Have you ever been prescribed a `Barbiturate` type of medicine by a doctor? Or have you heard this name somewhere? These are actually a type of medicine that relaxes our mind and body and brings sleepiness. Although these are a bit old medicine, doctors still recommend them for some specific medical conditions. But you have to be very careful while using them. Okay, let's talk about these `Barbiturates` clearly.
What are barbiturates simply?
Simply put, `Barbiturates` are a type of medication that depresses, or slows down, the activity of your central nervous system (that is, your brain and spinal cord). They belong to a class of drugs called `sedative-hypnotic`.
- Sedatives: These are used to calm you down and reduce anxiety.
- Hypnotics: These make you feel sleepy.
This medication works by increasing the activity of a neurotransmitter called `gamma-aminobutyric acid (GABA)` in our brain. `GABA` controls the activity of brain cells and makes them a little calmer. When you take `Barbiturates`, the effect of `GABA` increases, so your brain activity slows down even more, making you feel relaxed and sleepy.
For what situations do doctors prescribe this medication?
In the past, these `barbiturates` were widely used to provide anesthesia before surgery. To put the patient into a deep sleep. But today, new drugs have been developed that are safer and have fewer side effects.
However, barbiturates are still an indispensable medicine for some special cases.
These are mainly used:
- Prevent and control seizures: These are very effective in controlling seizures in people with conditions like epilepsy.
- For insomnia: These are given to treat short-term insomnia.
- To calm the patient before anesthesia: These are used to reduce the patient's mental restlessness and put them to sleep quickly before surgery.
- To control high intracranial pressure: If intracranial pressure (`intracranial hypertension`) increases in a situation such as a brain injury, these medications may be given to reduce it.
The most important thing is that this medicine should only be taken on the advice of a doctor, in the dosage and for the duration prescribed by him or her . Never use other people's medicines or take more than the doctor has prescribed.
What are the most commonly used types of barbiturates?
There are several types of `Barbiturates` in the world. Some are used in our country, some are not. Here are some of the most commonly seen.
| Drug Name | What is it mainly used for? |
|---|---|
| Phenobarbital | It is commonly used to prevent and control seizures (especially in children). |
| Amobarbital | Used to treat short-term insomnia and for some neurological tests. |
| Butalbital | This is not given alone. It is given in combination with other medications like Paracetamol, Aspirin, and Caffeine for migraines and headaches. |
| Pentobarbital | It is used to calm you down before anesthesia and to stop ongoing seizures. |
| Primidone | A drug that is converted into Phenobarbital in the body. This is also given to prevent seizures. |
The effectiveness and benefits of these medicines
One special advantage of barbiturates is that they vary in duration of action. Some are eliminated from the body in minutes, while others remain in the body for days. This allows the doctor to choose the right medication for the patient's needs.
They are divided into 4 main categories based on their duration of action.
| Category | Active time | Examples |
|---|---|---|
| Ultra-short-acting | A very short time, like 15 minutes. | Methohexital |
| Short-acting | About 3-4 hours. | Pentobarbital, Secobarbital |
| Intermediate-acting | About 4-6 hours. | Amobarbital, Butalbital |
| Long-acting | 12 hours or more. | Phenobarbital |
What are the risks and complications of barbiturates?
The main reason why barbiturates are not used as widely as they used to be is because of their risks and side effects. It is very important to be aware of these.
- Tolerance, Dependence, and Addiction:
- Tolerance: When you continue to take the same dose, your body becomes accustomed to it and cannot get the same effect as before. Then, you have to increase the dose of the drug to get the same effect.
- Dependence: The body becomes so used to the drug that it is unable to function normally without it. If the drug is stopped suddenly, withdrawal symptoms such as restlessness and tremors may occur.
- Addiction: This is a mental condition in which a person continues to seek and use a drug despite knowing that it will have negative consequences, but is unable to stop using it.
- Heart palpitations and breathing problems: These medications lower your heart rate and blood pressure. If you overdose, your breathing can stop completely and even be life-threatening. This is a very dangerous condition.
- Interactions with other medications: Barbiturates affect the function of our liver. Therefore, other medications you take (e.g., birth control pills, blood thinners) may be eliminated from the body more quickly, reducing their effectiveness.
- Risks for pregnant and breastfeeding mothers: Taking this medication during pregnancy may affect the development of the baby in the womb. Also, it can pass to the baby through breast milk. Therefore, if you are pregnant, trying to become pregnant, or breastfeeding, be sure to tell your doctor about this.
When should you see a doctor and go to the ETU?
If you have been prescribed barbiturates, continue to attend your appointments as your doctor tells you. These are not usually long-term medications. Your doctor will assess your condition and decide whether you need to continue taking the medication or switch to another treatment.
Also, if you feel like the medication isn't working properly, or if side effects are interfering with your daily activities, be sure to talk to your doctor.
When to go to the Emergency Treatment Unit (ETU) immediately
The symptoms of a barbiturate overdose are similar to those of alcohol intoxication. If you notice any of these symptoms, immediately take the patient to the nearest hospital emergency room (ETU) .
- Difficulty breathing (dyspnea) or shortness of breath Severe drowsiness, loss of consciousness, or coma
- Confusion, inability to think clearly
- A very slow heartbeat (bradycardia) or perhaps a rapid but weak pulse Severe dizziness
- Nausea and vomiting
- Decreased body temperature (hypothermia)
- Blue discoloration of the lips or fingernails (cyanosis) - This means that the body is not getting enough oxygen.
- Inability to focus the eyes, abnormally small or large pupils
Barbiturate overdose is a life-threatening medical emergency, so do not ignore these symptoms.
Is it okay if I drink alcohol while taking this medicine?
Absolutely not! `Barbiturates` and alcohol are a very dangerous combination. Since both of them slow down the nervous system, the effect is very severe when they are taken together. This can cause respiratory arrest, loss of consciousness, damage to internal organs, and even death. Therefore, avoid drinking alcohol completely while taking this medication.
Drug dependence and withdrawal symptoms
As mentioned earlier, if you continue to use this medication, your body can become dependent on it. If you suddenly stop taking it, your body will experience withdrawal symptoms. These can be dangerous.
- Extreme restlessness and agitation
- Hand tremors
- Confusion
- Severe convulsive states
If you experience these symptoms, that is, if you feel discomfort when you stop taking the medicine, do not be ashamed or afraid to tell your doctor about it. Doctors know that this can happen due to the nature of these medicines. Then, he can gradually reduce the dose of the medicine and help you get off the medicine without any discomfort.
Take-Home Message
- Barbiturates are a type of medication that slows down brain activity, causing calmness and drowsiness.
- These are used to treat conditions such as seizures and insomnia.
- This medication should only be taken if prescribed by a doctor. Take it only in the prescribed dose and for the prescribed period of time.
- There is a serious risk of addiction and overdose with these. If you notice symptoms such as difficulty breathing or loss of consciousness, go to the ETU immediately.
- Avoid drinking alcohol completely while taking this medication. It is very dangerous.
- Keep your medicine locked up and safe, especially out of reach of children and young people.
- If you have any concerns, discomfort, or questions about the medication, talk openly with your doctor about it.
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