Sedatives encompass a wide variety of drugs with different mechanisms of action that can induce depression of the central nervous system (CNS). In the first part of the 20th century, the pharmacotherapy of anxiety and insomnia relied on barbiturates, which were replaced with benzodiazepines as drugs of choice in the second part of the previous century. Besides those two groups of drugs, other sedatives are also used for that purpose.

Barbiturates and benzodiazepines

Barbiturates are nonselective CNS depressants that used to be the mainstay of treatment to sedate patients or to induce and maintain sleep. In modern medicine they have been largely replaced by the benzodiazepines, primarily because they can induce tolerance, physical dependence and serious withdrawal symptoms. Nevertheless, certain barbiturates are still employed as anticonvulsants (phenobarbital) and to induce anesthesia (thiopental). The representatives of this group are:

Amobarbital (Amytal)

Aprobarbital (Alurate)

Butabarbital (Butisol)

Mephobarbital (Mebaral)

Methohexital (Brevital)

Pentobarbital (Nembutal)

Phenobarbitol (Luminal)

Primidone (Mysoline)

Secobarbital (Seconal)

Thiopental (Penothal)

Benzodiazepines are the most widely used group of sedative drugs. Due to their safety and improved effectiveness, they have largely replaced barbiturates as drugs of choice in the treatment of anxiety. They also have hypnotic, anticonvulsant and muscle-relaxing activities, but do not exhibit analgesic action or antipsychotic activity. The representatives of this group are:

Alcohol (ethyl alcohol or ethanol)

Alprazolam (Xanax)

Chloral hydrate (Somnote)

Chlordiazepoxide (Librium)

Clorazepate (Tranxene)

Clonazepam (Klonopin)