Sedative, Hypnotic, Anxiolytic Use Disorders

Updated: Dec 06, 2023
  • Author: Ankit Jain, MD; Chief Editor: Glen L Xiong, MD  more...
  • Print
Overview

Background

Psychiatry has been given the role of investigating, understanding, and treating the effects of stress, including anxiety, dysphoria, and feelings of discomfort. In addition to conventional psychotherapy models, psychiatrists worked on pharmacological therapies and consequently sedatives, anxiolytics, and hypnotics were created. By the 19th century, bromide salts, chloral hydrate, and paraldehyde were used in medicine. Subsequently, barbiturates were first synthesized for medical use in 1903, followed by meprobamate in 1950. [1] By 1959, the benzodiazepine chlordiazepoxide was created, giving rise to at least 3000 different benzodiazepines, of which 13 are currently marketed. [2]  New benzodiazepines are currently being developed as well. [3]

The therapeutic value of these agents as anxiolytics and hypnotics has been well established, and they continue to serve an important role in managing many debilitating anxiety symptoms in the context of both psychiatric disorders and medical illness. However, the toxic effects of these drugs have also been established, including various withdrawal syndromes, dependence, and tolerance.

Per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), the appropriate diagnosis for a prolonged and problematic pattern of use of these substances would be “Sedative, Hypnotic, or Anxiolytic Use Disorder.”  For acute intoxication and withdrawal, the DSM-5-TRdiagnoses would be “Sedative, Hypnotic, or Anxiolytic Intoxication” and “Sedative, Hypnotic, or Anxiolytic Withdrawal,” respectively.

 
TOP PICKS FOR YOU