Introduction

A barbiturate is a drug that acts as a central nervous system depressant. Barbiturates are effective as anxiolytics, hypnotics, and anticonvulsants, but have physical and psychological addiction potential as well as overdose potential among other possible adverse effects. They have largely been replaced by benzodiazepines and nonbenzodiazepines ("Z-drugs") in routine medical practice, particularly in the treatment of anxiety and insomnia, due to the significantly lower risk of addiction and overdose and the lack of an antidote for barbiturate overdose.

Despite this, barbiturates are still in use for various purposes: in general anesthesia, epilepsy, treatment of acute migraines or cluster headaches, acute tension headaches, euthanasia, capital punishment, and assisted suicide. Barbiturates are medications used for treating headaches, insomnia, and seizures. Barbiturates are one of the older classes of medications.

Drugs and history of barbiturates

Examples of barbiturates available in the US include: amobarbital (Amytal), butabarbital (Butisol), pentobarbital (Nembutal), secobarbital (Seconal), belladonna and phenobarbital (Donnatal), butalbital/acetaminophen/caffeine (Esgic, Fioricet) and butalbital/aspirin/caffeine (Fiorinal Ascomp, Fortabs).

Barbiturates were first used in medicine in the early 1900s and became popular in the 1960s and 1970s as treatment for anxiety, insomnia, or seizure disorders. They evolved into recreational drugs that some people used to reduce inhibitions, decrease anxiety, and to treat unwanted side effects of illicit drugs.

Barbiturate use and abuse has declined dramatically since the 1970s, mainly because a safer group of sedative-hypnotics called benzodiazepines is being prescribed. Benzodiazepine use has largely replaced barbiturates in the medical profession, with the exception of a few specific indications. Doctors are prescribing barbiturates less, and the illegal use of barbiturates has also substantially declined, although barbiturate abuse among teenagers may be on the rise compared with the early 1990s. Addiction to barbiturates, however, is uncommon today.

Types of barbiturates

There are many different barbiturates. The primary difference among them is how long their effects last. The effects of some of the long-acting drugs may last up to 2 days. Others are very short-acting. Their effects last only a few minutes.

Barbiturates can be injected into the veins or muscles, but they are usually taken in pill form. The street names of commonly abused barbiturates describe the desired effect of the drug or the color and markings on the actual pill.

Drug interactions

Drug interactions of barbiturates include: alcohol, alprazolam, anticoagulants, antihistamines, atazanavir, birth control pills, boceprevir, clonazepam, corticosteroids, diazepam, doravirine, doxycycline, estrogen, griseofulvin, hypnotics, lurasidone, monoamine oxidase inhibitors (MAOIs), ombitasvir/paritaprevir/ritonavir and dasabuvir, phenytoin, progesterone, ranolazine, ritonavir, sedatives, sodium valproate, steroids, telaprevir, tranquilizers, valproic acid, voriconazole, zaleplon and zolpidem.+

This medication contains barbiturates. Do not take barbiturates if you are allergic to amobarbital (Amytal), secobarbital (Seconal), butabarbital (Butisol), pentobarbital (Nembutal), belladonna and phenobarbital (Donnatal), butalbital/acetaminophen/caffeine (Esgic, Fioricet), and butalbital/aspirin/caffeine (Fiorinal Ascomp, Fortabs) or any ingredients contained in these drugs.

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Regards

Mary Wilson

Editorial office

Clinical Pharmacology and Toxicology Research

E-mail: pharmatoxicol@eclinicalsci.com