Sleep Medications: Barbiturates

Barbiturates are chemical derivatives of barbituric acid. They depress the central nervous system, and produce a broad range of effects. Most barbiturates can become habit-forming, and are usually taken for their strong sedative effects.

Amobarbital used to be called 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®.

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.

The first barbiturate, barbital, hit the market in 1903 under the trade name Veronal. By 1930 a billion doses per year were being dispensed in the United States. Since then, use has fallen considerably.

Barbiturates suppress REM sleep, which is one reason they are not used for insomnia, except in rare cases for a short-term fix.

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