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Death may occur when barbiturates are combined with depressants such as opiates, benzodiazepines, gabapentinoids, thienodiazepines, alcohol or other GABAergic substances.[1]

It is strongly discouraged to consume moderate to heavy dosages of these substances together.

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The structure of barbituric acid

Barbiturates (also referred to as barbies) are a class of drugs that act as central nervous system depressants. Similarly to benzodiazepines, they produce a variety of effects including sleepiness, anxiety suppression, muscle relaxation, seizure suppression and sedation. Barbiturates have been largely replaced by benzodiazepines, generally because benzodiazepines have lower toxicity compared to barbiturates. However, barbiturates are still used today for various medical purposes, mostly for anesthesia.

It's worth noting that the sudden discontinuation of barbiturates can be potentially dangerous or life-threatening for individuals using regularly for extended periods of time, sometimes resulting in seizures or death.[2]

Chemistry

Barbiturates are based on the barbituric acid molecule. Commonly, two hydrocarbon substitutions are present at carbon R5. of the pyrimidine ring. It also contains three double-bonded oxygen substitutions at R2, R4 and R6.

Pharmacology

This pharmacology section is incomplete.

You can help by adding to it.

Subjective effects

Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWiki contributors. As a result, they should be viewed with a healthy degree of skepticism.

It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠. These effects are listed and defined in detail within their own dedicated articles below:

Physical effects

Paradoxical effects

Cognitive effects

Toxicity and harm potential

This toxicity and harm potential section is a stub.

As a result, it may contain incomplete or even dangerously wrong information! You can help by expanding upon or correcting it.
Note: Always conduct independent research and use harm reduction practices if using this substance.

Barbiturates are toxic at higher dosages. Barbiturates have a greater addiction potential than benzodiazepines. Overdose can be achieved easier with barbiturates than with benzodiazepines. Some barbiturates, such as phenobarbital, have been linked to the development to cancer. Using barbiturates concurrently with other depressants can be considered extremely dangerous, even in lower doses, and may lead to serious respiratory depression or possibly death.

Tolerance and addiction potential

Barbiturates can be considered extremely physically and psychologically addictive. Short-acting barbiturates are significantly more addictive than long acting barbiturates.

Tolerance will develop to the sedative-hypnotic and euphoric effects of barbiturates after prolonged use. It is unknown exactly how long it takes for tolerance to reach baseline. Barbiturates present cross tolerance with each other, meaning that tolerance to one barbiturate will lead to tolerance of all barbiturates.

Discontinuation

Barbiturate withdrawal is medically serious and can potentially cause a life-threatening withdrawal syndrome that can cause seizures, psychosis, and death. Drugs which lower the seizure threshold such as tramadol and amphetamine should be avoided during withdrawal. If an individual is addicted to a short-acting barbiturate such as pentobarbital, switching to a longer acting drug such as phenobarbital may be of some benefit.

Overdose

Barbiturate overdose may occur when a barbiturate is taken in extremely heavy quantities or concurrently with other depressants. This is particularly dangerous with other GABAergic depressants such as benzodiazepines and alcohol since they work in a similar fashion, but bind to distinct allosteric sites on the GABAA receptor, thus their effects potentiate one another. Benzodiazepines increase the frequency in which the chlorine ion pore opens on the GABAA receptor while barbiturates increase the duration in which they are open, meaning when both are consumed, the ion pore will open more frequently and stay open longer[3]. Barbiturate overdose is a medical emergency that may lead to a coma, permanent brain injury or death if not treated promptly and properly. Barbiturate overdose has an increased frequency of serious adverse effects when compared to other depressants.

Symptoms of a barbiturate overdose may include severe thought deceleration, slurred speech, confusion, delusions, respiratory depression, coma or death[4].


See also

References