The problem of insomnia becomes more relevant every year, especially for developed countries with a high level of technological and social development.

According to the conducted studies, every second patient presents to the doctor complaints about difficulties of falling asleep or unstable and superficial sleep. Therefore it is not surprising that the pharmacological market is full of a lot of hypnotic drugs, including those sold without a prescription. Of course, they to some extent help to eliminate the problem of insomnia, but at the same time, uncontrolled use causes dependence and tolerance, when the patient notices that the sleeping pills do not help as before.

The ineffectiveness of the drug for improving sleep depends largely on the type of pharmacological agents. Some of them very quickly become addictive, a gradual increase in dosage is required, sometimes even several times. For others, the appearance of tolerance is uncharacteristic; they can be used for a long time, without fear of side effects.

Why does addiction develop?

Some factors are contributing to the addiction to sleeping pills. First of all, people with a burdened psychiatric and narcological anamnesis are inclined to this: suffering from alcoholism, drug addiction, mental disorders, psychopathies. At them, achievement of a hypnotic effect is provided sometimes with the increased dosage of a hypnotic pharmaceutical preparation. Thus, patients with alcoholism have a parallel relationship between tolerance to alcohol and the use of high doses of benzodiazepines.

Women and children also tend to develop rapidly. Here, the role of the instability of mental processes and the desire to quickly achieve the desired hypnotic effect. Sometimes tolerance develops in people suffering from severe somatic pathology or taking other medications with psychotropic action (anticonvulsants, neuroleptics).

What drugs cause tolerance?

Of the most commonly prescribed, addictive may be the following drugs:

  1. Drugs of benzodiazepine series.
  2. Barbiturates.
  3. H1-histamine receptor blockers.
  4. Cyclopyrrolones.
  5. Antihistamines.


These drugs often cause that at some point after taking the medication the long-awaited sleep does not come. The reason for this – fast addiction to the drug, when you need an increase in the dose or even the frequency of reception. Most often in the pharmacy network there are: Triazolam, Estazolam, Temazepam.

Usually, when taking benzodiazepines, addiction develops within two to three weeks. However, some patients may develop tolerance if they use the drug for more than a week. During this period a person begins to notice that the medicine is not as good as before, it works, the dream becomes less prolonged. Also, attention is impaired; memory is reduced, dizziness, swaying while walking, drowsiness during the day.

It should be remembered that the characteristic sign of drug dependence is the daily intake of sleeping pills, an increase in dosage several times, an additional pill at night.

Also, drugs from this group can cause a phenomenon called ricochet insomnia. It develops if the patient uses a benzodiazepine drug for a long time and uncontrolled, gradually increasing the dose. In this case, the effectiveness of the drug is reduced, and with the cessation of its intake, insomnia develops and even more pronounced.


Representatives of this group are Phenobarbital, Ethanol-sodium. They are also capable of causing addiction and tolerance if the patient is long-term and systematically uses them as a sleeping pill. The danger of this situation is that an increase in dosage can lead to an overdose with respiratory depression.

H1-histamine receptor blockers

These medications are very often prescribed to people who have problems with sleeping. In the pharmacy network, a representative of this group, Donormil, is on sale.

As a rule, it is well tolerated, very rarely is addictive and does not require an increase in dosage. If after his admission still does not come to a calm and deep sleep, you should always consult a doctor, perhaps insomnia is caused by depression or organic pathology, in which case another treatment is needed.


The representative of this group is Zopiclone. In recent years, they are increasingly used to treat insomnia. Their advantage lies in the rapidity of the onset of pharmacological action, after them, there rarely appears tolerance, side effects, daytime sleepiness.


Such drugs as diphenhydramine can be found on the shelves of pharmacies. They are of little value and are often sold without a doctor’s prescription. An unpleasant moment after their uncontrolled reception can become tolerant to this product after a few days of use: no sleep, drowsiness during the day.

What medications are not addictive?

These drugs, in particular, include sedatives of plant origin, which normalize sleep: Persen, Novo-Passit.

A good relaxing and hypnotic effect is the herbal preparations containing valerian and motherwort. Also, doctors prescribe homoeopathic remedies, for example, Notta, Nervochel.

In recent years, most somnologists have been using Melatonin (Melaxen). It is a hormone produced by the epiphysis of the brain. It is allowed to take several months, there is no need to increase the dosage, there are almost no side effects.

According to the conducted studies also there is no getting used to Zolpidem, a drug from the group. According to the data given, his reception during the year did not cause dependence or tolerance.

How to avoid ineffectiveness of sleeping pills?

First of all, you should not buy yourself a medicine to improve sleep, even if it is advertised by acquaintances. Each specific situation requires the appointment of a certain type of medication with different effects on the formula of sleep, the time of onset of falling asleep, the half-life.

When medically treated for insomnia, experts advise adhering to the following principles:

  1. Considered the presence of the patient’s internal diseases, why there was insomnia, the type of violation of the formula of sleep.
  2. Treatment begins with herbal preparations or homeopathic remedies, if they are ineffective, pharmacological agents are prescribed.
  3. The duration of therapy with sleeping pills should not exceed four weeks, when they are taken for a longer period, the risk of addiction increases significantly.
  4. Taking sleeping pills must necessarily be combined with proper organization and hygiene of sleep.

It should be remembered that if only pharmacological agents are taken to help fall asleep, in most cases this is not enough to improve the quality of sleep.

Specialists recommend combined therapy with the use of psychotherapy, auto-training, sleep restriction techniques. It is also important to eliminate the causes of insomnia, such as depression or mental disorders, when antidepressants, anticonvulsants or antipsychotics may be effective.

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Sara T. Loving

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