Depressant

Distilled (concentrated) alcoholic beverages, sometimes called “spirit” or "hard liquor", roughly eight times more alcoholic than beer

An alcoholic beverage is a drink that contains alcohol (also known formally as ethanol), an anesthetic that has been used as a psychoactive drug for several millennia. Ethanol is the oldest recreational drug still used by humans. Ethanol can cause alcohol intoxication when consumed. Alcoholic beverages are divided into three general classes for taxation and regulation of production: beers, wines, and spirits (distilled beverages). They are legally consumed in most countries around the world. More than 100 countries have laws regulating their production, sale, and consumption.[2]

The most common way to measure intoxication for legal or medical purposes is through blood alcohol content (also called blood alcohol concentration or blood alcohol level). It is usually expressed as a percentage of alcohol in the blood in units of mass of alcohol per volume of blood, or mass of alcohol per mass of blood, depending on the country. For instance, in North America a blood alcohol content of "0.10" or more correctly 0.10 g/dL means that there are 0.10 g of alcohol for every dL of blood (i.e., mass per volume is used there).[3]

Barbiturates are effective in relieving the conditions that they are designed to address (insomnia, seizures). They are also commonly used for unapproved purposes, are physically addictive, and have serious potential for overdose. In the late 1950s, when many thought that the social cost of barbiturates was beginning to outweigh the medical benefits, a serious search began for a replacement drug. Most people still using barbiturates today do so in the prevention of seizures or in mild form for relief from the symptoms of migraines.

Xanax (alprazolam) 2 mg tri-score tablets

A benzodiazepine (sometimes colloquially "benzo"; often abbreviated "BZD") is a drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring. The first such drug, chlordiazepoxide (Librium), was discovered accidentally by Leo Sternbach in 1955, and made available in 1960 by Hoffmann–La Roche, which has also marketed the benzodiazepine diazepam (Valium) since 1963.

Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA_A receptor, resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties; also seen in the applied pharmacology of high doses of many shorter-acting benzodiazepines are amnesic-dissociative actions. These properties make benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures. Benzodiazepines are categorized as either short-, intermediate-, or long-acting. Short- and intermediate-acting benzodiazepines are preferred for the treatment of insomnia; longer-acting benzodiazepines are recommended for the treatment of anxiety.

In general, benzodiazepines are safe and effective in the short term, although cognitive impairments and paradoxical effects such as aggression or behavioral disinhibition occasionally occur. A minority react reverse and contrary to what would normally be expected. For example, a state of panic may worsen considerably following intake of a benzodiazepine. Long-term use is controversial due to concerns about adverse psychological and physical effects, increased questioning of effectiveness, and, because benzodiazepines are prone to cause tolerance, physical dependence, and, upon cessation of use after long-term use, a withdrawal syndrome. Due to adverse effects associated with the long-term use of benzodiazepines, withdrawal from benzodiazepines, in general, leads to improved physical and mental health. The elderly are at an increased risk of suffering from both short- and long-term adverse effects.

There is controversy concerning the safety of benzodiazepines in pregnancy. While they are not major teratogens, uncertainty remains as to whether they cause cleft palate in a small number of babies and whether neurobehavioural effects occur as a result of prenatal exposure; they are known to cause withdrawal symptoms in the newborn. Benzodiazepines can be taken in overdoses and can cause dangerous deep unconsciousness. However, they are much less toxic than their predecessors, the barbiturates, and death rarely results when a benzodiazepine is the only drug taken; however, when combined with other central nervous system depressants such as alcohol and opiates, the potential for toxicity and fatal overdose increases. Benzodiazepines are commonly misused and taken in combination with other addictive drugs. In addition, all benzodiazepines are listed in Beers List, which is significant in clinical practice.

Cannabis is often considered either in its own unique category or as a mild psychedelic.[4][5] The chemical compound tetrahydrocannabinol (THC), which is found in cannabis, has many depressant effects such as muscle relaxation, sedation, decreased alertness, and less tiredness. Contrary to the previous statement, activation of the CB1 receptor by cannabinoids causes an inhibition of GABA, the exact opposite of what central nervous system depressants do.[6]

(Pregabalin) Lyrica hard capsules

Gabapentinoids like Pregabalin and Gabapentin are depressants that bind to the auxiliary α₂δ subunit site of certain VDCCs, and thereby act as inhibitors of α₂δ subunit-containing VDCCs, lowering neurotransmitter release.[7][8][9] Gabapentinoids are GABA analogues,[10] but they do not bind to the GABA receptors, do not convert into GABA or another GABA receptor agonist in vivo, and do not directly modulate GABA transport or metabolism.[11][12] Phenibut is an exception is it also acts on the GABA B receptor.[13][14] Despite this Gabapentinoids mimic GABA activity by inhibiting neurotransmission.[15] Gabapentinoids prevent delivery of the calcium channels to the cell membrane, and disrupt interactions of α₂δ with NMDA receptors, neurexins, and thrombospondins.

Gabapentinoids have anxiolytic, anticonvulsant, antiallodynic, and antinociceptive properties.[8][16][17] They are used in epilepsy, postherpetic neuralgia, neuropathic pain associated with diabetic neuropathy, fibromyalgia, generalized anxiety disorder, and restless legs syndrome.[18][19][20][21][22][23]

Gabapentinoids are abused.[24][25][26] The FDA placed a black box warning on Neurontin (Gabapentin), and Lyrica (Pregabalin), for serious breathing problems.[27] Mixing Gabapentinoids with opioids, benzodiazepines, barbiturates or alcohol is potentially lethal.[28][29][30][31]

• Gabapentin
• Pregabalin
• Phenibut
• Mirogabalin (Japan Only)

Contrary to popular misconception, opioids are not depressants in the classical sense.[4] They do produce central nervous system depression, however, they also excite certain areas of the central nervous system. To remain true to the term 'depressant' – opioids cannot be classified as such. For opioid agonists and opium derivatives, these are classified differently. Analgesic or narcotic correctly identifies these drugs. However, they do have depressant actions nonetheless.

• Morphine
• Heroin
• Codeine
• Hydrocodone
• Oxycodone
• Methadone

• Alpha and beta blockers (Carvedilol, Propranolol, atenolol, etc.)
• Anticholinergics (Atropine, hyoscyamine, scopolamine, etc.)
• Anticonvulsants (Topiramate, carbamazepine, lamotrigine, etc.)
• Antihistamines (Diphenhydramine, doxylamine, promethazine, etc.)
• Antipsychotics (Haloperidol, chlorpromazine, clozapine, etc.)
• Gabapentinoids (Pregabalin, Gabapentin, Mirogabalin, etc.)
• Hypnotics (Zolpidem, zopiclone, chloral hydrate, eszopiclone, etc.)
• Muscle relaxants (Baclofen, phenibut, carisoprodol, cyclobenzaprine, etc.)
• Sedatives (Gamma-hydroxybutyrate, etc.)