Sleeping pills are given as medications for those who cannot sleep right away. If the serum level of these medications exceeds the therapeutic level, it may lead to sleeping pill overdose [1, 2].
What are Sleeping Pills?
Most of the sleeping pills available in the market belongs to the class of benzodiazepines. These drugs affect the level of neurotransmitters in the brain that may affect the regulation of sleep. The misinformation of these pills is that they do not really induce sleep but affect the activity of the brain. They are prescribed to patients suffering from anxiety and sleep disorders.
Sleeping pills should only be used as needed and not to be taken regularly over a long period because of its habit-forming properties. Some of the most common sleeping pills prescribed to patients are zolpidem (Ambien), trazodone (Desyrel) and alprazolam (Xanax).
Side effects that may be experienced with the intake of sleeping pills are diarrhea, constipation, dizziness, dryness of the mouth or throat, changes in appetite, burning or tingling sensation in the hands and feet and feeling of drowsiness in the daytime [1, 2, 3].
Issues and Concerns
One of the issues regarding the use of sleeping pills is its use in committing suicide. These medications are being used to end one’s life because of its ability to cause death without causing any pain. Some of the celebrities who died from overdosing on sleeping pills are Marilyn Monroe, Jimi Hendrix, Bryan Epstein, Mike Von Elrich and Heath Ledger [1, 2, 3].
How much is Sleeping Pills Overdose?
The toxic level of sleeping pills depend on the medications. Some medications are more potent than the others in such that there is a narrow margin between their therapeutic range and their toxic level. For zolpidem, the maximum daily dose is 10mg and the toxic dose begins at 70mg.
The recommended dose for Trazodone is at 150mg while the toxic dose is at 600 mg. Xanax has a very high toxic dose in which about 1333 tablets of 1.5mg Xanax tablets needs to be ingested to reach the 2000mg toxic level. Factors that may affect the toxicity are weight, age and the tolerance the individual has developed on the medication [4, 5].
What are Sleeping Pills Overdose symptoms?
When an individual overdose on sleeping pills, the symptoms that they may experience are as follows.
Central Nervous System effects
Symptoms that are caused by the depression of the central nervous system include slowing of mental processes and memory or attention disorders. They may have unusual dreams and experience parasomnia. In an episode of parasomnia, the person may sleepwalk and do things that they are not aware of. There may be a loss in consciousness or even death [2, 3].
Gastrointestinal System effects
GI symptoms that may be experienced include stomach pain, heartburns, constipation, diarrhea and changes in their appetite [2, 3].
Other symptoms that they may experience include cessation of breathing, decreased heart rate and shortness of breath [2, 3].
What is Sleeping Pills Overdose Management?
The first thing to do when a patient has overdosed on sleeping pills is to bring them to the hospital without any delay. The initial priority in the emergency department is the airway, breathing and circulation of the patient. Supplemental oxygen may be provided or an emergency endotracheal intubation may be performed depending on the condition of the patient. An intravenous access should be established to administer medications as needed [2, 3].
Once the patient is stable, decontamination may commence. A gastric lavage can be performed if the ingestion occurred less than an hour prior. Activated charcoal may be given to the patient to minimize the binding of the drug in the stomach but the airway must be protected during the administration to prevent aspiration. Elimination through urinary excretion should be promoted during the therapy [2, 3].
Administration of Flumazenil
Flumazenil is the antidote for benzodiazepine overdose because it competes with the receptor sites of benzodiazepine in the body. This treatment rapidly reverses the symptoms of drug overdose [2, 3].
Those who have attempted suicide using sleeping pills must be referred to a psychiatrist for an evaluation once they are asymptomatic. This may prevent another suicide attempt in the future [2, 3].
How to Prevent Sleeping Pill Overdose?
Taking more than 5 to 6 sleeping pills in any kind is greatly fatal. Alternative ways to naturally induce sleep may include drinking milk during night time before sleep, avoiding taking nap during the day, having a half bath before going to bed and making the room conducive for sleeping [1, 2, 3].
The use of sleeping pills can be dangerous and natural methods for inducing sleep must be tried first before resorting to sleeping pills, If you have more information about this, you can share what you know in the comment section below.
- Ratini, M. (2014, November 6). Drugs to Treat Insomnia. Retrieved from WebMD: http://www.webmd.com/sleep-disorders/insomnia-medications#2
- Goldberg, J. (2016, October 15). Understanding the Side Effects of Sleeping Pills. Retrieved from WebMD: http://www.webmd.com/sleep-disorders/guide/understanding-the-side-effects-of-sleeping-pills#3
- Mayo Clinic Staff. (2014, December 27). Prescription sleeping pills: What’s right for you? Retrieved from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/sleeping-pills/art-20043959
- Cooper, J. S. (2015, December 29). Sedative-Hypnotic Toxicity Treatment & Management. Retrieved from Medscape: http://emedicine.medscape.com/article/818430-treatment?pa=Ckj0JYPQTAK51vfN7fkstF3GQqV1QXZ8TbiVxOMH5lE6HkjbSByaMFjOaBIGT5%2B700vLod35jXCV3VlkXn7vK3f7Bj2Gvk6BKC47oRZ1BB8%3D#d10
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