Relative abuse liability of hypnotic drugs: a conceptual framework and algorithm for differentiating among compounds.

摘要: Hypnotic drugs, including benzodiazepine receptor ligands, barbiturates, antihistamines. and melatonin are useful in treating insomnia, but clinicians should consider the relative abuse liability of these drugs when prescribing them. Two types problematic hypnotic self-administration distinguished. First, recreational occurs medications used purposefully for subjective "high." This type usually polydrug abusers, who most often young male. Second, chronic quasi-therapeutic is a use which patients continue long-term despite medical recommendations to contrary. Relative defined as an interaction between reinforcing effects (i.e., capacity maintain drug behavior, thereby increasing likelihood nonmedical use) toxicity adverse having harm individual and/or society). An algorithm provided that differentiates 19 compounds: pentobarbital, methaqualone, diazepam, flunitrazepam, lorazepam, GHB (y-hydroxybutyrate, also known sodium oxybate), temazepam, zaleplon, eszopiclone, triazolam, zopiclone, flurazepam, zolpidem, oxazepam, estazolam, diphenhydramine, quazepam, trazodone, ramelteon. Factors analysis include preclinical clinical assessment effects, withdrawal, actual abuse, acute sedation/memory impairment, overdose lethality. The shows both vary from high none across compounds. primary implication range differences concern about inappropriate use, or not deter physicians hypnotics clinically indicated.