Doses should be reduced when these drugs are used concurrently. Sudden withdrawal after prolonged use may precipitate severe tremors or seizures. For other potential problems of hypnotic drug use, see Ch. 190 and Anxiolytic and Hypnotic Drug Dependence in Ch. Many benzodiazepine derivatives have a marked hypnotic effect.
Benzodiazepines have less addictive potential than other hypnotics.
Doses that induce serious respiratory and vital center depression are considerably larger for benzodiazepines than for barbiturates and most other hypnotics. A few patients report an increase in daytime anxiety after repeated use or withdrawal. Chloral hydrate is a relatively weak but safe hypnotic. It can cause tolerance and addiction and induce hepatic drug-metabolizing enzymes. Barbiturates are not recommended as hypnotics.