What Are Sedatives?

Sedatives are medications or substances that calm or slow down nerve and brain activity. You may have heard them referred to as central nervous system (CNS) depressants, tranquilizers, or downers. Hypnotics, antianxiety medications, and anxiolytics are also considered sedatives.

Prescription sedatives are used to help people sleep, feel less anxious, or relax during a medical procedure — among other uses. Other medications, such as opioids, also have some sedating effects, but they aren’t used primarily for these effects.

Keep reading to learn more about sedatives, including how they work in the body and ways to prevent sedative misuse.

What are sedatives?

Sedatives are substances that calm your brain and body. They do so by slowing down your CNS, or the brain and spinal cord. Most work by increasing the activity of a neurotransmitter (chemical messenger) called gamma-aminobutyric acid (GABA). This reduces nerve activity, promoting a calming and relaxing effect. 

Many sedatives affect GABA. But sedatives can differ in several ways, including:

• What they’re prescribed for

• How they’re given (i.e., orally, through a muscle, or through a vein)

• The intensity of their effects

• How long their effects last

• Their potential for misuse

EXPERT PICKS: WHAT TO READ NEXT

• Benzodiazepine side effects: Learn about the risks associated with these common sedative medications.

• What to know about “Z-drugs”: Read about Z-drugs like zolpidem (Ambien), including their benefits and risks.

• Sedative use disorder: Learn about this substance use disorder and how you can identify signs of misusing a sedative medication.

If you need a sedative, a healthcare professional will help determine the sedative that is best for you and your specific medical needs.

What type of prescription medications are sedatives?

Three groups of medications are classically considered sedatives:

• Benzodiazepines

• Barbiturates

• “Z-drugs” — also known as selective benzodiazepine receptor subtype agonists, GABA agonists, or nonbenzodiazepine hypnotics

The term “sedative” is also more broadly used to refer to a wide variety of other medications that help people feel relaxed and sleepy. So you may hear this term when discussing other substances, such as procedural sedation agents (i.e., propofol), opioids, alcohol, and antipsychotics.

Below, we’ll cover information about the three groups of traditional sedative medications. All three groups are considered controlled substances because they can cause dependence and misuse. They also have limits on how they’re prescribed and refilled.

1. Benzodiazepines

The most frequently prescribed sedatives are benzodiazepines (also called “benzos”). They treat a wide range of health conditions, such as:

• Anxiety

• Panic attacks

• Insomnia (trouble sleeping)

• Alcohol withdrawal

• Status epilepticus (a long-acting seizure or multiple, back-to-back seizures)

• Muscle spasms

Some of the most commonly prescribed benzodiazepines include:

• Alprazolam (Xanax, Xanax XR)

• Clonazepam (Klonopin)

• Diazepam (Valium, Valtoco, Diazepam Intensol, Diastat)

• Lorazepam (Ativan, Loreev XR, Lorazepam Intensol)

Benzodiazepines have their own individual FDA-approved uses, though benzodiazepines are often used off-label as well.

Keep in mind that benzodiazepines are generally recommended for short-term or intermittent use. Taking them long term increases the risk of dependence and misuse. And it’s important to take them exactly as prescribed. Taking too much, or combining them with other sedative medications, especially opioids, increases the risk of overdose. Benzodiazepines and opioids carry a boxed warning about the risk of overdose with the combination.

2. Barbiturates

Barbiturates are medications used to treat seizures, trouble sleeping, and tension headaches. They can also provide sedation.

Some common barbiturates are:

• Phenobarbital (Sezaby)

• Pentobarbital

• Butalbital, which is only found in combination medications such as acetaminophen / butalbital (Allzital, Butapap), butalbital / acetaminophen / caffeine / codeine (Fioricet with codeine), and butalbital / aspirin / caffeine

Some barbiturates may also be prescribed off-label. For example, healthcare professionals may use phenobarbital in the treatment of benzodiazepine or alcohol withdrawal. 

Like benzodiazepines, it’s important to take barbiturates exactly as your healthcare professional prescribes. This is because they carry a risk for dependence and misuse. Taking these medications differently than prescribed — or with other substances that can be sedating, like alcohol or opioids — may cause slowed breathing and can even be life-threatening.

3. Z-drugs

Z-drugs are a group of medications used to treat insomnia. They’re generally meant for short-term use. These sleep medications have a different structure than benzodiazepines, but they produce similar effects in the body. Some examples include:

• Zolpidem (Ambien, Ambien CR, Edluar)

• Eszopiclone (Lunesta)

• Zaleplon (Sonata)

Like other sedatives, Z-drugs are controlled substances and can lead to dependence and misuse. They can also cause overdose — especially when combined with other sedative substances. They have a boxed warning about their risk of causing complex sleep behaviors, such as sleepwalking and driving while asleep. These can all be dangerous.

Z-drugs are only recommended for short-term use. But exactly how long that means isn’t clearly defined. So talk to your healthcare professional about how long you should take the medication.

