Barbiturates withdrawal signs

Delirium Delirium due to barbiturate withdrawal is, again, similar to that seen with abrupt alcohol withdrawal. The chief sign is one of impaired memory, of both recent and past memories. Delirium is also associated with confusion and disorientation (not knowing person, place or time). The hallucinations associated with delirium are more visual in nature and are described as terrifying. Often, patients develop a high fever. These symptoms stop by the third or fourth day, and rarely last longer than a week. 

Chronic use of high doses of the long-acting barbiturates may produce psychological and physical dependence. Abrupt discontinuation of therapy may result in withdrawal signs and symptoms. Mild withdrawal may include weakness, anxiety, muscle twitching, insomnia, nausea, and vomiting. Severe withdrawal may consist of hallucinations, autonomic instability, delirium, and seizures. Unlike opioid withdrawal. 

Chronic use leads to tolerance (cross with other S-H drugs), possibly via down-regulation of BZ receptors. Psychological and physical dependence occurs, but abuse liability and withdrawal signs are less intense than with ethanol or barbiturates. Rebound REM sleep, insomnia, and anxiety are common on discontinuance. 

During the 1940s, research indicated that barbiturates produced intoxication and were addictive. People showed signs of withdrawal when they stopped taking barbiturates. 

C. Oral. The oral regimen for treatment of barbiturate or other sedative-dmg withdrawal syndrome is administration of 200 mg orally, repeated every hour until signs of mild Intoxication appear (eg, slurred speech, drowsiness, or nystagmus). Most patients respond to 600 mg or less. Repeat the total Initial dose every 6 hours as needed. Phenobarbital Is an alternative (see below). 

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