Doctors and nurses often administer sedation to patients in order to dull the patient's anxiety related to painful or anxiety-provoking procedures.A sedative is a substance that depresses the central nervous system (CNS), resulting in calmness, relaxation, reduction of anxiety, sleepiness, slowed breathing, slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes.

Sedatives may be referred to as tranquilizers, depressants, anxiolytics, soporifics, sleeping pills, downers, or sedative-hypnotics. At high doses or when they are abused, many of these drugs can cause unconsciousness (hypnotic) and death.

All sedatives can cause physical and psychological dependence when taken regularly over a period of time, even at therapeutic doses. When dependent users decrease or end use suddenly, they will exhibit withdrawal symptoms ranging from restlessness, insomnia and anxiety to convulsions and death. When users become psychologically dependent, they feel as if they need the drug to function although there is no biological dependent.

A new medication recently approved for insomnia treatment does not appear to have any characteristics that might lead to dependence or abuse, researchers report earlier.

The sleep aid, Rozerem (known generically as ramelteon), acts in the same way as melatonin, the natural hormone that has been linked to healthy sleep in numerous studies.

Because of concerns about mental confusion and becoming dependent, "physicians and patients alike are often wary of using sleeping medications," Dr. Roland R. Griffiths told Reuters Health. "Our study found no evidence of potential for abuse or impairing effects of ramelteon up to 20 times the recommended therapeutic dose."

Griffiths and colleagues at the Johns Hopkins University School of Medicine, Baltimore, Maryland conducted a study involving 14 patients with a history of sedative abuse, over a period of about 18 days in a residential research facility.

On different days and in random order, the participants received three different doses of ramelteon, three different doses of the sedative triazolam, or an inactive placebo pill.

Ramelteon had no significant effects on cognition or movement control and no apparent potential for abuse, the team reports in the Archives of General Psychiatry. In fact, 11 of the subjects thought that ramelteon at its highest dose was actually a placebo.

Conversely, subjects and observers agreed that triazolam had a wide range of dose-related effects on motor and cognitive performance.

"Ramelteon represents a useful alternative to existing insomnia medications that could have broad appeal to patients who are otherwise reluctant to use such compounds," Griffiths concluded.

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