As stated in the press release by the pharmacist Sigita Korbutaitė from “Gintarinė vaistinė,” some patients still underestimate sedatives or sleeping pills, especially if they were once prescribed by a doctor.
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“We notice that people sometimes consider these drugs a harmless aid. Some patients think that if the medicine was prescribed by a doctor, it is automatically safe and do not consider how long it can be used. Especially older patients, who were first prescribed sleeping pills 10 or more years ago, often can no longer fall asleep without their help. The body gets used to the effect, tolerance develops, and stopping the medicine becomes increasingly difficult,” says the pharmacist.
When is medicine help, and when is it masking problems?
Psychiatrist Laura Andriuškevičienė from the “Lotus Medica” clinic emphasizes that sedatives are not inherently bad. In certain situations, they may be necessary, but this should be part of a treatment plan, not a long-term way to silence anxiety or insomnia.
“In cases of acute anxiety disorder, panic attack, or situational anxiety due to a personally significant, traumatic situation, sedatives may be necessary. If anxiety arises suddenly, disrupts daily functioning, and prevents performing usual duties, it is important to stop the panic attack or intense anxiety episode in time. This can help prevent the progression of the disorder and give the person strength to seek further help,” explains the psychiatrist.
According to her, the duration of use depends on the person’s condition, symptom intensity, previous mental health disorders, history of addictions, and cooperation with the doctor.
“It is important to understand that the medicine must have a clear purpose, duration of use, and be combined with other means of support,” emphasizes L. Andriuškevičienė.
Signs of addiction resemble anxiety symptoms
The line between prescribed treatment and psychological attachment to the medicine can be unnoticed. The psychiatrist says that signs of addiction often resemble the same symptoms for which the person initially sought help.
“After a few weeks of regular use, persistent thoughts about having the medicine may appear, strong anxiety at the thought of running out of the medication, fear that usual activities cannot continue without it. Another important sign is using the medicine not according to the doctor’s recommendations or very strong psychological discomfort when trying to quit,” she lists.
Pharmacist S. Korbutaitė points out that even when taking medicine as directed, it is important to assess daily activities and other health risks. Benzodiazepines can affect reaction, coordination, memory, and alertness.
“This is especially relevant for people who drive, work with machinery, or already take other central nervous system-acting drugs. For older patients, these medicines can increase the risk of falls, which is dangerous for those living alone or with mobility difficulties. Caution should also be exercised by those with lung diseases, sleep apnea, liver function disorders, or a history of addictions,” emphasizes the pharmacist.
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The most dangerous combination – with alcohol
One of the most common mistakes is thinking that a small amount of alcohol while taking sedatives or sleeping pills is not dangerous.
“Alcohol together with sedatives or sleeping pills can affect breathing, reaction, and alertness. A person may become drowsy, coordination and consciousness may be impaired, and in severe cases – breathing as well. There is no safe amount of alcohol when taking such medicines, as even a small amount can significantly enhance the effect of the medicine,” warns S. Korbutaitė.
There are also situations where interactions with other medicines are not considered. One patient, who started taking a doctor-prescribed medicine for insomnia, woke up only at noon the next day and was surprised that the effect was so strong.
“It turned out that she was taking opioid painkillers as needed, and their suppressive effect was enhanced together with the sleeping pills. Such situations remind why it is important to inform the pharmacy not only about newly prescribed medicine but also about all other medications being taken,” notes the pharmacist.
Stopping suddenly is dangerous
If sedatives or sleeping pills have been used for a long time, they should not be stopped independently and suddenly. The psychiatrist first advises assessing whether the person has already developed dependence on the medicine, whether they want to change the treatment direction, and improve emotional health by other means.
“Often a safe way to reduce regular sedative use is to decrease the active substance by a quarter every four days, but this must be decided with a doctor. It is important to follow the regimen of other daily medications and receive psychological support. The doctor can help manage withdrawal symptoms if they occur and offer an anxiety treatment plan with non-addictive medicines and lifestyle measures,” says L. Andriuškevičienė.
Sudden discontinuation can provoke insomnia, increased anxiety, tremors, sweating, and in more severe cases – seizures. Therefore, one of the most important steps is not to experiment with doses.
S. Korbutaitė adds that when insomnia or anxiety recurs, it is first worth reviewing daily habits – maintaining a regular sleep schedule, limiting screens in the evening, avoiding caffeine 6–8 hours before sleep, and being physically active during the day.
“For some people, breathing exercises or meditation help. It is possible to consult about melatonin, herbal preparations with lavender, valerian, lemon balm, or passionflower, magnesium, but in serious problems, these measures may not help,” says the pharmacist.
