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Groups of sedatives. What is the sedative effect? When and how to take bromides

Sometimes when buying some medicines in the insert to them you can read that this pharmaceutical product- with a pronounced sedative effect. Oh, these pharmacists and doctors! How difficult it can be to understand them, because they are used to expressing themselves in Latin. Sedative action - what is it? And now we will tell you about this in detail, and at the same time we will tell you about sedative medications and when and in what cases their use is indicated. In fact, everything is very easy to decipher, even if you don’t know Latin. So…

Sedative effect - what is it?

IN Latin There is such a word - “sedatio”, which can be translated into Russian as “calmness”. The fog is starting to clear, isn't it? Sedatives act on humans as sedatives, relaxants, and sometimes hypnotics.

They are distinguished from tranquilizers by a milder effect, the absence of strong side effects, they are usually well tolerated by most people and do not become addictive. Today, many people need such medicines. And not only adults, but even children.

When to use sedatives

Sedatives, a list of which will be presented in this article, are sold in all pharmacies. But I wonder why they are needed in such quantities, maybe you can do it somehow without sedatives? You can, of course, but you don’t need to!

There is a well-known expression that states that all diseases come from nerves. History is silent about who first made this statement, but apparently that person knew exactly what he was talking about. Anyway, modern medicine I agree with this statement and does not recommend anyone to be nervous and irritated for a long time. But people are designed in such a way that they cannot always cope with own emotions, and constant nervous tension caused by various stressful situations, along with insomnia, they torment modern people in the most ruthless way.

And mild sedatives sold in pharmacies without prescriptions cannot always help. In some cases, the help of a qualified psychologist or psychotherapist and stronger medications are required, which must be prescribed by a doctor.

But if a person is simply nervous because of some conflict at work or in the family, from overwork, while taking exams, etc., then, most likely, you can do without a doctor and independently purchase certain sedatives, reviews which inspire him with the greatest optimism and confidence. Moreover, there are really a lot of them now. Just don’t rush to buy the first expensive newfangled product you come across that the pharmacy will recommend. Because often new imported advertised drugs turn out, upon closer examination, to be renamed analogues of cheaper domestic drugs.

Traditional herbal sedatives

Soothing preparations based on herbal components are known to almost everyone. Who among us has not had the opportunity to drink good old valerian at least once in our lives! An alcoholic tincture of valerian officinalis is available in most home medicine cabinets, just in case of emergency, so to speak.

Sedative medications based on valerian are produced by the pharmacy industry not only in the form of tinctures, but also in tablets. All of these can be successfully used as a mild sedative for various neuroses, stressful conditions, insomnia, and neurasthenia. It would seem that everything is fine - drink yourself a tincture or tablets and calm down. But with valerian it’s not so simple.

The fact is that in case of overdose this drug causes severe depression nervous system, a person begins to feel depressed, drowsy, performance decreases sharply, etc. So you should not think that the more herbal preparation, the better. You must follow the dosage indicated in the leaflet that comes with the medicine.

The next leader among traditional sedatives- motherwort and sedatives made from it, also sold in the form of tinctures and tablets. Both have the ability to regulate the state of the nervous system and calm. These drugs help with neuroses and insomnia. True, some people may have an individual intolerance to motherwort. In this case, it cannot be used. It is also not recommended for pregnant and breastfeeding women.

Combined herbal sedatives

There are sedatives plant origin, which are relatively new, at least compared to the usual valerian and motherwort. good effective means Tablets and solutions for oral administration are considered - "Novopassit" and "Persen", produced in tablets and capsules - "Persen-Forte". These drugs are combined, that is, they contain several active medicinal components.

The composition of the drug "Novopassit" includes extracts of hawthorn, hops, St. John's wort, passionflower, black elderberry, valerian and chemical substance Guaifenesin. Composition of "Persena": lemon balm, valerian, peppermint and a number of additional substances: corn starch, magnesium stearate, lactose, talc, glycerol, sucrose, etc.

In pharmacies today you can buy other herbal combined sedatives without prescriptions, a list of which you can see below:

Soothing drops "Gerbion".
Balsam "Moscowia".
Dormiplant tablets.
Elixir "Klosterfrau Melisana".
Lily of the valley-valerian drops.
"Nobrassite" solution.
Passifit syrup.
Patrimin tablets.
"Fitorelax" in tablets.

List of chemical-based sedatives

The medicines that will be discussed are available in the pharmacy chain for free sale. Most of these drugs (along with the chemical component) also contain plant extracts. Let's take a closer look at these sedative medications.

1. Drops "Valocordin" - also contain valerian, belladonna, lily of the valley and menthol.

2. "Valoserdin" - also drops. Ingredients: phenobarbital, ethyl bromoisovalerate, oregano oil, peppermint oil.

3. "Ipronal" - in this sedative drug active substance is a proxybarbal.

4. Cardolol drops - they contain: the substance phenobarbital, peppermint oil, ethyl ester of alpha-bromoisovaleric acid.

5. "Corvalol" - drops. Ingredients: oil peppermint, phenobarbital, ethyl bromoisovalerate.

6. "Lavocordin" - another drops with a sedative effect. In addition to phenobarbital, peppermint oil and ethyl bromizovalerate, they also contain hop oil.

