Eddy Elmer: Common exogenous psychoactive depressant drugs

Ethyl Alcohol
Sleep-Inducing Agents, Sedatives, Hypnotics
Anxiolytics ("Tranquilisers" / "Minor Tranquilisers")
Neuroleptics ("Antipsychotics" / "Major Tranquilisers")
ADHD Drugs
Thymoleptics: "Antimanics" / "Mood Stabilisers"
Anticonvulsants and Antiepileptics
General Anesthetics (Major Hypnotics in Therapeutic Doses) and Anesthetic Inductors
Neuromuscular Blockers ("Muscle Relaxants")
Belladonna Drugs (Anticholinergics)
Antagonists
Withdrawal Symptom Reduction Drugs
Cessation Assistance Drugs

General Chemical Class / Type	Generic	Trade

Ethyl Alcohol
Beverage Alcohol	beer, ale, wine, champagne, whiskey, brandy, distilled spirits, vodka, liquor, liqueur
Ethanol	rubbing alcohol?
Sedative-Hypnotics: Annotations: A sedative-hypnotic is anything that makes you sleepy or puts you to sleep (but a sleep you can be awaken from, unlike general anesthesia); includes barbiturates, certain of the benzodiazepines at high doses, and neuroleptics. Given for short-term assistance with daily sleep (usually barbiturates and benzodiazepines only); before, during, and after some surgical and other medical procedures to cause sedative-hypnotic state (from which you can be awaken, unlike general anesthesia); before administration of general anesthetic in order to assist induction of general anesthesia; and for patient restraint. Given in hospital or by prescription.
Used First Historically	chloral hydrate opium paraldehyde	Noctec Paral
Barbiturates Annotations: Contraindicated for general anesthesia because the high doses needed for such anesthesia can depress breathing centres.	Long-acting: barbital phenobarbital Medium-acting: allobarbital amobarbital amobarbital-secobarbital amylobarbital butobarbital Short-acting: cyclobarbital pentobarbital quinalbarbital secobarbital Ultra-short-acting: hexobarbital methohexital thiopental	Luminal Tuinal Nembutal Seconal Sombulex Brevital Thiotone, Pentothal
Barbiturate Substitutes	chloral hydrate droperidol ethchlorvynol ethinamate (other?) glutethimide methaqualone methprylon paraldehyde	Noctec Inapsine Placidyl Valmid Doriden Sopor, Parest Quaalude, Mecquin, Mandrax Noludar Paral
Imidzopyridines	zolpidem	Ambien
Benzodiazepines Annotations: Sedative-hypnotics only in high doses.	clorazepate diazepam flunitrazepam flurazepam temazepam triazolam	Tranxene Valium Rohypnol Dalmane, Somnol Restoril Halcion
Phenothiazines and Other Neuroleptics Annotations: Propiomazine is a phenothiazine, but is not used as a neuroleptic. Phenergan is a phenothiazine, but not used as a neuroleptic because it does not do a good job of blocking dopamine receptors. It is actually an antihistamine, blocking H1 receptors.	propiomazine hydrochloride promethazine	Largon Phenergan
Other Sedatives and Hypnotics	gamma-hydroxybutyric acid (GHB) (often abused to induce euphoria and sedation) l-tryptophan (serotonin precursor)
Anxiolytics ("Tranquilisers" / "Minor Transquilisers") Annotations: An anxiolytic is anything anything that relives anxiety; includes benzodiazepines, sedative-hypnotics (including barbiturates), BuSpar, zolpidem (Ambien), neuroleptics, and other drugs. Meant to be used only on a short-term basis for acute anxiety. Longer-term treatment of anxiety is more safely and effectively accomplished with thymoleptics (antidepressants), especially the SSRIs and newer antidepressants (see Stimulants Chart). Clonidine also useful for Tourette's disorder.
Benzodiapezines Annotations: Anxiety associated with depression is responsive to some of these drugs. In high doses, some can be used as sedative-hypnotic before some surgical and other medical procedures (but patient can still be awaken, unlike general anesthesia; eg diazepam), or can be used before general anesthetic in order to help induce general anesthesia. They are short-, intermediate-, and long-acting. They also have amnestic properties (especially lorazepam).	alprazolam (short) chlordiazepoxide (long) clonazepam (intermed) clorazepate (long) diazepam (long) estrazolam (med) flunitrazepam (long; 10x stronger than diazepam) flurazepam (long) halazepam lorazepam (med) midazolam (short) oxazepam prazepam temazepam (med) triazolam (short) quazepam	Xanax Librium, Novopoxide Klonopin Tranxene, Azene Valium ProSom Rohypnol Dalmane Paxipam Ativan Versed Serax, Oxipam Centrax Restoril Halcion Doral
Barbiturates (see chart above) Annotation: Barbiturates generally no longer used for sole purpose of anxiety reduction; used for sleep, or for anxiety when sleep is also a problem.
Other: Barbiturate Substitutes	meprobamate paraldehyde	Miltown, Equanil Paral
