Central Nervous System Depressants

Barbiturates

Barbiturates are one of the oldest classes of depressants and were first synthesized in the mid-1800s. They may be used during the induction of surgical anesthesia as sedative-hypnotic agents to induce a coma, to control seizures, or to relieve intracranial pressure in patients with head trauma. When administering barbiturates, it is often difficult to determine the correct dosage required for a desired effect; unfortunately, even very small doses can lead to death. Barbiturates are extremely addicting and must be prescribed with caution.

Barbiturates are known on the street as downers and work by depressing activity of the entire nervous system. They can produce sedation and reduce motor activity when taken in low doses; however, at high doses, they can distort judgment, decrease cognitive activity, elicit hypnosis, and produce anesthesia (i.e., loss of consciousness) at extremely high doses. Other common effects of barbiturate overdose include respiratory failure, coma, and death. Long-term use of these drugs can cause aggressiveness, severe insomnia, and dependency as the level of intake increases. Ten times the prescribed therapeutic dose of barbiturates can cause death. Given the severe depressive effects of these compounds, many accidental overdoses occur when they are taken with other CNS depressants, most notably alcohol.

The most common barbiturate is phenobarbital, which is used as a sleep aid or for treating disorders such as epilepsy. It is a long-acting barbiturate and can last for up to 24 hours. phenobarbital helps in depressing abnormal stimulating neurons and improves chemical imbalance within the brain. Although it is widely used to treat epilepsy, it can be habit forming and may result in addiction, cognitive disorders, and mood disorders. Secobarbital (i.e., Seconal) is another common barbiturate and was historically prescribed for epilepsy and insomnia. Because of its intense sedative properties, it is no longer widely prescribed. The drug has been linked to several overdoses and suicides among the famous (e.g., Judy Garland, Jimi Hendrix, and Marilyn Monroe, to name a few).

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