Died from Sedative-Hypnotic Overdose

Please add the profiles of those who have died from an overdose of a sedative-hypnotic drug.

See also "Related projects" as the person may belong in more than one project (i.e.. suicide or accidental death, but please go with the one on the death certificate.) You could put "suicide by overdose of..." or "accidental overdose of ..." in the Geni profile's "cause of death" line.

Sedative-hypnotics are a group of drugs that cause the central nervous system depression or slows down the body's functions. Often these drugs are referred to as tranquilizers and sleeping pills or sometimes just as sedatives. Their effects range from calming down anxious people to promoting sleep. Both tranquilizers and sleeping pills can have either effect, depending on how much is taken. At high doses or when they are abused, many of these drugs can even cause unconsciousness and death.

A sedative or tranquilliser is a substance that induces sedation by reducing irritability or excitement. See: Wikipedia - Sedative for a listing of types of sedatives.

Sedatives can be misused to produce an overly-calming effect (alcohol being the classic and most common sedating drug). In the event of an overdose or if combined with another sedative, many of these drugs can cause unconsciousness (see hypnotic) and even death.

Hypnotic (from Greek Hypnos, sleep) or soporific drugs, commonly known as sleeping pills, are a class of psychoactive drugs whose primary function is to induce sleep and to be used in the treatment of insomnia (sleeplessness), or surgical anesthesia.

• This group is related to sedatives. Where as the term sedative describes drugs that serve to calm or relieve anxiety, the term hypnotic generally describes drugs whose main purpose is to initiate, sustain, or lengthen sleep. Because these two functions frequently overlap, and because drugs in this class generally produce dose-dependent effects (ranging from anxiolysis to loss of consciousness) they are often referred to collectively as sedative-hypnotic drugs.
• There is some overlap between the terms "sedative" and "hypnotic".

History:

Hypnotica was a class of somniferous drugs and substances tested in medicine of the 1890s and later, including: Urethan, Acetal, Methylal, Sulfonal, Paraldehyd, Amylenhydrate, Hypnon, Chloralurethan and Ohloralamid or Chloralimid.

Research about using medications to treat insomnia evolved throughout the last half of the 20th century. Treatment for insomnia in psychiatry dates back to 1869 when chloral hydrate was first used as a soporific. Barbiturates emerged as the first class of drugs that emerged in the early 1900s, after which chemical substitution allowed derivative compounds. Although the best drug family at the time (less toxic and with fewer side effects) they were dangerous in overdose.

During the 1970s, quinazolinones and benzodiazepines were introduced as safer alternatives to replace barbiturates; by the late 1970s benzodiazepines emerged as the safer drug.

Benzodiazepines are not without their drawbacks; substance dependence is possible, and deaths from overdoses sometimes occur, especially in combination with alcohol and/or other depressants. Questions have been raised as to whether they disturb sleep architecture.

Nonbenzodiazepines are the most recent development (1990s–present). Although it's clear that they are less toxic than their predecessors, barbiturates, comparative efficacy over benzodiazepines have not been established. Without longitudinal studies, it is hard to determine; however some psychiatrists recommend these drugs, citing research suggesting they are equally potent with less potential for abuse.

Other sleep remedies that may be considered "sedative-hypnotics" exist; psychiatrists will sometimes prescribe medicines off-label if they have sedating effects. Examples of these include mirtazapine (an antidepressant), clonidine (generally prescribed to regulate blood pressure), quetiapine (an antipsychotic), and the over-the-counter sleep aid diphenhydramine (Benadryl – an antihistamine). Off-label sleep remedies are particularly useful when first-line treatment is unsuccessful or deemed unsafe (for example, in patients with a history of substance abuse).

Types of Hypnotics:

