If earlier the treatment of depressive ...

Earlier in the treatment of depressive disorders have traditionally used a combination therapy with antidepressants and tranquilizers, including hypnotics, it is currently in practice by implementing the newest antidepressants (mirtazapine, Mianserin), with properties to improve sleep and do not require additional destination of tranquilizers, hypnotics . In cases of iatrogenic dissomnii, of course, need to review the dose of the drugs, potentially responsible for the violation of sleep mode useful for maneuvering the medication during the day, etc., that is, it is desirable to do everything possible to do without the extra assignments of psychotropic drugs. In appointing the older drugs, including with the soporific effect, doses should be reduced by half in comparison with those used in young and middle age, and courses of therapy should not exceed the required duration, interrupted time when the effect or be replaced by medication in the unsteady mode. The choice of drug for the treatment of sleep disorders for medical treatment of sleep disorders in elderly patients and the elderly are now avoided the first-generation hypnotics (ie, barbiturates) because of the high risk of respiratory depression during sleep. The most widely used in treating secondary sleep disorders are derivatives of benzodiazepine hypnotics, or second generation. At their appointment should be based on the prevailing characteristics of sleep disorders and information on the pharmacokinetic properties of drugs, especially when they were half-life of the organism. Depending on this, drugs are divided into three groups: short-acting drugs (up to 6 hours); drugs mean duration of action (up to 12 hours), long-acting drugs (more than 12 hours). Short-acting drugs (midazolam, triazolam, flurazepam) are appointed at the expressed difficulty falling asleep. Often, to facilitate the use of tranquilizers, sleep without sleeping pills (oksazepam, tofisopam, Temazepam, diazepam), which remove the feeling of inner tension and mild anxiety, thus facilitating sleep through sedation. Leaving no drowsiness, they can still be a cause of daily muscular relaxation. Benzodiazepine hypnotics mean duration of action (bromdigidrohlorfenil benzodiazepine, Temazepam) are shown to improve sleep, achieve greater depth of sleep, frequent nocturnal awakenings elimination. Traces of reaction after their admission often in the form of morning sleepiness miorelaxation. Benzodiazepine drugs with long half-life used in patients with impaired sleep, superficial sleep and early awakening. These drugs significantly improve the performance of sleep, but most leave behind a trace of sleepiness during the day, thereby increasing the risk of adverse effects with prolonged use. In geriatric practice in the appointment of benzodiazepine drugs in patients with sleep disorders have to maneuver between the efficacy of a long-acting with the risk of their accumulation in the senile body and safer in this regard, drugs with short half-life, but with a significantly greater incidence of sleep disorders in their cancellation.