Editing Hypnotic (section)

==History==
[[File:A corrupt old man tries to seduce a woman by urging Wellcome L0034228.jpg|thumb|''Le Vieux [[seducer|Séducteur]]'' by {{Interlanguage link multi|Charles Motte|fr}}.<br />(A corrupt old man tries to seduce a woman by urging her to take a hypnotic draught in her drink)]]

'''Hypnotica''' was a class of somniferous drugs and substances tested in medicine of the 1890s and later. These include [[Ethyl carbamate|urethan]], [[1,1-Diethoxyethane|acetal]], [[methylal]], [[sulfonal]], [[paraldehyde]], [[tert-Amyl alcohol|amylenhydrate]], [[Acetophenone|hypnon]], chloralurethan, ohloralamid, or chloralimid.<ref>Pacific Record of Medicine and Surgery - Volume 5 - Page 36 1890</ref>

Research about using medications to treat insomnia evolved throughout the last half of the 20th century. Treatment for insomnia in psychiatry dates back to 1869, when [[chloral hydrate]] was first used as a soporific.<ref name="isbn0-19-517668-5">{{cite book |title=A Historical Dictionary of Psychiatry |vauthors=Shorter E |publisher=Oxford University Press |year=2005 |isbn=978-0-19-517668-1 |pages=41–2 |chapter=Benzodiazepines |access-date=2014-02-06 |chapter-url=https://books.google.com/books?id=M49pEDoEpl0C&pg=PA41}}</ref> [[Barbiturate]]s emerged as the first class of drugs in the early 1900s,<ref name="rzepa">{{cite web |title=Barbiturates |url=http://www.ch.ic.ac.uk/rzepa/mim/drugs/html/barbiturate_text.htm |url-status=dead |archive-url=https://web.archive.org/web/20071107090620/http://www.ch.ic.ac.uk/rzepa/mim/drugs/html/barbiturate_text.htm |archive-date=2007-11-07 |access-date=2007-10-31}}</ref> after which chemical substitution allowed derivative compounds. Although they were the best drug family at the time (with less toxicity and fewer side effects), they were dangerous in [[drug overdose|overdose]] and tended to cause physical and psychological dependence.<ref>{{cite journal |vauthors=Whitlock FA |date=June 1975 |title=Suicide in Brisbane, 1956 to 1973: the drug-death epidemic |journal=The Medical Journal of Australia |volume=1 |issue=24 |pages=737–743 |doi=10.5694/j.1326-5377.1975.tb111781.x |pmid=239307 |s2cid=28983030}}</ref><ref>{{cite journal |vauthors=Johns MW |year=1975 |title=Sleep and hypnotic drugs |journal=Drugs |volume=9 |issue=6 |pages=448–478 |doi=10.2165/00003495-197509060-00004 |pmid=238826 |s2cid=38775294}}</ref><ref>{{cite journal |vauthors=Jufe GS |date=July–August 2007 |title=[New hypnotics: perspectives from sleep physiology] |journal=Vertex |volume=18 |issue=74 |pages=294–299 |pmid=18265473}}</ref>

During the 1970s, [[quinazolinone]]s<ref>{{Cite journal |vauthors=Voegtle MM, Marzinzik AL |date=July 2004 |title=Synthetic Approaches Towards Quinazolines, Quinazolinones and Quinazolinediones on Solid Phase |journal=QSAR & Combinatorial Science |volume=23 |issue=6 |pages=440–459 |doi=10.1002/qsar.200420018 |issn=1611-020X}}</ref> and [[benzodiazepine]]s were introduced as safer alternatives to replace barbiturates; by the late 1970s, benzodiazepines emerged as the safer drug.<ref name="isbn0-19-517668-5" />

Benzodiazepines are not without their drawbacks; [[substance dependence]] is possible, and deaths from overdoses sometimes occur, especially in combination with [[alcohol (drug)|alcohol]] or other [[depressant]]s. Questions have been raised as to whether they disturb sleep architecture.<ref name="pmid15783240">{{cite journal |vauthors=Barbera J, Shapiro C |year=2005 |title=Benefit-risk assessment of zaleplon in the treatment of insomnia |journal=Drug Safety |volume=28 |issue=4 |pages=301–318 |doi=10.2165/00002018-200528040-00003 |pmid=15783240 |s2cid=24222535}}</ref>

[[Nonbenzodiazepine]]s are the most recent development (1990s–present). Although it is clear that they are less toxic than barbiturates, their predecessors, comparative efficacy over benzodiazepines has not been established. Such efficacy is hard to determine without [[longitudinal studies]]. However, some psychiatrists recommend these drugs, citing research suggesting they are equally potent with less potential for abuse.<ref name="pmid9640488a" />

Other sleep remedies that may be considered "sedative–hypnotics" exist; psychiatrists will sometimes prescribe medicines [[off-label]] if they have sedating effects. Examples of these include [[mirtazapine]] (an antidepressant), [[clonidine]] (an [[antihypertensive]] medication), [[quetiapine]] (an antipsychotic), and [[over-the-counter]] allergy and [[antiemetic]] medications [[doxylamine]] and [[diphenhydramine]]. Off-label sleep remedies are particularly useful when first-line treatment is unsuccessful or deemed unsafe (as in patients with a history of [[substance use disorder]]s).{{Citation needed|date=March 2025}}