Sedating antihistamines also have significant antimuscarinic activity and should be used with caution in patients with prostatic hypertrophy, urinary retention and angle-closure glaucoma.
Examples of sedating antihistamines: Sedation is rare with non-sedating antihistamines, however patients should be made aware that a sedative effect may occur and performance of skilled tasks such as operating machinery or driving maybe affected.
In the first part of the 20th century, the pharmacotherapy of anxiety and insomnia relied on barbiturates, which were replaced with benzodiazepines as drugs of choice in the second part of the previous century.
In modern medicine they have been largely replaced by the benzodiazepines, primarily because they can induce tolerance, physical dependence and serious withdrawal symptoms.
Nevertheless, certain barbiturates are still employed as anticonvulsants (phenobarbital) and to induce anesthesia (thiopental).
Although they are undoubtedly effective to certain extent, some aspects of their psychopharmacology have to be resolved; for example, there is poor evidence of pharmacodynamics in humans, problematic efficacy evaluation in clinical studies, as well as cumbersome production of standardized extracts and lack of bioequivalence between different extracts.
The representatives of this group are: Other sedatives include alcohol, opioid sedatives, anesthetics, carbinols, agonists of melatonin receptors and other medicines that also act as CNS depressants via different mechanisms.