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The oldest of the hypnotic (sleep inducing} depressants,
chloral hydrate was first synthesized in 1832. Marketed as syrups or soft
gelatin capsules, chloral hydrate takes effect in a relatively short time (30
minutes) and will induce sleep in about an hour. A solution of chloral hydrate
and alcohol constituted the infamous "knockout drops" or "Mickey Finn." At
therapeutic doses, chloral hydrate has little effect on respiration and blood
pressure; however; a toxic dose produces severe respiratory depression and very
low blood pressure. Chronic use is associated with liver damage and a severe
withdrawal syndrome. Although some physicians consider chloral hydrate to be
the drug of choice for sedation of children before diagnostic, dental, or
medical procedures, its general use as a hypnotic has declined. Chloral hydrate
(Noctec® and other) and compounds, preparations, or mixtures containing
choral hydrate are in Schedule IV of the CSA.
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