The prevalence of sedative, hypnotic, or anxiolytic intoxication in the general population is unclear. However, it is probable that most nonmedical users of sedatives, hypnotics, or anxiolytics would at some time have signs or symptoms that meet criteria for sedative, hypnotic, or anxiolytic intoxication; if so, then the prevalence of nonmedical sedative, hypnotic, or anxiolytic use in the general population may be similar to the prevalence of sedative, hypnotic, or anxiolytic intoxication. For example, tranquilizers are used non- medically by 2.2% of Americans older than 12 years.
Alcohol use disorders. Since the clinical presentations may be identical, distinguishing sed- ative, hypnotic, or anxiolytic intoxication from alcohol use disorders requires evidence for re- cent ingestion of sedative, hypnotic, or anxiolytic medications by self-report, informant report, or toxicological testing. Many individuals who misuse sedatives, hypnotics, or anxiolytics may also misuse alcohol and other substances, and so multiple intoxication diagnoses are possible.
Alcohol intoxication. Alcohol intoxication may be distinguished from sedative, hypnotic, or anxiolytic intoxication by the smell of alcohol on the breath. Otherwise, the features of the two disorders may be similar.
_Other sedative-, hypnotic-, or anxiolytic-induced disorders. Sedative, hypnotic, or anx- iolytic intoxication is distinguished from the other sedative—, hypnotic-, or anxiolytic- induced disorders (e.g., sedative, hypnotic-, or anxiolytic-induced anxiety disorder, with onset during withdrawal) because the symptoms in the latter disorders predominate in the clinical presentation and are severe enough to warrant clinical attention.
Neurocognitive disorders. In situations of cognitive impairment, traumatic brain in- jury, and delirium from other causes, sedatives, hypnotics, or anxiolytics may be intoxi- cating at quite low dosages. The differential diagnosis in these complex settings is based on the predominant syndrome. An additional diagnosis of sedative, hypnotic, or anxio- lytic intoxication may be appropriate even if the substance has been ingested at a low dos- age in the setting of these other (or similar) co-occurring conditions.
Sedative, Hypnotic, or Anxiolytic Withdrawal
A. Cessation of (or reduction in) sedative, hypnotic, or anxiolytic use that has been pro- longed.
B. Two (or more) of the following, developing within several hours to a few days after the ces- sation of (or reduction in) sedative, hypnotic. or anxiolytic use described in Criterion A: 1. Autonomic hyperactivity (e.g., sweating or pulse rate greater than 100 bpm).
2. Hand tremor.
Insomnia.
Nausea or vomiting.
Transient visual, tactile, or auditory hallucinations or illusions.
Psychomotor agitation.
Anxiety.
Grand mal seizures.
@NQWP.“
C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.
Specify if:
With perceptual disturbances: This specifier may be noted when hallucinations with in- tact reality testing or auditory, visual, or tactile illusions occur in the absence of a delirium.