteon Rozerem
sodium oxybate Xyrem
suvorexant Belsomra
tasimelteon Hetlioz
tryptophan Generic
zaleplon Sonata
zolpidem Ambien, Edluar

Are miscellaneous anxiolytics, sedatives, and hypnotics safe?

The older agents can cause respiratory depression (slow and shallow breathing) and the risk of toxicity is increased if used in combination with alcohol and opiates and in people of an older age.

Severe allergic reactions have been reported with many sedative/hypnotics including angioedema, shortness of breath, nausea, and vomiting.

Tolerance is reported with many of the older agents, such as chloral hydrate. This is when chronic users can ingest large dosages without any ill effects; however, death may occur if a new user was to take a similar dose.

If sedative/hypnotics are taken during the middle of the night with less than 7 to 8 hours sleep remaining, or if higher than recommended dosages are taken, then there is a high risk of next-day impairment in the performance of tasks which may result in events such as falling asleep while driving.

Sedative/hypnotics have also been associated with bizarre behavior including sleep-related activities (such as driving while asleep, making phone calls while asleep), aggressiveness or extroversion that seem out of character. Amnesia may also occur.

Withdrawal effects have also been reported following a rapid dose decrease or abrupt discontinuation. If sedative/hypnotics have been administered for a long period of time then they should be discontinued slowly.

Many of the older agents are seldom used nowadays because of their high risk of toxicity. Examples of severe side effects associated with some miscellaneous anxiolytics, sedatives, and hypnotics include:

Significant drug interactions may exist with some miscellaneous anxiolytics, sedatives, and hypnotics.

For a complete list of severe side effects, please refer to the individual drug monographs.

What are the side effects of miscellaneous anxiolytics, sedatives, and hypnotics?

Each one of these agents works in a different way, which means some of their side effects differ; however, they all tend to cause dizziness and drowsiness. Examples of side effects associated with some miscellaneous anxiolytics, sedatives, or hypnotics include:

  • Buspirone: nausea, vomiting, dizziness, drowsiness, miosis, and gastric
  • Chloral hydrate: ataxia, diarrhea, dizziness, nausea, vomiting
  • Diphenhydramine/doxylamine: dry mouth, dizziness, drowsiness, low blood pressure, and a rapid heart-beat
  • Eszopiclone: dry mouth, dizziness, headache, sedation, unpleasant taste
  • Melatonin: a headache, short-term feelings of depression, daytime sleepiness, dizziness, stomach cramps, and irritability
  • Meprobamate: blurred vision, diarrhea, dizziness, nausea, unsteadiness, vomiting
  • Ramelteon: dizziness, fatigue, nausea
  • Sodium oxybate: confusion, diarrhea, dizziness, nausea, urinary incontinence, vomiting
  • Suvorexant: drowsiness, dizziness, dry mouth,
  • Tasimelteon: a headache, abnormal dreams, urinary tract infection, abnormal liver function tests
  • Tryptophan: dizziness, drowsiness, dry mouth, headache, loss of appetite, nausea
  • Zaleplon: a headache, drowsiness, dizziness, dysmenorrhea, nausea
  • Zolpidem: a headache, drowsiness, dizziness, diarrhea

For a complete list of side effects, please refer to the individual drug monographs.

List of Miscellaneous anxiolytics, sedatives and hypnotics:

Filter by:
Drug NameView by: Brand | Generic Reviews Avg. Ratings
Hetlioz (Pro)
generic name: tasimelteon
1 review
   