Beta Blockers	atenolol nadolol propranolol	Tenormin Corgard Inderal, Betachron
Antihypertensives (Alpha-Agonists)	clonidine	Catapres, Dixarit
Azaspirodecanediones	buspirone	Buspar
Antihistamines Annotations: Not very potent, so infrequently prescribed. Phenergan is a phenothiazine, but not used as a neuroleptic because it does not do good job of blocking dopamine receptors. It is actually an antihistamine, blocking H1 receptors.	diphenhydramine hydroxyzine benzoate hydroxyzine pamoate promethazine	Benadryl, Gravol Atarax Vistaril Phenergan
Neuroleptics ("Antipsychotics" / "Major Tranquilisers") Annotations: Used for 1. treatment of schizophrenia (acute); 2. long-term treatment and maintenance of treatment response in schizophrenia; 3. anti-typical antipsychotics like olanzapine (Zyprexa) may be used for short-term acute treatment of manic episodes in bipolar disorder and perhaps even for longer-term maintenance treatment of bipolar disorder (the same way lithium would be used to even out mood and prevent mood swings; mechanism of action probably related to decrease of dopamine and increase of serotonin) May be used as pre- and post-op hypnotic (low potency neuroleptics can provide hypnotic state which patient can be easily aroused). In some cases, may also be used for patient restraint. Haloperidol and pimozide also useful for Tourette's disorder. Also used for severe nausea & vomiting, chemotherapy-induced nausea & vomiting and PONV (but best for chemotherapy-induced), motion sickness (only some drugs), migraine, and Ménière's disease. All neuroleptics vary in potency from low, to medium, to high.
Typical Neuroleptics (Phenothiazines and Butryophenones) Annotations: Phenergan (promethazine) is a phenothiazine, but is not used as a neuroleptic because it doesn't do a good job of blocking dopamine receptors. It is, however, used as an anti-histamine (antagonises H1 receptors) and is used for PONV, pre- and post-op sedation, and motion-sickness. Torecan (thiethylperazine) is a phenothiazine, but is it is used as an anti-emetic and not as a neuroleptic. Its mechanism of action is unknown (most likely on CTZ and directly on vomiting centre).	acetophenazine (med) chlorpromazine (lo) chlorprothixene (lo) droperidol (med) flupenthixol fluphenazine (hi) haloperidol (hi) loxapine (med) mesoridazine (lo) methotrimeprazine metoclopramide molindone (med) perphenazine (med) pimozide (hi) pipotiazine prochlorperazine (med) promazine (lo) thioridazine (lo) thiothixene (hi) triflurpromazine (lo) trifluoroperazine (hi) trimethobenzamide triupromazine (lo)	Tindal Thorazine, Largactical Taractan Inapsine Fluanxol Permitil, Prolixin Haldol Loxitane Serentil Nozinan Reglan Lidone, Moban Trilafon Orap Pipotril Compazine Sparine Mellaril Navane Sparine Stelazine Tigan Vesprin
Atypical Neuroleptics Annotations: Olanzapine is useful in treating the manic phases of bipolar disorder.	clozapine iloperidone olanzapine quetiapine risperidone sertindole ziprasidone	Clozaril Zomaril Zyprexa, Lanzac Seroquel Risperdal Serlect Geodon
ADHD Drugs Annotations: In people with ADHD, stimulants paradoxically decrease hyperactivity.
Amphetamine-Related Stimulants Useful in Treating ADHD and Depression	methylphenidate pemoline	Ritalin, Concerta Cylert
Amphetamine and Drugs Closely-Related by Chemical Composition to Amphetamine	amphetamine isomer mix dextroamphetamine dextroamphetamine sulphate	Adderall Dexedrine DextroStat
Drugs that Metabolise to Amphetamine and/or Methamphetamine	fenproporex	Captagon
Antihypertensives (Alpha-Agonists)	clonidine guanfacine	Catapres Tenex
Non-stimulant Drugs	atomoxetine	Strattera
Other	bupropion HCl (antidepressant)	Wellbutrin
Thymoleptics: "Antimanics" / "Mood Stabilisers" Annotation: Used to "even out" moods so that manic and depressive episodes do not occur in the first place. May also be used for treatment of acute manic episodes (see also antipsychotics above).
Lithium Annotation: decreases noradrenaline and increases serotonoin	lithium carbonate lithium chloride? lithium citrate	Eskalith, Lithobid, Lithonate, Lithane, Lithizine Cibalith
Non-Lithium Drugs: Miscellaneous Anticonvulsants	carbamazepine sodium divalproex valproic acid	Tegretol, Carbatrol Depakote Depakene
Thymoleptics for Depressive Phase of of Bipolar Disorder Annotations: Treating depressive phase of bipolar disorder is difficult because 1. people in bipolar disorder's depressive phases are particularly prone to suicide; 2. traditional antidepressants take up to six weeks to work. Combination drugs like Symbyax, however, can lead to relief in as little as one week.	olanzapine (Zyprexa) and fluoxetine HCL (Prozac)	Symbyax
