Alprazolam is a short to medium-acting benzodiazepine sedative hypnosis, which has anti-anxiety, sedative hypnosis, anti-convulsion, anti-epileptic and skeletal muscle relaxation effects. Its anti-anxiety and sedative hypnosis effects are 10-35 times that of diazepam. The metabolites still have strong pharmacological activity. They are mainly used in clinical practice for anti-anxiety. They can be used as auxiliary drugs for patients with anxiety and depression. They can also be used for anti-panic and can be used for hypnosis. They are especially suitable for insomnia patients with sleep maintenance disorders. They can reduce the number of early awakening and awakening at night, prolong sleep time, and improve sleep quality.
lorazepam belongs to short to medium-effect benzodiazepine sedation, and has anti-anxiety, sedation, hypnosis, anti-convulsion, anti-epileptic, relaxation of skeletal muscle , anti-panic, anti-tremor, etc. Oral lorazepam is suitable for anxiety disorders or short-term relief of anxiety symptoms, including anxiety accompanied by mental depression, insomnia in anxiety or temporary, environmental stress states, and tension headache ; intravenous lorazepam is suitable for anti-convulsion and epilepsy, and anti-emetic during cancer chemotherapy, and can be used as an auxiliary medication before anesthesia and before endoscopy.
zolpidem is an imidazole pyridine hypnosis drug, which has a similar effect to benzodiazepine drugs, but it can selectively bind to benzodiazepine type I receptor β2 or ω1 receptor, regulate the chloride ion channel, and has a strong sedative and hypnotic effect, and has weak anticonvulsive, anti-anxiety and muscle relaxation effects. It can shorten the sleep time, reduce the number of awakenings at night, prolong the total sleep time, improve the quality of sleep, and have no obvious sedation and psychomotor disorders. Used for short-term treatment for transient, occasional insomnia or chronic insomnia.
zopicl is a third-generation hypnosis drug of cyclopyrrolidone and is an inhibitory neurotransmitter γ-aminobutyric acid (GABA) receptor agonist. Its structure is different from that of benzodiazepines. Its receptor binding site is the same as that of benzodiazepines, but it acts on different regions. Zopiclon has rapid effect and is stronger than benzodiazepines. It has sedation, hypnosis, anti-anxiety, muscle relaxation and anti-convulsive effects. It is suitable for insomnia caused by various reasons, especially for patients who cannot tolerate the residual effects of the next day.
Duzopiclone is also a non-benzodiazepine sedative hypnosis drug commonly used in clinical practice. It is a cyclopyrrolidone compound and is a dextroroton monoisomer of zopiclone. It has a 50-fold stronger affinity for central benzodiazepine receptors than zopiclone. It selectively acts on the A1 and A2 subtypes of the benzodiazepine receptor coupled to the benzodiazepine receptor. It has a stronger selectivity for the A1 subtype receptor and has a strong sedative hypnosis effect. It has no obvious anti-anxiety, muscle relaxation, anti-convulsive and forgetful effects. It is suitable for various types of insomnia.
yzopiclon has good sleep-safe effects after 6 consecutive months of use. After 6 months of continuous use, it can still remain effective without drug resistance. It is suitable for the treatment of long-term insomnia.
Zaleplon is also a non-benzodiazepine hypnosis, which has sedation, hypnosis, muscle relaxation, anti-anxiety and anti-convulsive effects. The central inhibitory effect is generated by acting on the γ-aminobutyric acid receptor-benzodiazepine complex, and it has strong selectivity for the A1 subtype receptor of γ-aminobutyric acid , and it can also bind to the A2 subtype receptor, but does not bind to other neurotransmitters. Zaleplon has a shorter half-life (approximately 1 hour) and duration of action than Dzopiclone, and is suitable for short-term treatments for difficulty falling asleep in adults.
Rametamine is an agonist of highly selective melatonin receptors 1 and 2 (MT1 and MT2). MT1 regulates sleep, and MT2 regulates the biological rhythm from day to night. It is used to treat difficulty falling asleep, which can effectively shorten the sleep time and increase the total sleep time. Rametidamine is a reasonable choice for patients with first-time insomnia, with no possibility of abuse and little risk of impaired function the next day.
Suvoreson is an orexin receptor antagonist used to treat insomnia characterized by difficulty falling asleep and/or difficulty in sleep maintenance. The orexin signaling pathway promotes awakening, and the antagonizes the orexin receptor to promote sleep. Suvoretan can reduce the incubation period of sleep onset and wake up after sleep without destroying the sleep structure.
doxepin is a tricyclic antidepressant, and its mechanism of action is the same as amitriptyline . In addition to antidepressant, it also has certain anti-anxiety and sedative effects, but its anticholinergic effects are weak. Doxepin can be used to treat anxiety depression or depressive neurosis , and can also be used for sedation and hypnosis. It is suitable for insomnia patients with difficulty in sleep maintenance.
trazodone is a triazolylpyridine antidepressant, and its exact mechanism has not been fully elucidated. It is generally believed that at therapeutic doses, trazodone can selectively inhibit the reabsorption of serotonin (5-HT) and can weakly prevent the reabsorption of norepinephrine, but has no effect on dopamine histamine and acetylcholine , nor does it inhibit the activity of monoamine oxidase (MAO) in the brain. Trazodone is especially suitable for elderly depression . If patients with refractory depression are ineffective after other antidepressants, they can be tried, or used to treat anxiety disorders with depression symptoms.
trazodone can block 5-HT2 receptors, improve sleep (such as reducing insomnia), and significantly shorten the incubation period of sleep in patients with depression in , prolong the overall sleep time, and improve sleep efficiency.