• Barbiturate:
  • Barbiturates are drugs that act as central nervous system depressants, and can therefore produce a wide spectrum of effects, from mild sedation to total anesthesia. They are also effective as anxiolytics, hypnotics, and anticonvulsalgesic effects; however, these effects are somewhat weak, preventing barbiturates from being used in surgery in the absence of other analgesics.
  • Barbiturate overdose is a factor in nearly one-third of all reported drug-related deaths. These include suicides and accidental drug poisonings.
  • Accidental deaths sometimes occur when a user takes one dose, becomes confused and unintentionally takes additional or larger doses.
  • With barbiturates there is less difference between the amount that produces sleep and the amount that kills.
  • Barbiturate withdrawal can be more serious than heroin withdrawal.
  • Barbiturates caused 396 deaths last year, some due to the drug alone, and some in connection with other drugs, suicide, accidents, or mental illness.
  • Examples include amobarbital (Amytal), pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), and sodium thiopental (Pentothal).
• Quinazolinones:
  • Quinazolinones are also a class of drugs which function as hypnotic/sedatives that contain a 4-quinazolinone core. Their use has also been proposed in the treatment of cancer.
  • Examples include cloroqualone, diproqualone, etaqualone (Aolan, Athinazone, Ethinazone), mebroqualone, mecloqualone (Nubarene, Casfen), and methaqualone (Quaalude).
• Benzodiazepines:
  • Benzodiazepines can be useful for short-term treatment of insomnia. Their use beyond 2 to 4 weeks is not recommended due to the risk of dependence.
  • The list of benzodiazepines approved for the treatment of insomnia is fairly similar among most countries, but which benzodiazepines are officially designated as first-line hypnotics prescribed for the treatment of insomnia can vary distinctly between countries.
  • Longer-acting benzodiazepines such as nitrazepam and diazepam (Valium) have residual effects that may persist into the next day.
  • Benzodiazepines caused 1,784 deaths last year, some due to the drug alone, and some in connection with other drugs, suicide, accidents, or mental illness.
  • The overdose death rate related to benzodiazepines more than quadrupled between 1999 and 2010, from 0.58 per 100,000 adults to 3.07 per 100,000 adults. The largest increase was among adults 18 to 64 years of age.
  • Between 2010 and 2013, the rate of overdose deaths leveled off as they only plateaued among white adults, who make up the largest group of benzodiazepine users. Overdose deaths continued to rise among black and Hispanic people.
  • Examples include Chlordiazepoxide (Librium), clonazepam, estazoiam, flunitrazepam, lorazepam, midazolam, oxazepam (Serax), triazolam (Halcion), alprazoam (Xanax) to name a few.
• Nonbenzodiazepines:
  • Nonbenzodiazepines are a class of psychoactive drugs that are very "benzodiazepine-like" in nature. Nonbenzodiazepines pharmacodynamics are almost entirely the same as benzodiazepine drugs and therefore entail similar benefits, side-effects, and risks. Nonbenzodiazepines, however, have dissimilar or entirely different chemical structures, and therefore are unrelated to benzodiazepines on a molecular level.
  • Examples include zopiclone (Imovane, Zimovane), eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien, Stilnox, Stilnoct), Chloral hydrate (Noctec), quinazolinone (Quaalude).

Many sedatives can be misused, but barbiturates and benzodiazepines are responsible for most of the problems with sedative use due to their widespread recreational or non-medical use.

• People who have difficulty dealing with stress, anxiety or sleeplessness may overuse or become dependent on sedatives.
• Some heroin users may take them either to supplement their drug or to substitute for it.
• Stimulant users may take sedatives to calm excessive jitteriness.
• Others take sedatives recreationally to relax and forget their worries.
• Barbiturate overdose is a factor in nearly one-third of all reported drug-related deaths. These include suicides and accidental drug poisonings. Accidental deaths sometimes occur when a drowsy, confused user repeats doses, or when sedatives are taken with alcohol.

Mortality/Morbidity, Statistics:

• A study from the United States found that in 2011, sedatives and hypnotics were a leading source of adverse drug events (ADEs) seen in the hospital setting: Approximately 2.8% of all ADEs present on admission and 4.4% of ADEs that originated during a hospital stay were caused by a sedative or hypnotic drug. A second study noted that a total of 70,982 sedative exposures were reported to U.S. poison control centers in 1998, of which 2310 (3.2%) resulted in major toxicity and 89 (0.1%) resulted in death. About half of all the people admitted to emergency rooms in the U.S. as a result of nonmedical use of sedatives have a legitimate prescription for the drug, but have taken an excessive dose or combined it with alcohol or other drugs.
• Most of the serious ingestions are suicide-related.
• Barbiturates have the highest morbidity and mortality of the sedative-hypnotics.
• Pure benzodiazepine ingestion usually causes little more than sedation and ataxia; it very rarely results in death. Death from sedative-hypnotics is caused by respiratory arrest. Alprazolam (Xanax) is relatively more toxic than other benzodiazepines in overdose

Notables dying from Drug Overdose & Intoxication:

• See this listing for more specific info on people & type of “drug(s)” involved. It includes many who overdosed on Sedative-Hypnotics.
  • Wikipedia - List of deaths from drug overdose & intoxication

Additional Reading:

• Wikipedia - Hypnotic
• Wikipedia - Sedative
• ADA - As a matter of fact ... Sedative-Hypnotics (Source: National Institute on Drug Abuse, 1984)
• In the Know Zone - Sedatives, tranquilizers & analgesics-Statistics
• CNN - Benzodiazepine overdose deaths has soared in recent years, study finds. by Carina Storrs, 18 Feb 2016
• PMC - Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit. by Daniel F Kripke, published 19 May 2016
• Encyclopaedia Britannica - Sedative-hypnotic drug
• Medscape - Toxicity, Sedative-Hypnotics

  ---

Jump back to:

• Cause of Death portal
  • Unnatural (Non Natural) death causes
    • Drug overdose

      ---