A wide variety of sedative-hypnotic products that do not require a prescription are available. Most of these over-the-counter products have antihistamines, such as pyrilamine, diphenhydramine, or promethazine, as the active ingredient. In most cases, the dose of the active ingredient is low and the preparations are safe.
Ethanol (ethyl alcohol) has central nervous system depressant properties and is widely used to relieve anxiety and produce sedation. Although some medical practitioners occasionally prescribe an alcoholic beverage for relieving minor anxiety and inducing sleep, individuals frequently self-medicate with ethanol. Many individuals who abuse alcohol may have started using it to relieve symptoms of central nervous system disorders, such as anxiety and depression.
Ethanol produces central nervous system depression over a wide range of doses. Its effects are additive or sometimes more than additive with other central nervous system depressants. Symptoms often associated with acute alcohol intoxication include increase in self-confidence, loss of inhibitions, euphoria, and loss of judgment. With increasing doses motor and intellectual impairment become prominent. Chronic abuse of ethanol leads to severe liver impairment (see Chapter 35).
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