Hypnotics and behavior.

Evaluation of the effects of hypnotics on waking behavior has primarily focused on two issues: (1) how these drugs affect performance the day after a nightly dose; and (2) how they affect memory processes, with special emphasis on anterograde amnesia. In terms of the relations between pharmacologic properties and residual effects, three conclusions can be drawn. First, dose is a major determinant of the presence or absence of morning effects. Every drug studied to date, if given in high enough dose, has produced morning performance decrements. Second, the longer-acting a compound, the more likely it is that a performance decrement will be observed. Finally, some data suggest that behavioral tolerance to the residual effects of hypnotics develops. The observation that benzodiazepines produce amnesia emerged from reports of their clinical use as presurgery medications. Although the initial reports involved intravenous diazepam and were anecdotal in nature, subsequent studies have demonstrated that amnesia is a characteristic of all the benzodiazepines, with the magnitude of the effect being a function of route of administration, dose, and the pharmacokinetics of the particular drug.