If used for sleep a hangover effect is experienced

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If used for sleep, a “hangover” effect is experiencedAlcohol increases all of these symptomsBe cautious when driving or preforming other tasks that require mental alertnessBecause tolerance develops, individuals who wish to experience the feeling of “intoxication” may be tempted to increase their own dose. Psychological dependence is more likely to occur with long term use of these medications.Abrupt discontinuation may result in the recurrence of target symptoms (anxiety, insomnia)Other withdrawal symptoms: tremors, perspiration, palpitations, increased sensitivity to light, abdominal discomfort or pain, and elevations in BP TAPER OFF GRADUALLYCan cause emotional instabilityoNon-Benzodiazepines: BuspironeControls anxiety (but has no effect on panic disorders) without the CNS depressant effects or the potential for abuse or withdrawal (no sedative, muscle relaxant, or anticonvulsant effects)Also, controls difficulty concentrating, tension, insomnia, restlessness, irritability, and fatigueS/E: dizziness, drowsiness, nausea, excitement, HAoSedative/Hypnotics – reduce activity, nervousness, irritability, and excitability without causing sleep, but if given in large doses, they havea hypnotic effectZolpidem(Ambien) oAntidote for Overdose: Flumazenil (Romazicon) or naloxone (Narcan)Stimulants and Wakefulness-Promoting Agents (amphetamines)oUsed adjunctively in treatment of depression and other mood disorder to address fatigue and low energyMethylphenidate(Ritalin), pemoline (Cylert): used for ADD, ADHDD-amphetamine (Dexedrine)Amphetamine/dextroamphetamine (Adderall)Dexmethylphenidate (Focalin)Lisdexamfetamine (Vyvanse)Modinafinil(Provigil) and Armodafinil (Nuvigil) – wakefulness promoting agents used for narcolepsy and other sleep disordersoRestricted for use only in narcolepsy, ADHD, and obesity (unresponsive to other treatments)oStimulate sympathetic nervous system producing alertness, wakefulness, vasoconstriction, suppressed appetite, and hypothermiaoTolerance develops – use cautiously in individuals who have a Hx of substance abuseoS/E: appetite suppression, insomnia, irritability, weight loss, nausea, HA, palpitations, blurred vision, dry mouth, constipation, and dizziness; BP changes, tachycardia, tremors, and irregular heart ratesDietary SupplementsoSt. John’s WortUsed for depression, pain, anxiety, insomnia, and premenstrual syndromeBelieved to modulate serotonin, dopamine, and norepinephrineRisk of developing serotonin syndrome is increased when taken with other serotonergic drugsoKavaUsed for anxiety reductionInteracts with dopaminergic transmission, inhibits the MAO-B enzyme system, and modulates GABA receptor. May also inhibit uptakeof noradrenalineUsed widely by Pacific Islanders as a social and ceremonial tranquilizing drinkRisk of severe liver injury, thrombocytopenia, leukopenia, and hearing impairment6
oValerian

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