Sedatives are a broad class of prescription medications that slow (depresses) the activity of your brain’s activity of central nervous system (brain and spinal cord).
Sedation is a state of calmness, relaxation or sleepiness as a result of certain sedative medications. sedation most commonly goes hand in hand with procedures or surgeries.
We use sedation to help relieve anxiety during procedures or to help to cope with very stressful events.
Sedation always involves sedative drugs, but not all sedative drugs are used for full medical sedation. Some people take prescription sedatives for certain medical conditions, like insomnia or anxiety.
There are three levels of sedation.
Minimal sedation helps you relax, but you’ll likely be awake. You’ll be able to answer questions and follow directions easily.
Moderate sedation makes you feel drowsy. You may even fall asleep. You may or may not remember parts of the procedure. You’ll be able to answer questions and follow directions.
Deep sedation makes you fall asleep. But it doesn’t make you lose consciousness as general anesthesia does. You’ll probably have little or no memory of the procedure.
Difference between sedation and anesthesia
Sedation is a decrease in awareness and a decrease in response to external stimulation. By itself, it results in calmness and relaxation.
General anesthesia is a reversible and controlled loss of consciousness. General anesthesia involves sedation, the inability to feel pain (analgesia), temporary amnesia and temporary muscle paralysis.
We can use sedation for minor surgeries or shorter, less complex procedures. General anesthesia is necessary for major surgeries, like open heart surgery, C/S or for children who may not be able to remain still during minor procedures
Here are some different conditions where we can use sedative drugs:
1. Anxiety disorders
2. Seizures
3. Panic disorders
4. Sleep disorders, like insomnia
5. Bipolar disorder
Mechanism of action for Sedatives
Sedatives work by disrupting certain nerve communications in the central nervous system. This slows down the brain’s activity. More specifically, sedatives boost the activity of gamma-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter that slows down the brain.
Increased GABA activity results in a decrease in brain activity. Each sedative has different levels of potency. Some sedatives only slow down the brain’s activity a little bit, while others can decrease the brain activity enough to put the patient in a controlled state of unconsciousness.
The main groups of sedatives include
Benzodiazepines are depressant drugs that slow down the messages that travel between the brain and the body; ex Diazepam, Triazolam, they are used for Anxiety disorders, insomnia and seizures.
Barbiturates are medications that cause the patient to relax or feel drowsy. They can also stop or prevent seizures.
The most common uses are for anesthesia purposes and treating seizures and insomnia, ex: Phenobarbital, Mephobarbital
Hypnotics (non-benzodiazepines) these are medications that mimic hypnotic effects and work similarly to benzodiazepines, but they aren’t the same. These drugs are most effective in treating insomnia and related sleep disorders.
Miscellaneous sedatives Other sedative medications that don’t fit into the other categories include Ramelteon (Melatonin agonist), Suvorexant (orexin antagonist) or opioid which are used in Insomnia.
Side effects of sedatives include
Sleepiness, Dizziness, Difficulty focusing or thinking, Blurred vision, Impaired depth perception, Slowed reaction times and reflexes, Not feeling pain the way you usually do. Addiction potential, Toxicity and overdose, Withdrawal. Frequent forgetfulness or losing your memory, Depression symptoms, such as fatigue, feelings of hopelessness or suicidal thoughts, and also can cause seriously problem of Liver issues or liver failure.