In general, the high-milligram, low-potency antipsychotics, such as chlorpromazine and mesoridazine, produce more sedation than the low-milligram, high-potency antipsychotics such as haloperidol and fluphenazine (Table 1). This principle tends to hold true for the
Further, among atypical antipsychotic compounds, tiapride and asenapine were the top two compounds most strongly associated with sedation and somnolence.
Large effects were reported for chlorpromazine, zotepine and clozapine. Clozapine, quetiapine and zotepine were more sedating than haloperidol, and aripiprazole was less sedating than haloperidol. Compared with low-potency first generation antipsychotics, only clozapine was significantly more sedating.
It seems that clozapine produces a lower increase of prolactin levels than olanzapine. On the other hand, clozapine is associated with a higher frequency of leukopenia (reduced white blood cell count), hypersalivation, sedation and seizures.
Olanzapine. Although olanzapine is more sedating than quetiapine, there are fewer reports of olanzapine for pharmacologic management of primary or secondary insomnia.
Predominantly sedating are olanzapine, quetiapine immediate and extended release, ziprasidone, asenapine, and iloperidone. Agents that are neither activating nor sedating are paliperidone and brexpiprazole.
Midazolam is the fastest acting of its class because of its lipophilic abilities, and it is superior to lorazepam and diazepam in its amnestic effects, making it the ideal benzodiazepine for use in short ED procedures.
Clonazepam, the most potent benzodiazepine, is used to treat seizures and anxiety disorders. Xanax can be considered the most potent benzodiazepine to treat anxiety.
Benzodiazepines most commonly used to treat anxiety disorders are clonazepam (Rivotril)*, alprazolam (Xanax) and lorazepam (Ativan). Also used are bromazepam (Lectopam), oxazepam (Serax), chlordiazepoxide (once marketed as Librium), clorazepate (Tranxene) and diazepam (Valium).
Clozapine, which has the strongest antipsychotic effect, can cause neutropenia.
Apart from clozapine, the following two drugs—aripiprazole and paliperidone—have been shown to be most effective, whereas quetiapine, ziprasidone and haloperidol displayed a relatively short time to discontinuation.
Drugs with the fastest onsets include haloperidol, risperidone, and olanzapine, with onsets appearing in 2 6 days. Chlorpromazine and thiothixene were at the slowest end of the continuum, with onsets of 2 weeks or longer.
Seroquel is an antipsychotic that helps to calm and relieve psychotic thoughts. It is often given because it is quite sedating; however, care is needed because it also lowers blood pressure.
Despite a lack of scientific evidence supporting its efficacy in improving sleep, quetiapine is increasingly being recommended at low dosages to treat sleep problems. Seroquel helps alleviate symptoms that may disrupt sleep, such as anxiety and depression.
Benzodiazepines such as Ativan, Librium, Valium, and Xanax are anti-anxiety medications. They also increase drowsiness and help people sleep.
Common sedatives include barbiturates, benzodiazepines, gamma-hydroxybutyrate (GHB), opioids and sleep inducing drugs such as zolpidem (Ambien) and eszopiclone (Lunesta). Sedatives are central nervous system depressants and vary widely in their potency.
A: There are two main types of sedative-hypnotics – benzodiazepines and Z-drugs. Common benzodiazepines include Xanax (alprazolam), Librium (chlordiazepoxide), Valium (diazepam), and Ativan (lorazepam). Common Z-drugs include Ambien (zolpidem), Lunesta (eszopiclone), and Sonata (zaleplon).
People with a history of addiction may benefit from taking anxiety medications that don't have addictive properties. SSRIs, SNRIs, buspirone, beta-blockers, pregabalin, gabapentin, hydroxyzine, PanX and diphenhydramine are all options for anxiety that are alternatives to addictive benzodiazepines.
Olanzapine can make you feel sleepy. If this happens to you, do not drive, ride a bike or use tools or machinery until you feel better. Some people find it hard to concentrate while they are taking olanzapine.
The most common reasons for NMU of olanzapine were to relax or relieve tension, to aid sleep or simply to escape from worries. This is consistent with the reports from case studies. Two of the published case studies describe a euphoric feeling or a 'high' from olanzapine.
Quetiapine and olanzapine have high histaminergic activity,5 which generally speaking, causes sedation. Related to that is the α1 effect; α1 affinity is also linked to sedation and somnolence, as well as other well-known side effects such as postural hypotension.
Quetiapine may be slightly less effective than risperidone and olanzapine in reducing symptoms, and it may cause less weight gain and fewer side effects and associated problems (such as heart problems and diabetes) than olanzapine and paliperidone, but more than are seen with risperidone and ziprasidone.
Sedation (sleepiness)
It is more common with certain antipsychotics than others, such as chlorpromazine and olanzapine.