CNS Depression: Symptoms and Treatment

Date: Dec-22-2016 Central nervous system depression refers to a condition where neurological function is decreased. It can result from substance overdoses, poisoning, or other medical conditions.

Central nervous system (CNS) depression most commonly results from a misuse of substances that slow brain activity. These substances are called CNS depressants.

Certain doses of these CNS depressants can be therapeutic, but at high doses they may reduce the activity of the nervous system to dangerously low levels.

Symptoms can vary widely from mild disorientation to death.

Contents of this article:

How common is CNS depression?

What is CNS depression?

Symptoms of CNS depression

The central nervous system and CNS depressants

Diagnosis and treatment

How common is CNS depression?

Relatively little is known about the prevalence of CNS depression or overdose because it has varying causes and symptoms.

Current statistics show that CNS depression or overdose is among the most prevalent causes of poisoning in many developed countries, including the United States and Canada.

The National Institute for Health (NIH) note that CNS depressant and opioid overdose or misuse is increasing in the U.S.

Data collected from 2002 to 2012 showed a 72 percent increase in opioid-related hospitalizations.

The Centers for Disease Control and Prevention (CDC) note that prescription painkiller overdose rates in American women increased 400 percent between 1999 and 2010.

What is CNS depression?

Some recreational drugs may cause CNS depression.

Several substances can depress the CNS, ranging from anti-anxiety and sleep medications to recreational drugs such as heroin. Alcohol, benzodiazepines, and opioids are among the main offenders for causing CNS depression.

CNS depression can also result from nondrug-related causes such as brain trauma due to severe injury, stroke, infection, tumor, or aneurysm. Other medical conditions that increase the risk of developing the condition include kidney, lung, heart and liver disease, diabetes, and thyroid disorders.

There are still very few studies on the long-term effects of CNS depression.

Symptoms of CNS depression

Symptoms of CNS depression or depressant overdose range from a loss of coordination to unresponsiveness. The symptoms will vary depending on the dosage taken, the size of the individual, and their medical history. The signs and symptoms will also vary depending on the types of substances involved.

Severe cases of CNS depression can lead to delirium, coma, and death. According to Mothers Against Prescription Drug Abuse (MAPDA), opioids are responsible for most overdose deaths.

Mild symptoms of CNS depression include:

Lack of coordination

Muscle weakness

Lethargy

Dizziness

Disorientation

Impaired spatial sense

Slurred speech or stutter

Slight shortness of breath or shallow breathing

Slightly reduced heart rate

Constipation

Dry mouth

Restlessness and agitation

Euphoria

Blurred, altered, or double vision

Severe CNS depression symptoms include:

Reduced heart rate

Reduced breathing rate, at less than 10 breaths per minute

Extreme confusion or memory loss

Nausea and vomiting

Poor judgement

Blue lips or fingertips

Irritability and aggressiveness

Clammy, cold skin

Sudden and intense mood swings

Slowed reflexes

Ultimately, severe symptoms can lead to unresponsiveness, coma, and death

The central nervous system and CNS depressants

The central nervous system consists of the brain, the spinal cord, and associated nerves.

Nausea may be a severe symptom of CNS depression.

The CNS controls most bodily functions by transporting messages back and forth between the brain and the rest of the nerves in the body using the spinal cord.

The CNS plays a role in both involuntary and voluntary processes. Involuntary processes do not require conscious thought. They regulate vital organs like the heart, lungs, and stomach. Voluntary processes involve conscious thought, including movement of the arms and legs.

CNS depressants are external substances that work to depress the CNS by slowing brain function. Many CNS depressants work by increasing the activity of the neurotransmitter gamma-amino butyric acid (GABA), a chemical that inhibits or slows the delivery of messages between cells.

There are several types of CNS depressants but the most common include barbiturates, benzodiazepines, opioids, and alcohol.

As these drugs slow or disrupt brain activity, most cause some combination of drowsiness, muscle relaxation, and anxiety reduction.

The NIH note that, when used appropriately, CNS depressants are fairly safe, but they always carry a risk of addiction. Many medically prescribed and high-dose depressants are also common street drugs or used recreationally.

Commonly prescribed CNS depressants

Benzodiazepines are often used to treat stress reactions, panic attacks, sleep disorders, and convulsions.