Other herbal sedatives

A lot has already been said about valerian and motherwort. Now let's talk about others herbal remedies, which have a sedative effect on the human body. What kind of medicines are these? These include, for example, peony tincture. It is not as popular as the above-mentioned drugs, but it is very effective for insomnia and increased nervous excitability.

Lily of the valley-valerian drops are another excellent drug produced by our medical industry. The name speaks for itself - the medicine contains two herbal components: lily of the valley and medicinal valerian. Overall this good remedy, but has a number of contraindications, such as endocarditis, myocarditis, cardiosclerosis, hypersensitivity. Drops from lily of the valley and valerian can also cause side effects such as nausea and vomiting, arrhythmia, diarrhea, headache, decreased attention, myasthenia gravis and allergic reactions. Both peony tincture and lily of the valley-valerian drops are sedatives available without prescription at any pharmacy. However, you need to be careful when taking them, read the instructions carefully and start with the smallest doses.

Brominated sedatives

Bromine-based drugs with a sedative effect are widely known. The history of their use goes back one and a half centuries. This is, one might say, a classic. Brominated sedatives are sold without a prescription. You can read a list of them below:

Drops "Bromenval" (in addition to sodium bromide, contain valerian, hawthorn, menthol).
Bromcamphor tablets.
Potassium bromide solution (used for children) and tablets.
Lily of the valley-valerian drops with sodium bromide.
Solution for oral administration "Sodium bromide".
A combined drug, which is a solution that contains both potassium bromide and sodium bromide.
Adonis-bromine tablets.

How do bromides affect the higher nervous activity, studied in the 19th century by our great compatriot - He and representatives of his school came to the conclusion that bromine has undoubted sedative properties and is good for irritability and insomnia. But you need to know that too long-term use of bromine-containing drugs can cause a condition called bromism, which is accompanied by memory impairment, severe lethargy, and sometimes skin itching and rashes.

When a child needs help

Excessive tearfulness and excitability (in young children).
A difficult adaptation period when a child begins to attend kindergarten or school.
Excessive nervousness during exams.
Hysterics and stressful situations.
Sleep disorders.
Awkward age.

Of course, these are not all the reasons; only the most common ones are listed here. Attentive parents will always notice in time that their child needs medical help and will contact a doctor to prescribe anti-anxiety medications for children. You should not start giving children medications from an adult home medicine cabinet, this warning especially applies to very young children. Good for kids homeopathic medicines. A separate chapter is devoted to them in this article.

Side effects and contraindications

It is unlikely that there are medications in the world that would suit absolutely everyone and would not give any unwanted reactions. Even sedatives of plant origin have contraindications. Frequent side effects are allergic reactions, and in case of an overdose of, for example, alcohol tinctures, there may be dizziness, confusion, etc.

Of course, each drug has its own characteristics, which can be found out when purchasing from a pharmacist at a pharmacy. Women who are expecting the birth of a baby and nursing mothers should be especially careful. Pregnant women tend to be nervous and worried, which is why they often need sedatives. But the choice must be very responsible so as not to harm either yourself or the child.

Sedatives for pregnant women

Glycine is considered to be a safe sedative. It is often prescribed to pregnant women. It should be borne in mind that this drug has a cumulative effect, that is, in order to feel its effect, you will have to take the pills for more than one day. But it has a very gentle effect on the body.

In the first trimester of pregnancy, expectant mothers should be especially careful when taking medications. Herbal preparations "Novopassit" and "Persen" are acceptable, but only on the recommendation of a doctor. Medicinal and motherwort tablets can be taken only after the sixteenth week. But the use of tinctures with alcohol is not allowed. In some cases, the doctor may prescribe homeopathic medications that have a sedative effect. What kind of medicines these are can be read in the next chapter.

What can homeopathy offer?

Homeopathic medicines are considered absolutely harmless and are suitable for almost any person. The good thing about homeopathy is that there is no harm from it, and in some cases the benefits are much greater than from traditional drugs. All homeopathic remedies must be completed completely clinical studies, so they can be trusted.

Among them there are also sedatives for children. "Passiflora Edas-11" (Russia) is suitable even for newborn babies; children from the second or third year of life are prescribed granules under the tongue "Rescue Remedy" (Russia), drops "Valerianahel" and granules "Kindinorm" (Germany); granules "Babysed", "Scamp" Russian production(for children from 6-7 years old). I just want to warn young mothers that they should not self-prescribe irritable or whiny kids and sedatives for babies, even if they are harmless. For babies, any drug therapy should be prescribed by a doctor.

Well, how can homeopathy please adults? The drugs “Avena comp”, “Nevrosed”, “Calm” and many others have a sedative effect.

What does traditional medicine offer?

Finally, let's talk about the lungs sedatives which are offered in abundance traditional medicine. All of these recipes can also be used as supplements to your intake. pharmaceutical drugs, and separately in order to obtain a sedative effect. This is what the age-old advises folk wisdom for insomnia:

1. Hot foot baths before bed. They calm the nerves well, relieve fatigue and promote rapid falling asleep and sound sleep.

2. General baths with the addition of coniferous infusions of fir or pine, mint leaves, calendula flowers, oregano, lemon balm and lavender to the water.

3. If you have trouble falling asleep, you can breathe in the infusion or lubricate it before going to bed. lavender oil whiskey.

