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Doxylamine is also a potent anticholinergic, meaning that it causes delirum at high doses—i.e., at much higher doses than recommended. [8] (Specifically it is an antagonist of the muscarinic acetylcholine receptors M 1 through M 5.) These sedative and deliriant effects have in some cases led to using the drug recreationally.
Pyridoxine/doxylamine, sold under the brand name Diclectin among others, is a combination of pyridoxine hydrochloride (vitamin B 6) and doxylamine succinate.It is generally used for nausea and vomiting of pregnancy (morning sickness); even though its efficacy has not been proven and subsequent research has led to the removal of recommendations in medical journals.
It is mainly used to treat allergies, insomnia, and symptoms of the common cold. It is also less commonly used for tremors in parkinsonism, and nausea. [11] It is taken by mouth, injected into a vein, injected into a muscle, or applied to the skin. [11] Maximal effect is typically around two hours after a dose, and effects can last for up to ...
Long-acting benzodiazepines with long-acting active metabolites, such as diazepam and chlordiazepoxide, are often prescribed for benzodiazepine or alcohol withdrawal as well as for anxiety if constant dose levels are required throughout the day. Shorter-acting benzodiazepines are often preferred for insomnia due to their lesser hangover effect.
Suvorexant is used for the treatment of insomnia, characterized by difficulties with sleep onset and/or sleep maintenance, in adults. [2] [6] At a dose of 15 to 20 mg and in terms of treatment–placebo difference, it reduces time to sleep onset by up to 10 minutes, reduces time awake after sleep onset by about 15 to 30 minutes, and increases total sleep time by about 10 to 20 minutes. [2]
Zolpidem, sold under the brand name Ambien among others, is a medication primarily used for the short-term treatment of sleeping problems. [11] [16] Guidelines recommend that it be used only after cognitive behavioral therapy for insomnia and after behavioral changes, such as sleep hygiene, have been tried.
One of the recommended benzodiazepine taper is to reduce the dose by 50% in the first 4 weeks, maintain the dose for 1–2 months, and then reduce the dose by 25% every 2 weeks. [15] Other common side effects of benzodiazepines are drowsiness, dizziness, somnolence and increased risk of ataxia.
Ramelteon, sold under the brand name Rozerem among others, is a melatonin agonist medication which is used in the treatment of insomnia. [3] [5] It is indicated specifically for the treatment of insomnia characterized by difficulties with sleep onset. [3] It reduces the time taken to fall asleep, but the degree of clinical benefit is small. [6]
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