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 chloral hydrate are in Schedule IV of the CSA.