Barbiturates are medicines that act on the central nervous system and cause drowsiness and can control seizures.
Barbiturates are in the group of medicines known as central nervous system depressants (CNS). Also known as sedative-hypnotic drugs, barbiturates make people very relaxed, calm, and sleepy. These drugs are sometimes used to help patients relax before surgery. Some may also be used to control seizures (convulsions). Although barbiturates have been used to treat nervousness and sleep problems, they have generally been replaced by other medicines for these purposes.
These medicines may become habit forming and should not be used to relieve everyday anxiety and tension or to treat sleeplessness over long periods.
Barbiturates are available only with a physician's prescription and are sold in capsule, tablet, liquid, and injectable forms. Some commonly used barbiturates are phenobarbital (Barbita) and secobarbital (Seconal).
Recommended dosage depends on the type of barbiturate and other factors such as the patient's age and the condition for which the medicine is being taken. Check with the physician who prescribed the drug or the pharmacist who filled the prescription for the correct dosage.
Always take barbiturates exactly as directed. Never take larger or more frequent doses, and do not take the drug for longer than directed. If the medicine does not seem to be working, even after taking it for several weeks, do not increase the dosage. Instead, check with the physician who prescribed the medicine.
Do not stop taking this medicine suddenly without first checking with the physician who prescribed it. It may be necessary to taper down gradually to reduce the chance of withdrawal symptoms. If it is necessary to stop taking the drug, check with the physician for instructions on how to stop.
See a physician regularly while taking barbiturates. The physician will check to make sure the medicine is working as it should and will note unwanted side effects.
Because barbiturates work on the central nervous system, they may add to the effects of alcohol and other drugs that slow the central nervous system, such as antihistamines, cold medicine, allergy medicine, sleep aids, medicine for seizures, tranquilizers, some pain relievers, and muscle relaxants. They may also add to the effects of anesthetics, including those used for dental procedures. The combined effects of barbiturates and alcohol or other CNS depressants (drugs that slow the central nervous system) can be very dangerous, leading to unconsciousness or even death. Anyone taking barbiturates should not drink alcohol and should check with his or her physician before taking any medicines classified as CNS depressants.
Taking an overdose of barbiturates or combining barbiturates with alcohol or other central nervous system depressants can cause unconsciousness and even death. Anyone who shows signs of an overdose or a reaction to combining barbiturates with alcohol or other drugs should get emergency medical help immediately. Signs include:
- severe drowsiness
- breathing problems
- slurred speech
- slow heartbeat
- severe confusion
- severe weakness
Barbiturates may change the results of certain medical tests. Before having medical tests, anyone taking this medicine should alert the healthcare professional in charge.
People may feel drowsy, dizzy, lightheaded, or less alert when using these drugs. These effects may even occur the morning after taking a barbiturate at bedtime. Because of these possible effects, anyone who takes these
drugs should not drive, use machines or do anything else that might be dangerous until they have found out how the drugs affect them.
Barbiturates may cause physical or mental dependence when taken over long periods. Anyone who shows these signs of dependence should check with his or her physician right away:
- the need to take larger and larger doses of the medicine to get the same effect
- a strong desire to keep taking the medicine
- withdrawal symptoms, such as anxiety, nausea or vomiting, convulsions, trembling, or sleep problems, when the medicine is stopped
Older people may also be more sensitive that others to the effects of this medicine. In older people, barbiturates may be more likely to cause confusion, depression, and unusual excitement. These effects are also more likely in people who are very ill.
People with certain medical conditions or who are taking certain other medicines can have problems if they take barbiturates. Before taking these drugs, be sure to let the physician know about any of these conditions:
ALLERGIES. Anyone who has had unusual reactions to barbiturates in the past should let his or her physician know before taking the drugs again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.
OTHER MEDICAL CONDITIONS. Before using barbiturates, people with any of these medical problems should make sure their physicians are aware of their conditions:
- alcohol or drug abuse
- kidney disease
- liver disease
- overactive thyroid
- underactive adrenal gland
- chronic lung diseases such as asthma or emphysema
- severe anemia
USE OF CERTAIN MEDICINES. Taking barbiturates with certain other drugs may affect the way the drugs work or may increase the chance of side effects.
The most common side effects are dizziness, lightheadedness, drowsiness, and clumsiness or unsteadiness. These problems usually go away as the body adjusts to the drug and do not require medical treatment unless they persist or interfere with normal activities.
More serious side effects are not common, but may occur. If any of the following side effects occur, check with the physician who prescribed the medicine immediately:
- muscle or joint pain
- sore throat
- chest pain or tightness in the chest
- skin problems, such as rash, hives, or red, thickened, or scaly skin
- bleeding sores on the lips
- sores or painful white spots in the mouth
- swollen eyelids, face, or lips
In addition, check with a physician as soon as possible if confusion, depression, or unusual excitement occur after taking barbiturates.
Patients who take barbiturates for a long time or at high doses may notice side effects for some time after they stop taking the drug. These effects usually appear within 8–16 hours after the patient stops taking the medicine. Check with a physician if these or other troublesome symptoms occur after stopping treatment with barbiturates:
- dizziness, lightheadedness or faintness
- anxiety or restlessness
- vision problems
- nausea and vomiting
- seizures (convulsions)
- muscle twitches or trembling hands
- sleep problems, nightmares, or increased dreaming
Other side effects may occur. Anyone who has unusual symptoms during or after treatment with barbiturates should get in touch with his or her physician.
Barbiturates may also interact with other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes barbiturates should let the physician know all other medicines he or she is taking. Among the drugs that may interact with barbiturates are:
- Other central nervous system (CNS) depressants such as medicine for allergies, colds, hay fever, and asthma; sedatives; tranquilizers; prescription pain medicine; muscle relaxants; medicine for seizures; sleep aids; barbiturates; and anesthetics
- Blood thinners
- Adrenocorticoids (cortisone-like medicines)
- Antiseizure medicines such as valproic acid (Depakote and Depakene), and carbamazepine (Tegretol)
The list above does not include every drug that may interact with barbiturates. Be sure to check with a physician or pharmacist before combining barbiturates with any other prescription or nonprescription (over-the-counter) medicine.
Eisenberg, Ronald. Clinical Imaging, Atlas of Differential Diagnosis. 5th ed. Philadelphia: Wolters Kluwer/Lippin-cott Williams & Wilkins, 2010.
Henn, Debra, and Deborah DeEugenio. Barbiturates. New York: Chelsea House, 2007.
Drug Enforcement Administration (DEA), Department of Justice (DOJ). “Drug Fact Sheet: Barbiturates.” http://www.justice.gov/dea/druginfo/drug_data_sheets/Barbiturates.pdf (accessed October 28, 2014).