Brain & Drugs
  • Insomnia & Sleeping Pills

    Complaints about delayed onset, duration and quality of sleep are common and support a lucrative commerce in sleeping pills. Sleep is interrupted by caffeine, body discomforts, illness, noise, threats, fear, anger, and anticipation of unpleasant experiences to come. Itching, pain, asthma and migraine headaches often begin or are worse at night. Heart attacks and strokes can occur during sleep, often in early morning hours.

    Sleep labs have revealed that reports of sleep disturbances and actual sleep records are often different. The discrepancy is not surprising, since the sleeper is moving in and out of consciousness and usually has a poor sense or no realistic sense of the timing, quality and duration of sleep. A normative view of sleep is that that you fall asleep when you are tired and wake up rested after many hours with no recollection of what happened to you while you were asleep. If you spend the night in a sleep lab, they will tell you that you were busy doing different things. Despite the obvious limitations of sleeping pills, in the US consumption increased 60% from 2000 to 2005 when 42 million prescriptions were filled. Drug companies spent about $300 million on advertising the promise that “sleep aids were safe and effective.”( Saul, S. Sales of Sleeping Pills are Causing Worries. NYT. Feb 7 2006.)

    Sleeping pills = dangerous drugs

    Sleeping pills are among the most dangerous prescription drugs, often used as suicide pills. Death by accidental overdose is common. The prescription drug manipulation of the modern psyche began in earnest in the 1950's with the growing use of "speed' for weight loss among housewives, barbiturate sleeping pills, and the introduction of Librium, the first modern tranquilizer. Housewives, actors and singers in the 50's and 60's were introduced to uppers and downers as tools of coping with the demands and disappointments of modern life. Most of the action centered around four drug classes: amphetamines, barbiturates, librium and alcohol. Citizens and celebrities died with alarming regularity from mixtures and overdoses of these drugs. even if you survived with these pills, the long-term results were not good. Problems of addiction, brain dysfunction (often called "nervous breakdowns" and "mental illness") and accidents became increasingly prevalent. The combination of alcoholic beverages, “uppers,” “downers” and sleeping pills produced chemical chaos in the brains of users, often with tragic results.

    Librium was replaced by a new class of drugs, the benzodiazepines. Valium was the best selling member of this class for many years until problems associated with its use became well known. Other Valium-like drugs were developed as tranquilizers and sleeping pills, to large extent, replacing barbiturates that were fatal in overdose. A common prescription for twenty capsules of secobarbital could kill. Valium as a sedative-tranquilizer has been replaced by related drugs with new names but the same set of problems for the brain: some examples are Ativan, Xanax, Serax, Lorazepam and several sleeping pills such as Dalmane and Halcion. A more recent class of sleeping pills has been promoted as safer and more effective than old pills, but these claims are not supported by the evidence.

    Zolpidem (Ambien)

    Zolpidem (Ambien) is an intensely advertised and commonly prescribed hypnotic. The drug company claimed that their drug had fewer side effects and less dependency potential than pre-existing insomnia drugs. Studies, however, have failed to demonstrate meaningful behavioral pharmacological differences between zolpidem and classic benzodiazepine-receptor agonists such as triazolam. Zolpidem is an agonist at the gamma-aminobutyric acid A type (GABAA) receptor. Zolpidem can produce interesting but undesirable brain dysfunction such as transient amnesia, sleep walking, and binge eating during the night, often not recalled the next day. For example, a lawyer quit taking the drug after one month, concerned that he awakened to find evidence that he raided the refrigerator and one occasion, he tore a towel rack out of a wall. He had no recollection of his nocturnal activities. He had started using Ambien because his racing mind kept him awake at night.

    Liappas et al reported cases of zolpidem abuse and dependence after taking the drug for insomnia. The drug is taken in high doses by some drug addicts for its hallucinogenic properties. Mahoney et al reported on experiences of hospitalized patients: “There was a high frequency of adverse drug reactions, particularly associated with zolpidem use. Zolpidem should be used cautiously in the hospital setting.”

    The US FDA finally required sleeping pill manufacturers to include warnings on the packaging advising consumers of potential risks, to write letters to doctors, advising them of harmful effects and to produce brochures that advise patients of the potential risks. The required warnings apply to:

    Ambien, Butisol, Carbrital, Dalmane, Halcion, Lunesta (in Canada - Immovane), Placidyl, Prosom, Restoril, Rozerem, Seconal, Sonata (in Canada -Starnoc).


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