Barbiturates

Barbiturates are a category of medication that causes relaxation and sleepiness. In the past, they were regularly prescribed to treat insomnia , alcohol withdrawal, seizures, and a range of mental health disorders. But because barbiturates are highly addictive, benzodiazepines are now more commonly prescribed instead.
What Are Barbiturates? Overview Barbiturates are sedative-hypnotic drugs, meaning they help you relax or fall asleep. They work by depressing the central nervous system. They increase a brain chemical called gamma-aminobutyric acid (GABA) that slows down brain cell activity.e60dc2a1-f33c-4a05-9b50-8e3e8e597629de6e55d3-ca79-4184-ab12-62babbded744 Barbiturates were very popular in the mid-to-late 20th century. They were typically prescribed to treat conditions such as insomnia, epilepsy , for anesthesia reasons, and for certain psychiatric disorders.e60dc2a1-f33c-4a05-9b50-8e3e8e597629618324ba-59bc-4551-aad3-a525a194ae5e Barbiturates are also highly addictive. By the 1970s, people had widely misused them, leading to accidental overdoses, addiction, and death. As a result, barbiturates were mostly replaced with safer drugs such as benzodiazepines, which also slow down brain activity.e60dc2a1-f33c-4a05-9b50-8e3e8e597629618324ba-59bc-4551-aad3-a525a194ae5e Barbiturates are still prescribed today, but they aren’t widely used in the United States. They’re often used as a second choice for seizures when other medications aren’t improving symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629de6e55d3-ca79-4184-ab12-62babbded744
What Conditions Do Barbiturates Treat? Conditions Historically, barbiturates were prescribed for:e60dc2a1-f33c-4a05-9b50-8e3e8e597629cdabd916-1207-4e35-9886-466afab5a850 Insomnia Epilepsy and seizures Tension headaches Alcohol withdrawal Anesthesia for surgery Since the 1970s, barbiturates have been largely replaced by benzodiazepines — depressant or sedative drugs that treat many of the same conditions and have a better safety profile.e60dc2a1-f33c-4a05-9b50-8e3e8e59762925bbd969-254c-4c2b-9f1f-01c3d2cd48c7 Barbiturates are still used today when other medications aren’t effectively treating a health condition. Those issues include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629cdabd916-1207-4e35-9886-466afab5a850 Seizures Tension headaches As anesthesia prior to surgery
Types of Barbiturates Types Barbiturates are usually taken orally, as tablets. But, they also can be injected into the muscle or vein.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e991a5e8-2050-4cb3-a914-62fbdeea866a Barbiturates are often classified according to how long their effects last. The four main types of barbiturates are: Ultra-Short Acting Barbiturates These barbiturates’ effects last 15 minutes or less.e60dc2a1-f33c-4a05-9b50-8e3e8e597629753afad9-d295-4d33-b47a-f1fc20a09cc1 Examples include methohexital (Brevital Sodium) and thiopental (Pentothal), which is no longer available in the United States. Methohexital is useful for short-duration sedation in some cardiovascular surgeries and other short emergency procedures. It’s also helpful for electroconvulsive therapy and for short outpatient surgeries in children.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e991a5e8-2050-4cb3-a914-62fbdeea866a Short-Acting Barbiturates The effects of short-acting barbiturates typically last around three or four hours. Examples include pentobarbital (Nembutal Sodium) and secobarbital (Seconal), which is no longer available in the United States. Pentobarbital is used before anesthesia or to stop seizures. It’s also prescribed off-label to help relieve pressure inside the skull after a traumatic brain injury (TBI) .e60dc2a1-f33c-4a05-9b50-8e3e8e597629e991a5e8-2050-4cb3-a914-62fbdeea866a Intermediate-Acting Barbiturates Intermediate-acting barbiturates have effects that last about three to six hours. This category of drugs includes amobarbital (Amytal) and butalbital (Fiorinal) . The brand names Amytal and Fiorinal have been discontinued in the United States.e60dc2a1-f33c-4a05-9b50-8e3e8e597629aa6a52e8-3ced-4c95-8ba0-6cd97be263ec Butalbital is sometimes used as part of combination medications — together with aspirin, acetaminophen, or caffeine — to treat migraines and tension headaches. The American Academy of Neurology (AAN) doesn’t recommend taking it for long periods of time because of how highly addictive it is and because it can lead to medication overuse headaches.