What are the causes and effects of dependence on barbiturates?

Barbiturates, also known as “downers,” are a class of sedative and hypnotic drugs that were commonly prescribed for the treatment of anxiety, insomnia, and seizures in the mid-20th century. While they may have been effective in treating these conditions, their addictive nature and potential for abuse have led to a decrease in their use. However, there are still individuals who become dependent on barbiturates, leading to a range of physical and psychological effects. In this essay, we will explore the causes and effects of dependence on barbiturates, shedding light on the dangers of this substance and its impact on individuals and society as a whole.

With regular use of barbiturates, barbiturate dependence develops. This in turn may lead to a need for increasing doses of the drug to get the original desired pharmacological or therapeutic effect. Barbiturate use can lead to both addiction and physical dependence, and as such they have a high potential for abuse. Psychological addiction to barbiturates can develop quickly. The GABAA receptor, one of barbiturates’ main sites of action, is thought to play a pivotal role in the development of tolerance to and dependence on barbiturates, as well as the euphoric “high” that results from their abuse. The mechanism by which barbiturate tolerance develops is believed to be different than that of ethanol or benzodiazepines, even though these drugs have been shown to exhibit cross-tolerance with each other. The management of a physical dependence on barbiturates is stabilisation on the long-acting barbiturate phenobarbital followed by a gradual titration down of dose. The slowly eliminated phenobarbital lessens the severity of the withdrawal syndrome and reduces the chances of serious barbiturate withdrawal effects such as seizures. Antipsychotics are not recommended for barbiturate withdrawal (or other CNS depressant withdrawal states) especially clozapine, olanzapine or low potency phenothiazines e.g. chlorpromazine as they lower the seizure threshold and can worsen withdrawal effects; if used extreme caution is required.

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