Author: James Anderson

Barbiturates: Definition, Types, Uses, Side Effects & Abuse

Barbiturates aren’t as common as in years past because newer drugs have largely taken their place. However, many of these drugs still see widespread use for specific conditions. Phenobarbital, for example, is common for treating seizures that resist first-line anti-seizure medications.

Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex (updated 3 Mar 2024), Cerner Multum™ (updated 17 Mar 2024), ASHP (updated 10 Mar 2024) and others. Barbiturates are a class of drugs that were used extensively in the 1960s and 1970s as a treatment for anxiety, insomnia, and seizure disorders. Apart from a few specific indications, they are not commonly prescribed these days, having been largely superseded by benzodiazepines, which are much safer, although still potentially addictive. Barbiturates and benzodiazepines aren’t the same types of medications, but they’re very similar.

Pharmacological barbiturates are based on the parent compound barbituric acid. The type of barbiturate depends on the substituent used at position 5 of this basic skeleton. Around 2,500 different types of barbiturates have been synthesized since 1881, which is when barbital, the first pharmacologically active form, was synthesized. However, only around 50 of these agents have ever been used clinically. Barbiturates used to be regularly prescribed to treat insomnia, depression, and anxiety.

How Many Types of Insomnia Are There?

The preferred IUPAC name of the base compound, barbituric acid, is 1,3-diazinane-2,4,6-trione. All barbiturates affect gamma-aminobutyric acid (GABA), a neurotransmitter (chemical) that nerves use to communicate with one another. Barbiturates have some risks, but these risks should be minimal if you take your medication exactly as prescribed. You also shouldn’t have a problem with barbiturate dependence if you take your medication as your healthcare provider instructs. You should also see your healthcare provider if you notice that barbiturate medications aren’t working as they should or if the side effects are disrupting your usual routine and activities. Most barbiturates aren’t for long-term use, so you might need to see your healthcare provider for follow-up.

Barbiturates are synthetic drugs used in medicine to depress the central nervous system (CNS). The effects of barbiturates range from mild sedation to coma, with their indications ranging from sedatives, hypnotics, or as part of anesthesia. Some barbiturates are also used to relieve tension or anxiety prior to surgery.

In the case of benzodiazepines, not only do they have additive effects, barbiturates also increase the binding affinity of the benzodiazepine binding site, leading to exaggerated benzodiazepine effects. (ex. If a benzodiazepine increases the frequency of channel opening by 300%, and a barbiturate increases the duration of their opening by 300%, then the combined effects of the drugs increases the channels’ overall function by 900%, not 600%). The effects of intermediate-acting barbiturates, such as butabarbital sodium, last between 6 and 12 hours, and these are used to treat insomnia. Pentobarbital is an example of a short-acting barbiturate that is also used to help patients fall asleep. The prolonged use of barbiturates—especially secobarbital and pentobarbital—may cause the development of a tolerance to them and require amounts much larger than the original therapeutic dose. Denial of a barbiturate to the habitual user may precipitate a withdrawal syndrome that is indicative of physiological dependence on the drug.

They both can stop seizures, cause you to relax and feel less anxious, or can help you feel drowsy and fall asleep when you receive general anesthesia. The Misuse of Drugs Act classifies barbiturates as class B drugs, which means that these drugs can be bought in accordance with a doctor’s prescription; however, any other form of possession or supply of barbiturates is considered an offense. The maximum penalty that a person can receive for any unauthorized possession of barbiturates is 5 years in prison and a fine for possession. The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker. Abrupt discontinuation of barbiturates in people who have been taking them for longer than one month can cause severe withdrawal symptoms, such as hallucinations, a high fever, and seizures.

Do Seizures Come in Clusters?

People who are withdrawing may experience anxiety, disorientation, and visual hallucinations. If untreated, this withdrawal can progress to high fever, heart failure, and eventually death. Because of its relaxing effects on many of the body’s organs, long-term barbiturate use can lead to breathing problems and pneumonia.

1. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
2. Injectable forms of barbiturates are classified as class A drugs, and oral and rectal forms as class B drugs.
3. Use of barbiturates as a recreational drug then became popular in the 1960s and 1970s, leading to abuse in some cases.
4. Some barbiturates are still made and sometimes prescribed for certain medical conditions.
5. That’s because these medications help ease a person into a deep sleep.

The ultra-short acting barbiturate of thiamylal is administered as an injection to induce unconsciousness in patients who are about to undergo surgery. Gaseous anesthetics are then used to maintain the patient’s unconsciousness throughout the surgical procedure. How quickly barbiturates act and how long their effects last can vary. They can be classified as ultra short-, short-, intermediate-, and long-acting. When people take barbiturates by mouth, their effects begin within 30 minutes of swallowing and last from 4 to 16 hours.

This class of barbiturates is used almost exclusively as anticonvulsants, although on rare occasions they are prescribed for daytime sedation. Barbiturates in this class are not used for insomnia, because, owing to their extremely long half-life, patients would awake with a residual “hang-over” effect and feel groggy. Some symptoms of an overdose typically include sluggishness, incoordination, difficulty in thinking, slowness of speech, faulty judgement, drowsiness, shallow breathing, staggering, and, in severe cases, coma or death. The lethal dosage of barbiturates varies greatly with tolerance and from one individual to another.

When should I see my healthcare provider?

Notably, the small difference between a normal dose and an overdose led to a number of accidental deaths, as well as people using them to commit suicide. As a person uses barbiturates more, the difference between a dose that causes the desired effect and that of a fatal overdose becomes narrower. This makes overdoses more common in long-term use such as for more than 2 weeks. However, although illegal barbiturate use is rare, it remains an extremely dangerous drug to abuse because of the high risk of fatal overdose. In the Netherlands, the Opium Law classifies all barbiturates as List II drugs, with the exception of secobarbital, which is on List I.

They’re older medications, which means they have decades of research to back them up. They can also serve as backup when the first-line medications don’t work. Sally first developed an interest in medical communications when she took on the role of Journal Development Editor for BioMed Central (BMC), after having graduated with a degree in biomedical science from Greenwich University. People who frequently use barbiturates may reach a constant state that is similar to a drunken daze.