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e991a5e8-2050-4cb3-a914-62fbdeea866a Long-Acting Barbiturates The effects of long-acting barbiturates usually last for 6 to 12 hours. Examples include phenobarbital and primidone (Mysoline) . Phenobarbital is a drug typically used for treating epilepsy in both adults and children. Primidone is used to treat seizure disorders.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e991a5e8-2050-4cb3-a914-62fbdeea866a
How Do Barbiturates Work? Function Barbiturates boost a chemical in the brain (a neurotransmitter) called gamma-aminobutryic acid (GABA). GABA blocks the activity of certain nerve cells, so by boosting it, barbiturates depress the central nervous system in a similar way to alcohol.e60dc2a1-f33c-4a05-9b50-8e3e8e59762937606dbb-3316-4ac6-b563-971857450924 Historically, the depressive effects of barbiturates have been helpful for treating insomnia or anxiety, as they can make you feel sleepy and relaxed. But when taken in higher doses, or more than recommended, barbiturates can cause serious effects.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295ae16f6f-fe11-4a54-9e2a-d7f5f87c26bc
What Are the Possible Side Effects of Barbiturates? Side Effects Most people who use barbiturates for seizure or pain don’t abuse them. But barbiturate use can lead to addiction problems for some people who take it. Some of their most common side effects include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294096afa8-4e5f-420e-9ece-16d75792a8e0 Drowsiness, dizziness, or confusion Headache Nausea or vomiting
Are There Any Risks Related to Barbiturates? Risks Misusing barbiturates or taking more than the recommended dose can have dangerous effects on a person’s health, including:e60dc2a1-f33c-4a05-9b50-8e3e8e597629070b1a27-bea6-4e02-a9e1-398ab4d29f10 Confusion and difficulty thinking Sleepiness Faulty judgment Lack of coordination Shallow, slowed, or difficulty breathing Slow or slurred speech Balance issues Swelling of the eyes, lips, or cheeks Rash, blistering, or peeling skin Fever If you suspect an overdose in yourself or in someone else, or if someone is having trouble breathing, call 911 or go to an emergency room immediately. You can also call your local poison control center at 800-222-1222 from anywhere in the United States. Barbiturates pose other serious risks, including:e60dc2a1-f33c-4a05-9b50-8e3e8e59762985f4ded5-bb44-4217-b5ff-5f37adf2aaa4e60dc2a1-f33c-4a05-9b50-8e3e8e597629a2cfe47d-7f84-48f0-a254-bdb5a76a90df High Potential for Dependence If a person takes barbiturates for longer than two weeks, they may become physically and psychologically addicted to them. Barbiturates also lose effectiveness after a few weeks, so a higher dose may be required to achieve the same effects. This increases the risks for abuse even further. Withdrawal Symptoms These can occur from long-term use. If you are not tapered off the medication, you may experience hallucinations (seeing or hearing things that aren’t there), fever, and seizures. Some withdrawal symptoms can be life-threatening. Risk of Harming the Fetus if Taken During Pregnancy Barbiturates are not suitable for pregnant people as they can harm the fetus, causing birth defects in newborns. Interactions With Other Drugs Barbiturates interact with many drugs, including steroids, blood thinners, immunosuppressants, and contraceptives. They can also have dangerous effects if combined with other drugs that have the same effect on the central nervous system, like opioids or benzodiazepines.
The Takeaway Barbiturates are powerful sedative medications that have largely fallen out of favor because they’re highly addictive. These medications were historically used for sleep issues, anxiety, and seizures, but today they are only prescribed in limited situations when other drugs haven’t helped. They can cause withdrawal symptoms when a person stops taking them, and they may have dangerous effects if combined with other sedative medications.

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