Miller N S, Gold M S
New York Hospital, Cornell University Medical College, White Plains.
J Fam Pract. 1989 Dec;29(6):665-70.
The quest for an ideal sedative-hypnotic drug has been fraught with failure. The goals of the perfect sedative-hypnotic drug are to: (1) produce a transient reduction in the level of consciousness for the purpose of sedation, calmness, and tranquility without lingering aftereffects; (2) produce sleep without the potential to arrest respirations and without aftereffects on sensorium and mood; and (3) produce no abuse, addiction, tolerance, or dependence. Nonetheless, clinical conditions have required the use of sedative-hypnotic drugs in spite of the inherent difficulties with them. The history of sedative-hypnotic drugs is replete with attempts to produce a safe and effective drug. The introduction of one sedative-hypnotic drug for another has been heralded by unguarded optimism and misguided claims. History has repeated itself with each new drug. Toxicities, abuse, addiction, and development of tolerance and dependence have remained in force for each drug that has appeared on the market. Only minor variations on a theme have differentiated one drug from another as the essential features have remained in force.
寻找理想的镇静催眠药物一直充满失败。理想的镇静催眠药物的目标是：（1）使意识水平短暂降低，以达到镇静、平静和安宁的效果，且无残留的后效应；（2）诱导睡眠，不具有抑制呼吸的可能性，且对感觉和情绪无后效应；（3）不产生滥用、成瘾、耐受性或依赖性。尽管如此，尽管镇静催眠药物存在固有困难，但临床情况仍需要使用它们。镇静催眠药物的历史充斥着生产安全有效药物的尝试。一种镇静催眠药物被另一种药物取代时，往往伴随着毫无防备的乐观情绪和误导性的宣称。每种新药的情况都是历史的重演。毒性、滥用、成瘾以及耐受性和依赖性的发展一直伴随着每一种上市的药物。由于基本特征一直存在，不同药物之间仅存在细微差别。