4. A small pillow (sachet), sewn with your own hands and stuffed with a mixture that includes peppermint, geranium, oregano, fern, pine needles, bay leaf, rose petals and a pinch of valerian roots, placed at the head of the bed, can best help you fall asleep.

5. from herbs that has a sleeping pill effect. To prepare it, you need to take equal parts of hop cones, rosemary, peppermint, lemon balm, St. John's wort and valerian root. Pour one tablespoon of the resulting mixture into a glass of boiling water and let it brew for 15-20 minutes. Then the solution is filtered and drunk in sips throughout the day.

6. Honey water. They say that this remedy perfectly helps the body relax and fall asleep. And preparing such a sleeping pill is very simple: add honey (a tablespoon) to a glass of warm water.

Finally, in order to relieve nervous tension, you can buy various dried herbs that have a sedative effect (lemon balm, hawthorn, valerian, hops, motherwort), prepare a mixture from them, brew it and drink it instead of tea throughout the day.

Responds to verbal commands with or without light tactile stimulation. Calming and (with increasing dose) hypnotic effect.

Opioids, benzodiazepines, barbiturates, alcohol, first-generation antihistamines, and other classes of substances have a sedative effect.

Sedative effects of first generation antihistamines

The sedative effect of antihistamines is determined by the fact that most first-generation antihistamines are fat-soluble, penetrate well through the blood-brain barrier and bind to H1 receptors in the brain. Sedative effect intensifies when combined with alcohol and psychotropic drugs. Sometimes psychomotor agitation may occur (usually in moderate therapeutic doses in children and in high toxic doses in adults). Due to the sedative effect, most medications cannot be used during work that requires attention - training, driving, etc. All first-generation antihistamines enhance the effect of sedatives and hypnotics, narcotic and non-narcotic analgesics, monoamine oxidase inhibitors and alcohol.

Many medications have a sedative effect, that is, they have a calming effect on the nervous system. It is expressed in the fact that many reactions in a person are inhibited. Including the reaction to stress. Thus, the person does not want to sleep, he is simply slowed down. Therefore, it is not recommended to drive a car.

A sedative effect is the same as a calming effect, it is simply said in scientific language. The term can often be found in instructions for medicines- for example, in the description: has a sedative effect. Not only medications have a sedative effect - alcohol, aromatic oils, massage, etc.

Etymology:

What drugs have a sedative effect?

There are good sedatives of plant origin - for example, Persen, Novopassit. Glycine is available in tablet form, it’s very useful, read it, and it also has a sedative effect.

The sedative effect can turn into a sleeping pill (for example, with an overdose of the drug, but you can easily take a nap from a therapeutic dose - it all depends on the individual reaction of the body). You can try using a sedative when you can’t fall asleep - it helps a lot (although sedatives are not sleeping pills). For example, one of the drugs whose names I listed above.

Sedation may be a side effect of the drug, not its intended purpose. For example, when you take an allergy medicine, you want to get rid of sneezing that occurs due to some allergen, and do not at all set yourself the goal of calming down. And the instructions for the antihistamine may indicate this effect as a possible side effect.

This is important:

So we figured out what sedation is. Now let's figure out what it is expressed in.

In simple terms, in our brain, when taking a sedative, the processes of inhibition begin to prevail over the processes of excitation.

What else would be useful to know?

Sometimes the effect can be the opposite of sedation:

Please note:

So, study the interaction with other medications section in the instructions for the medicine you are using.

Please also keep in mind that in the instructions, instead of the words monoamine oxidase inhibitors, you can find the abbreviation: MAO inhibitors. By the way, alcohol should not be used with this group of drugs, even in small quantities - muscle spasms may occur. chest(You yourself understand how this could end). In general, alcohol should not be used with many medications.

Always read the instructions for any medications very carefully.

Sedation is the calming effect of certain medications. Feelings of fear, anxiety, and restlessness are relieved. Often, sedatives also have a hypnotic effect. There are so-called daytime sedatives that only calm you down without causing drowsiness. Those who drive vehicles or do work that requires great concentration and attention should be careful with any sedatives.

Sedative effect Alcohol has a drug against worms (antihistamines), drugs, painkillers and, of course, sedatives.

Sedative effect- This is a calming effect that slows down the activity of the body.

A sedative effect is an effect caused by medications, when drowsiness appears (even if only as an extreme degree), or clouding of consciousness, some inhibition of actions. This effect can be caused by earlier generation sedatives or allergy medications, especially in large quantities. Taking certain herbs, for example valerian, motherwort, can also cause such a reaction.

Drugs with a sedative effect- These are sedatives. For example, valerian and more serious drugs - tranquilizers. The sedative effect is expressed in a decrease in the excitability of the nervous system and inhibition of reactions.

The sedative effect is very often confused with the effect of a sleeping pill, but it is rather a sedative. The hypnotic effect appears only when the dose of the drug is greatly increased. In fact, sedation is the suppression of consciousness using drugs (sometimes herbs). The sedative effect is manifested in the fact that a person hears and understands everything, but his movements are slightly inhibited and his reaction decreases. Therefore, drugs with a sedative effect should not be taken by drivers and workers in hazardous industries.

Sedatives (from lat. sedatio- calming) have a regulatory effect on the functions of the central nervous system, enhancing the process of inhibition or reducing the process of excitation. Sedatives include substances of various natures, and primarily herbal preparations with moderate sedative effect.