What effects do sedatives have on the body?

Sedatives may cause effects such as:

• Drowsiness

• Inability to focus

• Dizziness

• Short-term memory issues

• Behavior changes

• Withdrawal symptoms if stopped abruptly

Some of these effects are what make sedatives useful. For example, if you’re taking a sedative to help you sleep, you want it to cause drowsiness. But other effects may be undesirable. It’s important to learn how a sedative affects you before doing activities that require focus, like driving.

If you take too much, or if you combine sedatives, more serious risks can occur, including:

• Poor coordination and falls

• Confusion

• Hallucinations

• Worsening mental health symptoms, like aggression or delusions

• Slowed breathing

• Overdose

• Coma

When used as prescribed for a short period of time, sedative medications are typically safe and effective. But taking too much, or combining multiple sedative medications or substances, can be dangerous. Be sure your healthcare team knows about all of the medications you are taking and that you only take sedatives as prescribed to lower these risks.

How do you stop taking sedatives?

Most sedatives are intended for short-term use. If you take a sedative for several weeks or longer, you’re more likely to develop a physical dependence to them. This can happen even if you take your sedative exactly as prescribed. 

If you develop a dependence to a medication, you may feel ill and experience withdrawal symptoms if you don’t take it (like if you miss a dose). Sedative withdrawal symptoms depend on the medication you’re taking.

For example, benzodiazepine withdrawal can cause a wide variety of symptoms, ranging from mild to severe. Examples include:

• Nausea

• Diarrhea

• Anxiety and restlessness

• Trouble sleeping

• Panic attacks

• Depression

• Shakiness

• Seizures

Similar symptoms may be seen with Z-drug withdrawal. And barbiturate withdrawal is considered to be similar to alcohol withdrawal, with a serious concern for seizures.

Withdrawal-related concerns are why it’s not a good idea to stop taking a sedative suddenly. If you’re interested in stopping treatment, reach out to your prescriber. They can help you decide how to proceed so that you can stop taking your sedative safely.

What is sedative misuse?

Misuse is taking a medication in any way that’s different from how it’s prescribed. So taking sedatives that haven't been prescribed to you is considered misuse. And using prescription sedatives differently than how they’re prescribed is also misuse.

Misusing sedatives makes you more likely to develop a sedative use disorder, a type of substance use disorder (SUD). A SUD is a medical condition where a person continues to take a substance despite experiencing significant problems related to using that substance.

How does sedative misuse happen?

Sedatives can make you feel calm, relaxed, and happy. These rewarding feelings may encourage some people to take more of these medications than they’re prescribed. Also, if someone develops a tolerance and physical dependence to their medication, they may increase the amount they take on their own to prevent withdrawal symptoms.

Sedative misuse can be dangerous. So it’s important to be honest with your prescriber about how you’re using sedatives and educate yourself on the risks of misuse.

What are signs of sedative use disorder?

Sedative use disorder is a complex condition. Some people may be more at risk of developing it than others.

A person with sedative use disorder may:

• Spend a lot of time, effort, and/or money obtaining or taking sedatives

• Have cravings for sedatives when none are available

• Give up other interests and activities 

• Have increased conflict with loved ones

• Struggle to maintain responsibilities at home, work, and/or school

• Keep taking sedatives despite risks to their mental or physical health

• Need larger doses to achieve the desired effects (i.e., develop a tolerance)

• Experience withdrawal symptoms when no sedatives are available

Sedative use disorder is diagnosed by a medical professional. Before making a diagnosis, a medical professional will evaluate a person’s sedative use by asking them questions about how they’ve been using sedatives, how much they take and for how long, and how their life has been impacted. They may also recommend a physical exam, urine tests, and/or blood tests.

Resources for sedative use disorder

No one has to address sedative use disorder alone. If you think you’re exhibiting signs of this SUD, reach out to a healthcare professional immediately. If necessary, they can refer you to a specialist for further care. In some cases, you may need to start treatment with a medical detox, but you shouldn’t do this without guidance from a healthcare professional. 

Alternatively, the Substance Abuse and Mental Health Services Administration (SAMHSA) is a government organization that connects people to treatment for SUDs. Their Behavioral Health Treatment Service Locator can help you find a SUD treatment facility near you. You can also call SAMHSA’s National Helpline at 1-800-662-4357.

Common options for SUD treatment include therapy, support groups, and medications to manage withdrawal symptoms. You may benefit from a combination of two, or all three, of these options.

Why trust our experts?

Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Bailey E. Eason, PharmD, MS, BCPS

Bailey Eason has been licensed for 6 years and has held licenses in three states (North Carolina, Virginia, and Illinois). She has held positions as a health-system pharmacy administration resident, operating room pharmacy manager, pharmacy manager of clinical operations: surgery, neurology and controlled substances, and most recently as program director  of drug diversion for a large academic health system.

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If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.