Commonly prescribed benzodiazepines include:

Alprazolam, or Xanax

Clonazepam, or Klonopin

Diazepam, or Valium

Lorazepam, or Ativan

Common street names for benzodiazepines include:

Benzos

BZDs

Downers

V/val or valley girl

Chill pills

Barbiturates are now only rarely used to help treat seizure disorders and anxiety. They are sometimes used prior to surgery to promote sleep and relaxation.

Commonly prescribed barbiturates include:

Mephobarbital, or Mebaral

Phenobarbital, or Luminal

Butisol Sodium

Talbutal, or Lotusate

Common street names for barbiturates include:

Barbs

Downers

Sleepers

Phennies

Stumblers

Sleep medications are chemically different from other CNS depressants, but they work by stimulating the same inhibitory neurotransmitter, GABA.

Commonly prescribed sleep medications include:

Zolpidem, or Ambien

Zaleplon, or Sonata

Common street names for sleep medications include:

Zombie pills

No-go pills

Sleepeasy

Tic-Tacs

A-minus

Opiates and opioids are strong pain medications derived from opium, a substance made from the seeds of the poppy flower. Opiates are the active ingredients in opium, heroin, morphine, and codeine. Opioids are derived from opiates such as oxycodone, hydrocodone, and heroin.

Both opiates and opioids work by interfering with CNS nerves, blocking pain signals to the brain.

Given their strength and addictive qualities, opioids and opiates are only prescribed for people who have a severe condition.

Opioids can also occasionally be prescribed to reduce severe coughs and diarrhea for short periods of time.

Commonly prescribed opiates and opioids include:

Oxycodone, also known as OxyContin, Percodan, or Percocet

Hydrocodone, Vicodin, Lortab, or Lorcet

Morphine, for example Kadian, Avinza, and MS Contin

Codeine

Fentanyl, or Duragesic

Methadone

Hydromorphone, or Dilaudid

Common street names for opiates or opioids include:

H

Smack

Junk

Oxy

Cody

OC

Morph

China girl or China white

Risks of combining depressants

Combining CNS depressants of any kind greatly increases their effect and the likelihood of negative interactions like CNS depression.

A CNS depressant overdose may require immediate medical attention.

The Substance Abuse and Mental Health Services Administration (SAMHSA) report that among people aged 18 to 34 years, the number of emergency room admissions related to CNS depressants increased 300 percent between 2005 and 2011 in the U.S.

The U.S. Food and Drug Administration (FDA) recently added the highest level of warning to the labels of prescribed benzodiazepines and opioids, noting the severe risks of mixing the medications.

Alcohol also amplifies the effect of prescribed depressants, as do over-the-counter medications with similar properties such as painkillers, allergy medications, and sleep aids.

CNS depressants prescribed to help treat insomnia can be particularly dangerous when mixed with other CNS drugs or alcohol.

Mixing alcohol with most prescription drugs raises the likelihood of adverse effects and physical injury.

Many CNS depressants have become popular recreational or club drugs, and some have been implicated in sexual and violent crimes.

Commonly used to aid sexual assault, the sedative Xyrem is better known as the "date rape drug." Odorless, colorless, and tasteless when mixed with liquids, Xyrem is easily hidden in beverages. It commonly features in cases of sexual assault.

Tricyclic and tetracyclic antidepressants (TCA antidepressants) can also intensify the effects of CNS depressants, especially drowsiness.

Diagnosis and treatment

CNS depression or depressant overdose is treated according to the drugs or substances involved.

Some CNS drugs have antidotes that can reverse their effects. Naloxone, used to treat opioid overdoses, and Flumazenil, used to treat overdoses of benzodiazepine, are the most commonly used antidotes.

People experiencing a CNS depressant overdose are often unaware of their condition. If any of the severe symptoms of the condition, or if mild symptoms appear in combination, MAPDA recommend calling 911 or Poison Control for guidance. Hospitalization is required to treat severe cases.

The most important part of treatment is regulating breathing and heart rate. Oxygen is often given using an oxygen mask or mechanically using a respirator. Stimulants may be used to increase heart rate.

Written by Jennifer Huizen

Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.