One of the most common remedies is the drug Valerian officinalis rhizomes with roots(“Valerian tincture” and “Valerian thick extract”). Valerian is included in sedative mixtures No. 2 and 3. It is used in various combinations - “Persei forte” (with lemon balm and peppermint), “Songa night” (with lemon balm), “Lily of the valley-valerian drops” ( + lily of the valley herb tincture). The last drug recommended for the treatment of cardioneuroses and initial manifestations of heart failure. The drug "Sanason Lek" ( Valerian officinalis rhizomes with roots tincture + hop fruit extract) effective for insomnia caused by anxiety and fear.

Motherwort preparations – “Moonwort tincture”, “Lily of the valley-motherwort drops” – in addition to the sedative effect, exhibit hypotensive activity. Due to the addition of oregano and yarrow to motherwort, “Balm of Muscovy” is indicated not only for neuroses, but also for disorders of the outflow of bile. The drug "Fito Novo-Sed" has a sedative and anxiolytic effect, helps improve cerebral circulation, has an activating effect on the detoxifying function of the liver, increases the body's resistance to physical activity. These effects are ensured by the addition of motherwort herb with hawthorn and rosehip fruits, lemon balm herb and Echinacea purpurea. The drug "Valemidin" is used in adults for neuroses with increased blood pressure. In addition to the tincture of motherwort herb, it contains tinctures of hawthorn fruits, rhizomes with valerian roots, peppermint leaves and diphenhydramine.

Drugs have a moderate sedative effect grass, rhizomes and roots of peony evasive(“Peony extract”, “Evading peony tincture”), passionflower herb extract("Passiflora extract").

No less important are plant preparations with mild sedative effect: hawthorn fruits, hawthorn flowers, extract of hawthorn leaves and flowers, linden flowers, oregano herb, lemon balm herb.

Hawthorn extracts, in addition to the sedative, exhibit hypotensive, antianginal, antiarrhythmic, cardiotonic effects, which are used in the preparations “Hawthorn tincture”, “Cregium”, complex preparations “Bromenval”, “Fito Novo-Sed”, “Kedrovit”, “Fitorelax”, “Demidovsky” syrup", "Sedoflor".

The combination of the sedative and expectorant effects of oregano preparations is used in the preparations " Chest collection No. 1" and "Balm of the Mother Throne".

Melissa officinalis preparations - extract ("Lomagerpan") and tincture ("Melison") - are used for neuroses and increased nervous excitability.

Medicinal plants have soft action, do not accumulate in the body, do not cause toxic effects and drug dependence.

Bromides are sedatives. The drug "Bromenval" along with sodium bromide includes tinctures of hawthorn, valerian and racementol. The drug "Valocormid" in addition to sodium bromide contains tinctures of valerian, belladonna, lily of the valley and racementol. The drug "Cardiovalen" includes adonizide, hawthorn fruit extract, tincture of rhizomes with roots of valerian officinalis, gray jaundice juice and camphor. Bromides are not used on their own due to accumulation and bromism phenomena in case of overdose.

Barbiturates in small doses and drugs containing them are used as sedatives ( phenobarbital). The most famous combination is Corvalol ( peppermint leaf oil + phenobarbital + ethyl bromoisovalerate). The composition of the drugs "Valoserdin" is similar ( oregano common grass oil + peppermint leaves oil + phenobarbital + ethylbromoisovalerate),"Valocordin" (peppermint leaf oil + phenobarbital + hop fruit oil + ethyl bromizovalerianate). Sedative neuroleptics in small doses have a calming effect: chlorpromazine, levomepromazine("Tizercin"), thioridazine("Sonapax"), alimemazine("Teraligen"), They are used for psychomotor agitation for schizophrenia, other psychoses and mental retardation.

Sedative antidepressants pipofezin("Azafen"), amitriptyline(“Saroten Retard”) exhibit thymoanaleptic and sedative effects. They are used for depression, including against the background of somatic diseases.

First generation antihistamines characterized by a pronounced sedative effect. These include diphenhydramine("Diphenhydramine"), promethazine("Pipolfen"). Diphenhydramine is used independently as a sleep aid. Antihistamines eliminate the manifestation of allergies; the sedative effect can be useful to enhance the main effect, but reduces the reaction to external irritants.

The use of sedatives is effective in cases where the disease is associated with excessive psycho-emotional overstrain and stress, with overstimulation of the central nervous system. The central (brain and spinal cord) nervous system is shown in Fig. 4.1. Long-term use of sleeping pills as sedatives is inappropriate. Sedatives are contraindicated for drivers and workers in other professions whose work requires increased attention and good reaction.

Rice. 4.1.

Sleeping pills are called medicinal substances, which in humans cause a state close to natural physiological sleep. In small doses, sleeping pills have a sedative (calming) effect.