10
Compoz Nighttime Sleep Aid
generic name: diphenhydramine
2 reviews
   
9.0
Q-Dryl
generic name: diphenhydramine
1 review
   
9.0
Unisom SleepMelts
generic name: diphenhydramine
1 review
   
9.0
Edluar (Pro)
generic name: zolpidem
11 reviews
   
8.8
Intermezzo (Pro)
generic name: zolpidem
7 reviews
   
8.4
Somnote (Pro)
generic name: chloral hydrate
10 reviews
   
8.4
Sinequan (Pro)
generic name: doxepin
6 reviews
   
8.3
Xyrem (Pro)
generic name: sodium oxybate
82 reviews
   
8.1
Benadryl Children's Allergy
generic name: diphenhydramine
0 reviews
   
8.0
Sleep Aid (Pro)
generic name: doxylamine
4 reviews
   
8.0
Benadryl (Pro)
generic name: diphenhydramine
50 reviews
   
7.6
Ambien (Pro)
generic name: zolpidem
443 reviews
   
7.4
Benadryl Allergy
generic name: diphenhydramine
26 reviews
   
7.4
Ambien CR (Pro)
generic name: zolpidem
73 reviews
   
7.0
Banophen
generic name: diphenhydramine
0 reviews
   
7.0
Miltown
generic name: meprobamate
3 reviews
   
7.0
Placidyl
generic name: ethchlorvynol
0 reviews
   
7.0
Silenor (Pro)
generic name: doxepin
114 reviews
   
6.9
Sominex
generic name: diphenhydramine
27 reviews
   
6.9
Atarax (Pro)
generic name: hydroxyzine
97 reviews
   
6.5
Lunesta (Pro)
generic name: eszopiclone
211 reviews
   
6.4
Zolpimist (Pro)
generic name: zolpidem
6 reviews
   
6.4
BuSpar (Pro)
generic name: buspirone
399 reviews
   
6.3
Unisom SleepTabs
generic name: doxylamine
41 reviews
   
6.1
Sonata (Pro)
generic name: zaleplon
49 reviews
   
5.9
Vistaril (Pro)
generic name: hydroxyzine
175 reviews
   
5.9
Hyzine
generic name: hydroxyzine
2 reviews
   
5.5
Simply Sleep
generic name: diphenhydramine
14 reviews
   
5.4
Unisom SleepGels
generic name: diphenhydramine
14 reviews
   
5.4
Vanspar
generic name: buspirone
2 reviews
   
5.2
Nytol
generic name: diphenhydramine
8 reviews
   
5.1
Rozerem (Pro)
generic name: ramelteon
67 reviews
   
4.7
Belsomra (Pro)
generic name: suvorexant
371 reviews
   
3.6
Triaminic Thin Strips Cough & Runny Nose
generic name: diphenhydramine
0 reviews
   
3.0
Allermax
generic name: diphenhydramine
0 reviewsAdd rating
Aminomine
generic name: tryptophan
0 reviewsAdd rating
Care One Sleep Aid
generic name: doxylamine
0 reviewsAdd rating
Complete Allergy Relief
generic name: diphenhydramine
0 reviewsAdd rating
Dicopanol
generic name: diphenhydramine
0 reviewsAdd rating
Diphedryl
generic name: diphenhydramine
0 reviewsAdd rating
Diphenhist
generic name: diphenhydramine
0 reviewsAdd rating
Dytuss
generic name: diphenhydramine
0 reviewsAdd rating
Equaline Sleep Aid
generic name: doxylamine
0 reviewsAdd rating
Equate Sleep Aid
generic name: doxylamine
1 reviewAdd rating
MB-TAB
generic name: meprobamate
0 reviewsAdd rating
Nighttime Sleepaid (Pro)
generic name: doxylamine
0 reviewsAdd rating
PediaCare Children's Allergy
generic name: diphenhydramine
0 reviewsAdd rating
Precedex (Pro)
generic name: dexmedetomidine
0 reviewsAdd rating
Quenalin
generic name: diphenhydramine
0 reviewsAdd rating
Scot-Tussin Allergy
generic name: diphenhydramine
0 reviewsAdd rating
Siladryl Allergy
generic name: diphenhydramine
0 reviewsAdd rating
Silphen Cough
generic name: diphenhydramine
0 reviewsAdd rating
Sleepinal
generic name: diphenhydramine
0 reviewsAdd rating
Tranquil Nighttime Sleep Aid
generic name: diphenhydramine
0 reviewsAdd rating
Twilite
generic name: diphenhydramine
0 reviewsAdd rating
Valu-Dryl
generic name: diphenhydramine
0 reviewsAdd rating

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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