How Safe Are Tranquilizers and Sleeping Pills?

The term "tranquilizer" is a somewhat misleading one. The word is typically used in popular culture to describe sedatives, or substances used to induce sedation. The term "tranquilizer" is used less commonly today as it suggests that the drugs induce tranquility, a somewhat vague and inaccurate description of how they work.

It was only in 1953 that the term "tranquilizer" was coined to describe the effects the drug reserpine appeared to have on animals. Today, we would more accurately classify reserpine as an anti-hypertensive since its aim is to reduce high blood pressure rather than to induce a tranquil state. These days, when doctors used the word "tranquilizer," they may be doing so to classify the drugs into one of two groups:

• Minor tranquilizers are typically anxiolytic drugs used to reduce anxiety.
• Major tranquilizers are typically antipsychotic drugs used to treat psychotic features of schizophrenia, bipolar disorder, and other mood disorders.

Understanding Minor Tranquilizers

When people refer to tranquilizers, they usually mean it to suggest that the drugs can calm nerves, alleviate symptoms of stress, or assist with sleep. These types of drugs are broadly classified as anxiolytics. The medications are sometimes further broken down into five classes of drug:

• Benzodiazepines are prescribed to treat anxiety, insomnia, seizures, muscle spasms, agitation, alcohol withdrawal, and panic attacks. There are no less than 15 benzodiazepines approved for use in the U.S., including Ativan (lorazepam), Valium (diazepam), Klonopin (clonazepam), and Xanax (alprazolam).
• Barbiturates were once widely prescribed to treat insomnia and anxiety. They are seldom used today due to the high risk of abuse and dependence as well as their narrow therapeutic index, the dose required for the desired effect and the dose that can result in coma or death. While they have been largely replaced by benzodiazepines, barbiturates are sometimes used as an anticonvulsant (to treat seizures) or as a general anesthetic.
• Antidepressants are able to treat anxiety by regulating neurochemicals in the brain, particularly serotonin. While it may seem counterintuitive to treat anxiety with an antidepressant, these agents impact neurotransmitters involved in the regulation of both mood and anxiety.
• Sympatholytics are anti-hypertensive drugs that work on the body’s sympathetic nervous system (essentially the "fight-or-flight" response). This class of drug is effective in treating anxiety disorders such as post-traumatic stress disorder (PTSD).
• Opioids are highly addictive drugs which act on the brain’s opioid receptors to reduce pain. While they are predominantly used to treat severe pain, they are being investigated for their potential psychiatric benefits in some refractory conditions.

Informed Use of Minor Tranquilizers

When used appropriately and under the supervision of a qualified physician, minor tranquilizers such as benzodiazepines can be both effective and beneficial. While it may seem reasonable to assume that some of these drugs are "safer" than others, they do have the potential to cause dependence and addiction if misused.

Minor tranquilizers are generally taken for a short time. Overuse can also cause side effects that lead to a worsening of symptoms, including :

• Agitation
• Aggression
• Confusion
• Depression
• Dizziness
• Fatigue
• Grogginess
• Headaches
• Lack of coordination
• Memory loss
• Paranoia
• Slurred speech
• Suicidal thoughts

If you or a loved one is experiencing symptoms of addiction, speak with your doctor about treatment options. Going "cold turkey" is usually not a good idea given the potential for withdrawal symptoms, sometimes severe. Some health insurance plans today provide partial or full coverage of addiction treatment.