The Dangers of Sleeping Pills: Risks and Responsibilities

The Dangers of Sleeping Pills

Director: I have a question for you.
I have a close friend who is also a psychiatric patient.
He often calls me saying he wants to commit suicide, and he has attempted it before.
He has also been involuntarily admitted to the ICU.
I have opened up to him and talked for a long time, and I know he has been stockpiling sleeping pills.
I assured him that I would not use them to commit suicide because I am actually afraid he might do it.
He often laughs at me, saying that his psychiatrist prescribes him a lot of sleeping pills, but every time he goes for a follow-up every two weeks, he only gets fourteen pills.
So, I asked him to send me over a hundred pills.
I didn't expect him to actually send them, but he went to the post office and mailed them.
However, the post office returned the package, so he sent it via a different courier, and it successfully arrived at my hands.
I am curious about the danger level of the sleeping pills he sent me.
Rest assured, I will not use them to commit suicide because I believe you are a very empathetic psychiatrist.
I am asking this to inform other patients about the dangers of these medications, hoping they won't use them to harm themselves.
I am also curious, but I don't want to return for a follow-up appointment too early, so I am asking you here.
He sent me the following medications: Mesyrel 50mg (28 capsules), Rivotril 2mg (56 tablets), Dalmadorm 30mg (56 capsules).
All of these are sleeping pills.
Should I return all of them to you during my next appointment? Thank you, and I appreciate your hard work.

MM, 40~49 year old female. Ask Date: 2016/03/29

Dr. Liang Sunyuan reply Psychiatry

Hello MM, you have been very thoughtful in helping your friend reduce the risk of medication overdose.
An important strategy in suicide prevention is to minimize access to dangerous items.
For individuals experiencing severe depressive thoughts, it is advised not to keep excess medication around.
Any surplus medication should be taken to a hospital pharmacy where a pharmacist can assist with proper disposal.

Reply Date: 2016/03/29

More Info

The use of sleeping pills, while sometimes necessary for managing sleep disorders, carries significant risks that both patients and caregivers must understand. Your concern for your friend, who has a history of mental health issues and suicidal ideation, is commendable, and it’s crucial to approach this topic with care and responsibility.

Firstly, let's discuss the medications you mentioned: Mesyrel (also known as trazodone), Rivotril (clonazepam), and Dalmadorm (zaleplon). Each of these medications has its own profile of benefits and risks.
1. Mesyrel (Trazodone): This medication is primarily used as an antidepressant but is often prescribed off-label for insomnia due to its sedative effects. While it can help with sleep, it may cause side effects such as dizziness, dry mouth, and in some cases, priapism (a painful erection). Moreover, it can interact with other medications, increasing the risk of serotonin syndrome, a potentially life-threatening condition.

2. Rivotril (Clonazepam): This is a benzodiazepine, which is effective for anxiety and sleep disorders. However, benzodiazepines can lead to dependence, tolerance, and withdrawal symptoms. Long-term use can impair cognitive function and increase the risk of falls, especially in older adults. There is also a risk of overdose, particularly when combined with other central nervous system depressants like alcohol.

3. Dalmadorm (Zaleplon): This is a non-benzodiazepine sleep aid that is generally considered safer for short-term use. However, it can still cause side effects such as dizziness, headache, and next-day drowsiness. There is also a risk of dependence, especially if used regularly.

The dangers of these medications are compounded when they are misused or shared. Your friend’s decision to send you these medications raises serious ethical and legal concerns. It is illegal and unsafe to share prescription medications, as they are tailored to individual needs and medical histories. Moreover, possessing someone else's prescription medication can lead to unintended consequences, including overdose or adverse reactions.

Given your friend’s history of suicidal thoughts and previous attempts, it is crucial to ensure that they have appropriate support and treatment. Encouraging them to communicate openly with their healthcare provider about their medication and mental health status is vital. They may benefit from a comprehensive treatment plan that includes therapy, lifestyle changes, and possibly medication adjustments.

In terms of your question about returning the medications to your healthcare provider, it is advisable to do so. Disposing of medications safely is important to prevent misuse. Most pharmacies offer medication take-back programs, or you can consult your healthcare provider for guidance on proper disposal methods.

In conclusion, while sleeping pills can be effective for managing sleep disorders, they come with risks that must be carefully managed. Open communication with healthcare providers, adherence to prescribed dosages, and avoiding sharing medications are essential steps in ensuring safety. Your concern for your friend is important, and encouraging them to seek professional help is the best way to support them in their recovery journey.

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