Withdrawal symptoms from barbiturates

Substance-Induced Anxiety Disorder. Numerous medicines and drugs of abuse can produce panic attacks. Panic attacks can be triggered by central nervous system stimulants such as cocaine, methamphetamine, caffeine, over-the-counter herbal stimulants such as ephedra, or any of the medications commonly used to treat narcolepsy and ADHD, including psychostimulants and modafinil. Thyroid supplementation with thyroxine (Synthroid) or triiodothyronine (Cytomel) can rarely produce panic attacks. Abrupt withdrawal from central nervous system depressants such as alcohol, barbiturates, and benzodiazepines can cause panic attacks as well. This can be especially problematic with short-acting benzodiazepines such as alprazolam (Xanax), which is an effective treatment for panic disorder but which has been associated with between dose withdrawal symptoms. 

In some cases, withdrawal symptoms can be fatal, so a person cannot just stop taking barbiturates. The physician will establish a plan of gradual withdrawal from barbiturates. 

The nature of the withdrawal symptoms depends upon the neurotransmitter systems which are the target of the drug. Thus cocaine and the amphetamines alleviate fatigue, cause anorexia and elevate mood withdrawal therefore results in feelings of fatigue, hyperphagia and depression. Abrupt withdrawal from the sedatives, such as barbiturates or following... 

Barbiturates are also present in high concentrations in the breast milk of women who take them. Infants who consume this breast milk may experience side effects like excess sleepiness and lethargy. They may also experience withdrawal symptoms when weaned from breast milk. Long-term adverse effects of infant exposure to barbiturates in breast milk have not been well documented. However, the American Academy of Pediatrics cautions against breast-feeding while taking barbiturates because there may be risks to the infant. 

One major reason for the movement away from the medical use of barbiturates involves tolerance and dependence. Tolerance develops fairly rapidly to many effects of the barbiturates. Whereas a given dose may be effective at inducing sleep for a while, if the drug is used regularly the patient soon may require a higher dose in order to sleep. If doses escalate too much and regular use persists, the patient will experience an abstinence syndrome when he or she attempts to withdraw from barbiturates. The symptoms of the barbiturate withdrawal syndrome are similar to those of alcohol— shakes, perspiration, confusion, and in some cases full-blown delirium tremens (DTs) (see Chapter 9)—but convulsions and seizures are more likely to occur in barbiturate... 

Opioids (especially methadone and heroin) are the most common cause of serious neonatal drug withdrawal symptoms. Other dmgs for which a withdrawal syndrome has been reported include phencyclidine (POP), cocaine, amphetamines, tricyclic antidepressants, phenothiazines, benzodiazepines, barbiturates, ethanol, clonidine, diphenhydramine, lithium, meprobamate, and theophylline. A careful dmg history from the mother should include illicit drugs, alcohol, and prescription and over-the-counter medications, and whether she is breast-feeding. 

German chemists knew in the 1900s that barbiturates could be addictive. However, people who took barbiturates did not always exhibit symptoms of drug dependence or withdrawal. By the 1940s, the addictive nature of barbiturates alarmed groups ranging from the American Medical Association (AMA) to the United States Food and Drug Administration (FDA). 

Depressant drugs share many traits. Alcohol, barbiturates, nonbarbiturate sedatives, and of course benzodiazepines all have similar effects w hcn equated for dose. In addition, cross-tolerance (xxurs between these drugs and they potentiate one another. Crossdependence also occurs because an appropriate dose of any dcpres.sant can be used to reduce the withdraw al symptoms produced by any other. In fact, benzodiazepines are commonly used to witlidraw alcoholics from alcohol. Thus, substantial evidence indicates a common mechanism of action for depressant drugs (Julicn, 2001). 

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