Among sleeping pills there are:

1. Derivatives of barbituric acid long acting: phenobarbital;
2. Combination drugs containing barbiturates: "Reladorm" (diazepam + cyclobarbital), as well as the already mentioned above as sedatives “Corvalol”, “Valoserdin”, “Valocordin”.
3. Benzodiazepine derivatives: midazolam, nitrazepam, flunitrazepam, lorazepam("Lorafen"),
4. H1-histamine blockers: doxilamia.
5. Bsnzodiazepine-like drugs.
5.1. Cyclopyrrolones: zopiclone("Imovan").
5.2. Imidazopyridines: zolpidem.
5.3. Pyrazolo-pyrimidines: zaleplon("Andante")
6. Melatonin analogues (melatonin receptor agonists): melatonin("Melaxen"),
7. Other sleeping pills and sedatives: "Bromenval" (hawthorn fruit tincture + valerian officinalis rhizomes with roots tincture + sodium bromide + racementol), peony herb, motherwort herb.

Barbiturates inhibit the functions of the central nervous system; they are agonists of the inhibitory neurotransmitter of the central nervous system - gamma-aminobutyric acid (GABA). The diagram of the postsynaptic membrane receptor for the GABA transmitter along with the benzodiazepine receptor is shown in Fig. 4.2. Activation of the barbiturate receptor increases the duration of opening of the chloride channel, activation of the benzodiazepine receptor increases the frequency of opening of the chloride channel.

Rice. 4.2.

1 – benzodiazepine receptor; 2 – chlorine channel; 3 – glial cell; 4, 9 – GABA; 5 – mitochondria; 6 – glutamic acid; 7 – glutamate decarboxylase; 8 – synaptic vesicle; 10 – synaptic membrane; 11 – subsynaptic membrane; 11 – GABA receptor; 12 – GABA-modulin

The following subtypes of GABA receptors have been identified: GABA-A receptors (α, β, γ, δ, ε), ΓΑΜΚ-Β receptors and three subtypes of GABA-C receptor (p1-3). Activation of GABA-A and GABA-C receptors leads to the opening of channels permeable to chlorine ions, which leads to the entry of these ions into the cell and hyperpolarization of the membrane. The GABA-B receptor acts through G proteins on potassium channels. The most important difference between the GABA-A and GABA-C receptors is as follows: the GABA-A receptor is quickly activated and also quickly loses sensitivity to the action of the mediator. The last phenomenon is called desensitization. The GABA-C receptor is activated slowly, but is much less prone to desensitization. Activation of the GABA-C receptor occurs at significantly lower concentrations of GABA than in the case of the GABA-A receptor. This is associated with differences in the effect of drugs on GABA receptors.

The diagram of the GABA-A receptor is shown in Fig. 4.3. The figure illustrates the three main binding sites on the GABA-A receptor and the chloride channel. The subunits that make up the receptor are not shown. The chloride channel opens when two GABA molecules bind to the corresponding site on the receptor. The binding sites for benzodiazepines and barbiturates are physically separated from each other and from the GABA-binding site. Bicuculline blocks the GABA binding site, causes convulsions, and is a GABA antagonist. Flumazenil competes with benzodiazepines (eg, diazepam) for the binding site and is considered their antagonist.

Rice. 4.3.

GABA receptors and drugs affecting them are presented in table. 4.1.

Barbiturates have wide range pharmacological activity, depending on the dose, cause depression (sedation), sleep and anesthesia (narcosis), depress respiration, and induce the activity of microsomal liver enzymes. Selected drugs differ from each other in the speed of onset of the hypnotic effect and duration of action, which is due to the characteristics chemical structure.

Barbiturates are not used long-term as sedative-hypnotics if benzodiazepines are contraindicated. In addition, long-acting barbiturates - phenobarbital– used to treat epilepsy and hyperbilirubinemia. Ultra-short-acting drugs - sodium thiopental("Thiopental"), hexobarbital(“Hexenal”) are used as anesthetics. Side effects Barbiturates are numerous, including dysfunction of the central nervous system (drowsiness, convulsions, speech disorders, depression, paradoxical agitation in the elderly). Possible breathing problems due to the inhibitory effect on respiratory center CNS, bradycardia, orthostatic hypotension, nausea, vomiting, diarrhea, skin lesions, headache, fever, hepatotoxicity, megaloblastic anemia (with long-term use phenobarbital). Withdrawal syndrome (insomnia when stopping the drug) may develop. All barbiturates are characterized by the ability to disrupt sleep structure. The stages of slow-wave sleep are presented in table. 4.2.

Table 4.1

GABA receptors and drugs affecting them

Stages of slow-wave sleep

Table 4.2

Stage I – drowsiness (10%)

Stage II – sleep of medium depth (45-50%)

Stage III – deep sleep

Stage IV – deepest sleep

Delta sleep (20%)

Absence of α-rhythm (wakefulness rhythm) on the electroencephalogram (EEG). The appearance of low-amplitude slow activity with a frequency of 3-7 per 1 s

The appearance of the rhythm of “sleep spindles” (oscillations of biopotentials grouped in packs) with a frequency of 13–16 per 1 s (sigma rhythm).