Anticonvulsants and Antiepileptics Annotations: May also be used as thymoleptics (anti-manics & mood-stabilisers)
Primarily Anticonvulsants and Antileptics	oxcarbazepine lamotrigine tiagabine	Trileptal Lamictal Gabatril
Barbiturates	phenobarbitol primidone	Luminal Mysoline
Benzodiazepines	clonazepam	Klonopin
Succinimides	ethosuximide	Zarontin
Hydantoins	phenytoin	Dilantin
Neuroletpics (Antipsychotics/Major Tranquilisers)	various of the neuroleptics (see list above)
Miscellaneous Anticonvulsants	carbamazepine gabapentin topiramate sodium divalproex valproic acid	Tegretol, Carbatrol Neurontin Topomax Depakote Depakene
General Anesthetics (Major Hypnotics in Therapeutic Doses) and Anesthetic Inductors
Liquid (Volatile) Inhalation	chloroform diethyl ether divinyl ether ether ethyl chloride fluroxene halothane methoxyflurane trichlorethylene	Vinethene Fluomar Fluothane Penthrane
Gaseous (Non-Volatile) Inhalation	cyclopropane desflurane enflurane ethylene isoflurane nitrous oxide sevoflurane	Ethrane Ultane, Sevorane
Barbiturates Annotations: Can be used before, during, and after surgery and other medical procedures to induce sleep or sleepy state (from which you can be awaken, unlike general anesthesia), or before administration of general anesthetic in order to assist induction of general anesthesia. Contraindicated for general anesthesia because the high doses needed for such anesthesia can depress breathing centres.	Short-acting: pentobarbital Ultra-short-acting: methohexital thiopental/thiopentone	Nembutal Brevital Thiotone, Pentothal
Benzodiazepines Annotation: In high doses, some can be used before, during, and after surgery and other medical procedures to induce sleep or sleepy state (from which you can be awakened, unlike general anesthesia, eg diazepam), or can be used before general anesthetic in order to help induce anesthesia. Benzodiazepines also have amnestic properties (especially lorazepam).	diazepam midalozam	Valium Versed
Opioids Annotation: Opioids generally used only as an adjunct to anesthesia. Using opioids exclusively would be contraindicated because the high doses needed for anesthesia would depress the breathing centre (?)	fentanyl	Sublimaze
Some of the Neuroleptic-type drugs Annotation: Used before, during, and after some surgical and other medical procedures to cause sedative-hypnotic state (from which you can be awaken, unlike general anesthesia). Also used before administration of general anesthetic in order to assist induction of general anesthesia.	promethazine (not used as a neuroleptic)	Phenergan
Other Intravenous	droperidol etomidate ketamine (dissociative anesthetic) propofol	Inapsine Amidate Ketacet, Ketaril, Ketalar Diprivan
Rectal	amylene barbiturate sodium salts chloral hydrate ether in oil evipal (?) paraldehyde sodium pentothal trichlorethanol	Avertin Paral Pentothal
Neuromuscular Blockers ("Muscle Relaxants") Annotation: Usually given before and during surgery and various other medical procedures Pancuronium and vecuronium are used as emergency intubation drugs.
Depolarising Blockers	decamethonium succinyl choline	Anectine, Quelicin, Sucostrin
Non-Depolarising Blockers	atracurium cisatracurium? curare doxacurium? etomidate? gallamine metacurine mivacurium pancuronium pipecuronium rocuronium sicatracurium tubocurarine vecuronium	Atrac, Tracrium Nimbex Nuromax Amidate Mivacron Pavulon Norcuron
Belladonna Drugs (Anticholingerics) Annotation: Usually given before and during surgery and various other medical procedures, in order to reduce secretions and reflex movements.
	atropine bellafoline scopolamine
Antagonists
Alcohol Antagonist	naltrexone	ReVia, Naltrexone
Anesthetic Overdose Reversal	various of the stimulants, including amphetamines (see Stimulants Chart)
Withdrawal Symptom Reduction Drugs
Various of the Benzodiazepines (see above)	flumazeril	Mazicon
Cessation Assistance Drugs
Alcohol Aversive Annotation: Prevents alcohol metabolism.	difulsiram	Antabuse
Azaspirodecanediones	buspirone	Buspar
Strong Antiemetics Annotation: For early onset alcoholism (still experimental). Used especially for PONV and with chemotherapy.	ondansetron HCl	Zofran
Acamprosate Annotations: Reduces relapse in weaned alcoholics. Approved in Europe. FDA investigating.	acamprosate	Campral
Various of the SSRI's (see above) Annotations: For late-onset (ie low-risk, low-severity) alcoholism	see above
Benzodiazepines Annotations: Help reduce cravings	oxazepam (for controlling nicotine cravings)	Oxipam

by Eddy M. Elmer

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Clinical Group: Depressants