Understanding Insomnia Medications (cont.)
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Benzodiazepine hypnotic drugs include estazolam (ProSom), flurazepam (Dalmane), temazepam (Restoril), and triazolam (Halcion).
How do benzodiazepine hypnotic drugs work?
These drugs bind to benzodiazepine receptors (omega-1 and omega-2) in the brain, thereby inducing sleep.
Who should not use these medications?
People with the following conditions should not use benzodiazepines:
Use: Take the prescribed dose 30 minutes before bedtime. Elderly individuals are prescribed smaller doses.
Drug or food interactions: Certain drugs, such as cimetidine (Tagamet), azole antifungal medications, antibiotics (for example, erythromycin [E-Mycin, Ery-Tab]), or drugs used to treat AIDS, lessen the body's ability to eliminate benzodiazepines, thereby increasing the risk of toxicity. Some drugs, such as rifampin (Rifadin) or St. John's Wort, may speed the metabolism (breakdown for use in the body) of sedative-hypnotics, thereby decreasing their effectiveness.
Side effects: Benzodiazepines may impair coordination, balance, or mental alertness and are more likely to disrupt REM sleep, causing less restful sleep.
Pregnancy: Benzodiazepines are Pregnancy Category X. This means benzodiazepines are contraindicated in women who are or may become pregnant as they may cause fetal harm when administered to a pregnant woman. Because many drugs are excreted in human milk, caution should be exercised when administered to a woman breastfeeding, as the effect on a nursing infant is not known.
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