The appearance of K-complexes (2–3-phase high-amplitude potentials). There is an increase in the amplitude of oscillations and a decrease in its frequency

The appearance on the EEG of a slow rhythm in the sigma range with a frequency of 2 in 1 s

Dominance of high-amplitude slow sigma rhythm

In a healthy person, sleep begins with the first stage of slow-wave sleep (Non-REM- sleep), which lasts 5–10 minutes. Then comes the second stage, which lasts about 20 minutes. Another 30–45 minutes occur during stages 3–4. The sleeper then returns to the second stage of slow-wave sleep, after which the first episode occurs REM sleep, which has a short duration of about 5 minutes. This entire sequence is called a cycle. The first cycle lasts 90–100 minutes. Then the cycles are repeated, with the proportion of slow-wave sleep decreasing and the proportion of REM sleep gradually increasing (REM- dream), the last episode of which in in some cases can reach 1 hour. On average, with full healthy sleep, five complete cycles are observed (Fig. 4.4). The sequence of changes in stages and their duration is conveniently represented in the form of a hypnogram, which clearly displays the structure of the patient’s sleep (Fig. 4.5).

Rice. 4.4.

* – the most vivid and memorable dreams during REM sleep; x – rational dreams during the slow phase

Rice. 4.5.

Better tolerated than barbiturates benzodiazepine derivatives, causing sleep close to physiological sleep. Drugs flunitrazepam("Rohypnol"), lorazepam("Lorafen"), nitrazepam("Radedorm"), midazolam have a sedative-hypnotic and anxiolytic effect (relieve anxiety, fear), interacting with benzodiazepine receptors (BD1 and BD2) of the central nervous system. The hypnotic effect is due to affinity (affinity) for BD1 receptors. Interaction with benzodiazepine receptors is accompanied by activation of GABA receptors, which leads to inhibition of the functional activity of CNS cells. The main significance for the hypnotic effect is the inhibition of the activity of cells of the reticular formation.

Reticular formation represents a collection of nerve cells in central departments brain stem. Neurons of the reticular formation thanks to a large number branching and intertwining processes form a dense nervous network, hence the name reticular, or reticular, formation. Thanks to the influx of appropriate impulses from the sensory organs, the reticular formation creates a “working atmosphere” in the cells of the cortex and thereby maintains a state of wakefulness. The reticular formation is the most ancient part of the brain stem and spinal cord. It is presented in the form of a network of numerous nuclei and nerve fibers connecting them, which is connected to all structures of the brain and spinal cord and is directly involved in their functioning. The reticular formation refers to the constantly active (waking) part of the brain. A schematic representation of specific and activating systems of the brain is presented in Fig. 4.6.

Rice. 4.6.

1 – nuclei of the visual thalamus; 2 – reticular formation; 3 – specific afferent pathway; 4 – branches from a specific path to the cells of the reticular formation; 5 – activating system

Unlike barbiturates, benzodiazepine derivatives do not cause the induction of microsomal liver enzymes. Used to facilitate falling asleep, increase sleep duration, prepare for surgical intervention(premedication), treatment of neuroses accompanied by feelings of anxiety and fear, as anticonvulsants when administered parenterally, to relieve alcohol withdrawal. The drugs differ in their duration of action, which is due to the peculiarities of their chemical structure. Midazolam – remedy for sleep disorders and premedication before surgical operations And diagnostic procedures, for induction and maintenance of anesthesia. Nitrazepam used to treat sleep disorders and to treat epileptic (myoclonic) seizures. Bromodihydrochlorophenylbenzodiazepine(“Phenazepam”) is an anxiolytic with a pronounced sedative effect, facilitates falling asleep in patients with neuroses and reactive psychoses.

Side effects from the nervous system are daytime fatigue, lethargy, a feeling of dizziness, numbness, impaired coordination of movements, impaired ability to concentrate. When taking sleeping pills, including benzodiazepines, you should refrain from hazardous activities that require attention, such as driving a car, working with moving machinery, and avoid drinking alcohol. When using large doses, long-term treatment Possible disturbance of articulation, gait, double vision, hallucinations. Paradoxical reactions are possible - increased aggressiveness, agitation, fear, suicidal tendencies, sleep and sleep disorders. IN in rare cases respiratory depression occurs in susceptible patients. Allergic reactions are possible, very rarely - increased appetite.

The drugs are contraindicated in medicinal and alcohol addiction, drug addiction, acute poisoning with alcohol, sleeping pills and other psychotropic drugs, during pregnancy and lactation.

Preparation zolpidem excites omega receptors in the alpha subunit of GABA receptor complexes localized in the cerebral cortex and a number of subcortical structures. Interaction with omega-benzodiazepine receptors leads to the opening of chlorine channels in the cells of the central nervous system and a hypnotic effect. The drug does not have the ability to accumulate. For transient and chronic insomnia (insomnia) in elderly patients, it improves the ability to fall asleep, increases the duration and quality of sleep, and reduces the number of awakenings. Side effects are rare. The drug is contraindicated in case of hypersensitivity, acute or severe respiratory failure, myasthenia gravis, severe liver dysfunction, pregnancy, breastfeeding, under 15 years of age.

Preparation zopiclone(“Relaxon”) is a cyclopyrrolone derivative, an agonist of omega-1 and omega-2 benzodiazepine receptors in the central nervous system. It increases the sensitivity of the GABA receptor to the mediator (GABA), which causes an increase in the frequency of opening of channels in the membrane of neurons for incoming chlorine currents and an increase in the inhibitory effect of GABA in various parts of the central nervous system. It is prescribed for situational insomnia, short-term and chronic insomnia, secondary disorders sleep at mental disorders. Sleep occurs within 20–30 minutes after administration and lasts 6–8 hours. Contraindications are the same as for the drug "Zolpidem", with the exception of people under 18 years of age. Due to the possibility of developing drug dependence, it is not used for a long time. Cancellation should be carried out gradually. Paradoxical reactions (insomnia) are more often observed in elderly patients.

