Sleep Disorders

Sleep Medications: Barbituates

Barbiturates are develop from barbituric acid. They depress the CNS, and produce a broad range of effects depending on the drug and the dosage. Most barbiturates can become habit-forming, and are usually taken for their strong sedative effects.

Amobarbital was formerly known as amylobarbitone. It is indicated for the treatment of anxiety, insomnia, and epilepsy. It has a history as a “truth serum” and has sometimes been used to extract evidence from criminal suspects, although this has lost its trustworthiness recently with the discovery that suspects can be pressured into having a “false memory” of the incident. Frequently occurring side effects are confusion, drowsiness, irritability, slow heartbeat, slurred speech and loss of coordination. Amobarbital is marketed in the U.S. as Amytal® by Carilion.

Pentobarbital’s uses include preoperative sedation and seizures. It is used off-label to reduce intracranial pressure in Reye’s syndrome and traumatic brain injury, and to bring on a coma in patients with a cerebral ischemia (bleed). It has also been used for physician-assisted suicide. The most common side effects reported are lethargy, drowsiness, a “hangover”-like feeling, and rash. Ovation Pharmaceuticals sells pentobarbital in the United States under the trade name Nembutal®.

Secobarbital is more popularly known by the brand name Seconal®, produced by Eli Lilly & Company. It is used to treat epilepsy, and as preoperative anesthesia. It is used to treat insomnia short-term, particularly in patients who have become accustomed to barbiturates. Many people who take secobarbital experience impaired motor functions, anxiety, dizziness, confusion, irritability, and nausea and/or vomiting. Secobarbital has a long history of recreational abuse in the 1960-1970s, and played a role in many celebrity deaths.

Barbituates suppress REM sleep, which is one reason they are not used in the long run.