What are CNS depressants?
Central Nervous System(CNS) depressants, sometimes referred to as sedatives and tranquilizers, are substances that can slow brain activity. This property makes them useful for treating anxiety and sleep disorders. Among the medications commonly prescribed for these purposes are the following:
- Benzodiazepines, such as diazepam (Valium) and alprazolam (Xanax), are sometimes prescribed to treat anxiety, acute stress reactions, and panic attacks. The more sedating benzodiazepines, such as triazolam (Halcion) and estazolam (ProSom) are prescribed for short-term treatment of sleep disorders. Usually, benzodiazepines are not prescribed for longterm use because of the risk for developing tolerance, dependence, or addiction.
- Non-benzodiazepine sleep medications, such as zolpidem (Ambien), eszopiclone (Lunesta), and zalepon (Sonata), have a different chemical structure, but act on some of the same brain receptors as benzodiazepines. They are thought to have fewer side effects and less risk of dependence than benzodiazepines.
- Barbiturates,such as mephobarbital (Mebaral), phenobarbital (Luminal Sodium), and pentobarbital sodium (Nembutal), are used less frequently to reduce anxiety or to help with sleep problems because of their higher risk of overdose compared to benzodiazepines. However, they are still used in surgical procedures and for seizure disorders.
Most CNS depressants act on the brain by affecting the neurotransmitter gammaaminobutyric acid (GABA). Neurotransmitters are brain chemicals that facilitate communication between brain cells. Although the different classes of CNS depressants work in unique ways, it is through their ability to increase GABA—and thereby inhibit brain activity—that they produce a drowsy or calming effect beneficial to those suffering from anxiety or sleep disorders.
What are the possible consequences of CNS depressant use and abuse?
Despite their many beneficial effects, benzodiazepines and barbiturates have the potential for abuse and should be used only as prescribed. The use of non-benzodiazepine sleep aids is less well studied, but certain indicators have raised concern about their abuse liability as well. During the first few days of taking a prescribed CNS depressant, a person usually feels sleepy and uncoordinated, but as the body becomes accustomed to the effects of the drug and tolerance develops, these side effects begin to disappear. If one uses these drugs long term, larger doses may be needed to achieve the therapeutic effects. Continued use can also lead to physical dependence and withdrawal when use is abruptly reduced or stopped (see textbox, Dependence vs. Addiction). Because all CNS depressants work by slowing the brain’s activity, when an individual stops taking them, there can be a rebound effect, resulting in seizures or other harmful consequences. Although withdrawal from benzodiazepines can be problematic, it is rarely life threatening, whereas withdrawal from prolonged use of barbiturates can have life-threatening complications. Therefore, someone who is thinking about discontinuing CNS depressant therapy or who is suffering withdrawal from a CNS depressant should speak with a physician or seek immediate medical treatment.
Is it safe to use CNS depressants with other medications?
Only under a physician’s supervision is it safe to use CNS depressants with other medications. Typically, they should not be combined with any other medication or substance that causes CNS depression, including prescription pain medicines, some OTC cold and allergy medications, and alcohol. Using CNS depressants with these other substances—particularly alcohol—can affect heart rhythm, slow respiration, and even lead to death.