Preparation melatonin("Melaxen") – synthetic analogue glands internal secretion(epiphysis). It is obtained from amino acids of plant origin. It regulates the sleep-wake cycle and circadian changes physical activity and body temperature (Fig. 4.7), adapts the body to rapid changes in time zones, reduces stress reactions, and inhibits the secretion of pituitary hormones. The drug does not cause drug dependence when used in physiological doses. Side effects in the form of allergic reactions, swelling, headache, nausea, vomiting, diarrhea, and morning drowsiness are rare. Should not be used by transport drivers and people whose profession involves increased concentration of attention.

Rice. 4.7. Graphs of circadian (time, hours, during the day) human biorhythms

Antihistamines diphenhydramine("Diphenhydramine"), doxylamine(“Donormil”) have a hypnotic, M-anticholinergic effect. Doxylamine does not change sleep phases. Antihistamines reduce the time it takes to fall asleep and increase the duration and quality of sleep. They are effective for itchy dermatoses and other manifestations of allergies. Side effects are associated with the M-anticholinergic effect - dry mouth, constipation, urinary retention. Contraindications: glaucoma, diseases accompanied by urinary retention, age under 15 years.

Things to remember:

! Sedative-hypnotics may cause drug addiction!

! All hypnotic drugs slow down a person’s reactions to external stimuli, so sleeping pills should not be prescribed before or during work to persons whose profession requires rapid motor and mental reactions. (transport driver)!

As a result of careless use of sleeping pills or during an attempt to commit suicide, acute poisoning sleeping pills. IN initial stages poisoning victims complain of weakness, drowsiness, fatigue, headache. Subsequently, signs of deep depression of the central nervous system develop: loss of consciousness, lack of response to painful stimuli, weakened reflexes, respiratory depression, decreased body temperature, relaxation of skeletal muscles, and a drop in blood pressure. To delete sleeping pills it is necessary to rinse the stomach, they are prescribed orally activated carbon, saline laxatives (magnesium and sodium sulfates). Oxygen therapy, artificial ventilation lungs, hemodialysis, prevention of pneumonia and bedsores are carried out in a specialized medical institution.

Sedatives of plant origin, presented in table. 4.3, make it easier to fall asleep and can be recommended for sleep disorders.

Table 4.3

Herbal sedatives for sleep disorders

Preparation		Application, dosage regimen
"Corvalol"	Peppermint oil + phenobarbital + ethyl bromoisovalerate	Take 15–30 drops orally, after dissolving in small quantity(30–50 ml) water before bed. Single dose If necessary (for example, with tachycardia) it can be increased to 40–50 drops. Children – 3–15 drops per day
"Novopassit"	Hawthorn fruit extract + black elderberry	2 tablets, or 10 ml, for children under one year old is determined at the rate of 1 drop
	flower extract + Valerian officinalis rhizomes with roots extract + St. John's wort herb extract	for 1 month of a child’s life, for children aged 1–3 years – 10–15 drops, 3–5 years – 20 drops, 5–7 years – 25–40 drops, 7–12 years – 40–45 drops
	Valerian medicinal rhizomes with roots tincture + + lemon balm medicinal herb extract + peppermint leaf extract	For adults and adolescents over 12 years of age with insomnia - 2-3 tablets or 1-2 capsules 1 hour before bedtime. For children aged 3 to 12 years, the drug is prescribed only under the supervision of a doctor and only in the form of tablets.
	Valerian medicinal rhizomes with roots tincture + + hop fruit extract	Orally, adults and children over 12 years old – 2-3 film-coated tablets, 1 hour before bedtime

Busy work schedule conflict situations, financial problems, constant noise metropolis, difficult environmental conditions and other unfavorable factors negatively affect the human nervous system, preventing you from fully relaxing after a hard day and getting quality rest. The economic crisis and political conflicts only increase nervousness and bring discord into the spiritual world of each of us.

If you notice that in lately constant fatigue, tearfulness and insomnia appear, causeless attacks of irritability occur, and you flinch at the slightest noise, then the best option will consult a doctor, since a nervous breakdown or other symptoms of a nervous system disorder can only be a manifestation of serious mental disorders, as well as hormonal imbalance or severe pathology internal organs, which can only be diagnosed by a specialist.

After collecting anamnesis and relevant examinations, a competent doctor will prescribe sedatives or other dosage forms on a strictly individual basis. In this article we will make a brief overview of sedatives available in pharmacies without a prescription.

Sedatives: what are they?

In order to reduce psychological stress, many resort to over-the-counter sedatives (from the Latin word sedatio - calm) drugs, both herbal and synthetic or combined. Sedatives are often prescribed in the treatment of neurasthenia and neuroses; they are prescribed for hypertension, insomnia, menopausal disorders and irritable bowel syndrome.

The main function of sedatives is to reduce the body's reactions to external unfavorable and irritating factors. Under the influence of this group of drugs, the intensity of excitation processes decreases, while inhibition processes in the body intensify. As a rule, the effect of such drugs on the human body is mild, in contrast to more serious drugs from the category of antipsychotics, anxiolytics (anti-anxiety) and tranquilizers.

