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A. Temporary use (less than 1 month) of short-acting benzodiazepines is especially helpful when there is an identifiable precipitant (eg, death of a loved one).

B. Zolpidem (Ambien) and zaleplon (Sonata) have the advantage of achieving hypnotic effects with less tolerance and less daytime sedation.

C. The safety profile of these benzodiazepines and benzodiazepine receptor agonists is good; lethal overdose is rare, except when benzodiazepines are taken with alcohol.

D. Zolpidem (Ambien) is a benzodiazepine agonist with a short elimination half-life that is effective in inducing sleep onset and promoting sleep maintenance. Zolpidem is associated with greater residual impairment in memory and psychomotor performance than zaleplon.

E. Zaleplon (Sonata) is a benzodiazepine receptor agonist that is rapidly absorbed (TMAX = 1 hour) and has a short elimination half-life of 1 hour. Zaleplon does not impair memory or psychomotor functioning at as early as 2 hours after administration, or on morning awakening. Zaleplon does not cause residual impairment when the drug is given in the middle of the night. It can be used at bedtime or after the patient has tried to fall asleep naturally.

F. Benzodiazepines with long half-lives, such as flurazepam (Dalmane), may be effective in promoting sleep onset and sustaining sleep. These drugs may have effects that extend beyond the desired sleep period, resulting in daytime sedation or functional impairment.

G. Sedating antidepressants are sometimes used as an alternative to benzodiazepines or benzodiazepine receptor agonists. Amitriptyline (Elavil), 25-50 mg at bedtime, or trazodone (Desyrel), 50-100 mg, are common choices.

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Do Not Panic

Do Not Panic

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.

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