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7. Sleep disorders

Hypnotics and sedatives (for anxiolytics see section 3.1)

 Hypnotics and sedatives  Preparations Comments

Hypnotics should be avoided in the elderly as they are at increased risk of becoming ataxic and confused leading to falls and injury. When hypnotics are used in the elderly lower starting doses should be used as elimination half life is significantly increased in this group and can lead to accumulation.


192mg capsules

For use in the elderly. Not for alcohol withdrawal.


2mg MR tablets (Circadin ) 

1mg/ml suspension (Ascomel)                                                

Approved for use in neurodevelopmental disorders in patients under the age of 18 years. To be initiated by a specialist team (CAMHs). Prescribing can be transferred to primary care only if specified criteria are met. (See prescribing support document). The listed preparations are not licensed for this indication.

NOT approved for other indications.

Promethazine hydrochloride

10mg and 25mg tablets 

25mg/5ml oral liquid    

25mg/ml injection

Clinically significant anticholinergic side-effects.

Time to onset of action 1-2 hours. Long duration of action (half life 16 -19 hours)

Injection for HPFT prescribing only



10mg and 20mg tablets               

10mg/5ml oral solution

Time to onset of action: 30 to 60 mins.        

Medium duration of action (half life 8 – 10 hours)     

Treated as full controlled drug within HPFT.



3.75mg and 7.5mg tablets

Time to onset: 15 to 30mins of action.     

Short duration of action (half life 3.5 - 6 hours)




5mg and 10mg tablets

Time to onset of action: 7 to 27 mins

Short duration of action (half life 2.5 hours)


Continue to 8.Substance dependence


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