Despite the low toxicity of most sedative drugs and high level safety in case of overdose, as well as the absence of addiction and withdrawal syndrome, their choice should be approached with the utmost seriousness and caution, since each sedative has its own contraindications and particular effects on human body. Since nervous disorders have different origins, sedatives are selected individually.

Those people whose professions are related to high concentration attention, for example, drivers, surgeons, teachers, accountants, machine operators production lines, bank employees, security operators, proofreaders, etc., before using any sedatives, a mandatory consultation with a doctor is required, since the activation of inhibition processes in the body can lead to serious problems at work and adverse consequences with health and safety.

How do sedatives affect the human body:

Inhibition of nervous reactions and elimination of excessive excitation of the central nervous system.
Normalization of the functions of the autonomic nervous system, including reducing the speed of myocardial rhythm, eliminating excessive sweating, relieving spasms in the intestines and tremors in the hands.
Elimination of signs of nervous disorders - aggressiveness, increased irritability external influences, tearfulness, melancholy.
Normalization of sleep. Sedatives are not a cure for insomnia, but they promote quality sleep by inhibiting the functions of the cerebral cortex and eliminating excessive sensitivity.

Herbal based sedatives

Our ancestors also used various plants having sedative properties. Most by safe means This group includes those made from plant extracts. They carry minimal load on the liver and excretory system. Currently, both single-component drugs and those containing several ingredients can be purchased at the pharmacy.

Valerian

Based on the root and other parts of valerian officinalis, many medicinal forms: alcohol tincture (drops), tablets, briquettes. It is included in most sedative mixtures and teas. The most popular drug among people is valerian tincture.

To calm and reduce nervousness, just take 40 drops diluted in 30 ml drinking water(per 80 kg body weight). However, alcohol forms are contraindicated for persons suffering from alcoholism or taking antipsychotics and other psychotropic drugs. In some cases, valerian can cause a significant slowdown in heart rate and even cause bradycardia.

Motherwort

Another unique medicinal plant with sedative qualities. On sale you can find alcohol tincture motherwort, soothing drops and tablets with its extract.

Motherwort tincture helps relieve stress, treat neuroses, it helps normalize heart rate and has a hypotensive effect. The drug is prescribed for VSD, severe course menopause, painful menstruation, arrhythmias, heart pain, neurological problems. Take 25 to 30 drops with 50 ml of water. Use as prescribed by a doctor 1 to 3 times a day.

Stratoflower (passionflower)

Passionflower preparations are effective for insomnia, excessive irritability, aggressiveness and neurasthenia. Use of extract-based medications of this plant helps slow down the heart rate, eliminate tremors in the hands and relieve spasms that cause headaches.

Stratoflower tincture helps with sleep disturbances that occur with neuroses, as it has a relaxing effect. She is appointed to complex therapy hypertension, neoplasms, gastrointestinal diseases, endometriosis, pathologies of the musculoskeletal system. Take 20 drops three times a day half an hour before meals.

Peony

Peony tincture is effective for VSD and neurasthenia. She normalizes emotional background and sleep, eliminates phobias, obsessive and anxiety states, reduces excitability, increases endurance and performance, has an anticonvulsant and antispastic effect. As a sedative, peony tincture is usually prescribed for 30 days. A single dose of 30-40 drops diluted in 30 ml of water before meals. To adjust the duration of treatment, single and daily dosage, consultation with a specialist is required.

St. John's wort

Preparations based on St. John's wort, for example, Deprim, Neuroplant, Negrustin, have an antidepressant effect and normalize the state of the nervous system. The sedative effect is due to the ability of the biologically active substances of the plant to inhibit the reuptake of hormones responsible for the emotional background (dopamine, norepinephrine, serotonin). Take medications as prescribed by a doctor or according to the instructions on the package.

Combination drugs

A number of drugs developed by pharmacists contain several active plant and synthetic components. Such products are considered more effective compared to mono formulas.

The most popular sedative multicomponent drugs include:

Phytosed, which contains lemon balm, hawthorn, hops, motherwort and coriander (alcohol based), helps with sleep disorders, eliminates mental and emotional stress, reduces fatigue;
Novo-passit(St. John's wort, passionflower, blood-red hawthorn fruits, valerian root, lemon balm) relieves panic attacks, eliminates anxiety and irritability, calms the nervous system;
Persen contains extracts of mint, valerian, lemon balm, has a sedative and antispasmodic effect, helps with insomnia, irritability, tearfulness and hyperexcitability (nervous);
Corvalol, made on the basis of mint, phenobarbital, hops, ethylbromoisovalerate, has a mild sedative effect, calms the nerves, normalizes heart rate and relieving vascular spasms;
Valocordin, more strong drug than Corvalol, with a similar composition, reduces increased excitability, has a hypnotic effect, eliminates the causes of neuroses;
Zelenin drops, which contain valerian, tincture of lily of the valley, belladonna, levomenthol are prescribed for VSD, chronic heart failure, hyperexcitability, and neuroses.

All of the listed sedatives are taken as prescribed by a doctor or according to detailed instructions for them. Before taking any sedative forms, carefully study the available ones. side effects and contraindications. I would like to emphasize once again that it is advisable to eliminate disturbances in the functioning of the nervous system under the supervision of a specialist. Do not self-medicate and be healthy!