Which benzodiazepines are most effective

Use prescription sleeping pills correctly

If sleep disorders are very pronounced, prescription sleeping pills can help for a while. However, the preparations should only be used for a short time.
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Around ten percent of Germans suffer from insomnia. You only fall asleep after hours, cannot sleep through the night or wake up much too early. If the sleep disorders are particularly severe and herbal sleeping pills fail, the doctor can prescribe chemical sleeping pills.

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Sleeping pills - an overview of their effects

Prescription sleeping pills work primarily in the brain. Depending on the substance, they generally promote the readiness to sleep, work quickly and only for a few hours and thus make it easier to fall asleep. Or they work longer and enable those with insomnia to sleep through the night.

The aim of any treatment with prescription sleeping pills should primarily be restful and therefore healthy sleep. In addition, these drugs also make it possible to relieve the fear of not being able to fall asleep, which is an additional burden for many people with insomnia and often leads to a vicious circle.

The following groups of active ingredients are particularly often prescribed:

1. Benzodiazepines as sleeping pills

Benzodiazepines are psychotropic drugs that induce sleep, relax muscles, and relieve anxiety. The willingness to sleep increases with the first tablet. Benzodiazepines with these active ingredients are particularly often prescribed for insomnia:

  • Flurazepam
  • Nitrazepam
  • Temazepam
  • Triazolam

The active ingredient tetrazepam, which also belongs to the group of benzodiazepines, has not been prescribed since 2013 because it can cause severe side effects. In addition, benzodiazepines have a relatively high potential for addiction.

2. Sleeping pills that work similarly to benzodiazepines

This is a new group of substances that has a similar effect to benzodiazepines, but has a much lower risk of addiction. That is why they are also called non-benzodiazepine agonists. The corresponding active ingredients are called

  • Zolpidem
  • Zopiclone
  • Zaleplon

These sleeping pills have a sleep-inducing effect, but less so against cramps and anxiety (like the real benzodiazepines). Non-benzodiazepine agonists are ideal for the short-term treatment of sleep disorders.

3. Neuroleptics as sleeping pills

These are primarily highly effective drugs against epilepsy, but they also make you tired. Neuroleptics are only prescribed for sleep disorders in exceptional cases. They can cause severe side effects, such as movement disorders. However, unlike benzodiazepines, they are not addictive.

4. Antidepressants as sleeping pills

Some drugs against depression tend to make you happier, while others dampen fears, promote relaxation and sleep. The latter are also prescribed as sleeping pills. Suitable active ingredients are

  • Amitriptyline
  • Doxepin
  • Trimipramine
  • Mirtazapine

Because there is virtually no risk of addiction with antidepressants, these drugs are often prescribed as sleeping pills for the long-term treatment of sleep disorders.

5. Antihistamines as sleeping pills

The first generation of these drugs for allergy symptoms had a typical side effect: they made you tired. That is why the doctor sometimes recommends these active ingredients even for sleep disorders. You have the advantage of not being addictive. Frequently used active ingredients against sleep disorders are for example:


  • Diphenhydramine
  • Doxylamine
  • Meclozin
  • Promethazine

6. Barbiturates as sleeping pills

These previously classic sleeping pills and sedatives are no longer prescribed because of their high risk of addiction in the case of insomnia. The name comes from the barbituric acid that is used for the drugs. Barbiturates are now only prescribed for short periods of time for epilepsy.

Sleeping pills - the side effects

However, sleeping pills often have side effects as well. Depending on the substance, the following undesirable effects can occur:

Patients who take sleeping pills also have to consider: The drugs reduce mental and physical performance. The Responsiveness in traffic and at work is decreasing. So it makes sense to forego driving a car, for example.

Sleeping pills and addiction

However, the most dangerous side effect is addiction. Among the drug-related addictions, addiction to sleeping pills is very prominent. Benzodiazepines are particularly dangerous in this context: These highly effective psychotropic drugs should not be taken for longer than one to four weeks. In addition, it is important to strictly adhere to the dosage prescribed by the doctor.

In addition, benzodiazepines lose some of their effectiveness with prolonged use. If the patient then increases the dose against the advice of the doctor, dependence is almost guaranteed. The most important thing then is to speak to the attending physician as quickly as possible and to carry out a slow withdrawal.

Sleeping pills: There is a risk of rebound if you stop taking it

If a patient has been taking prescription sleeping pills for a long time, they should only gradually stop taking them under medical supervision to avoid unpleasant symptoms. Because if someone plagued by insomnia abruptly leaves off the remedy, so-called withdrawal insomnia is possible. This means that the insomnia recurs immediately after stopping the tablets, often even worse. Medically one speaks of the rebound effect (from the English "rebound" for relapse).

The patient needs about a tenth of the intake time to stop taking the sleeping pill without any problems. As a rough rule of thumb, the following applies: after taking the tablets for several weeks, slowly discontinue the tablets for days, after months of taking for weeks and after years of taking for months.

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