Mental health issues are not something to be taken lightly for. In the modern days, it seems as important as physical health. Having a mental disorder can be difficult to live with but living in this modern way has made many treatment options for it more accessible. There are many medicines used to treat mental disorders that may also be used to treat diseases unrelated to mental issues. In this DoctorOnCall’s article, we will learn more about barbiturates that are commonly used in both mental disorders and neurological disease, and is it a psychoactive drug?

Barbiturates are substances that are synthetically made as pharmaceutical products. Barbiturates belong to the sedative-hypnotic drug class. Barbiturates were first introduced to medicine in 1904. It was used in many treatments including anxiety, insomnia, seizure and anaesthetic agent before benzodiazepines are introduced in the 1960s. Nowadays, the usage of barbiturates are less preferred to reduce the potential of drug abuse. There were 2500 derivatives that have been produced but only 50 are now used for medical purposes. There are 12 barbiturates under international control.

Some of the common medications under the barbiturates group are phenobarbital, thiopental, butalbital, methohexital, pentobarbital, amobarbital and primidone. Barbiturates are also known as central nervous system depressants as it produces effects of mild sedations to general anaesthesia. It is classified as ultra-short, short-, intermediate- and long acting. The way barbiturates work is by enhancing the action of GABA by binding to the GABA-A receptor or chloride channel. GABA is a neurotransmitter or brain chemical that produces a calming effect on the body. Thus, usage of barbiturates that enhance GABA action is able to produce the sedative effect.

However, due to the fact that action of barbiturates is less specific due to the binding sites when compared to benzodiazepine, this unique action has led barbiturates no longer being recommended to be used for a lot of conditions. Benzodiazepine does not react with the chloride channel which is in contrast with barbiturates as barbiturates can cause an increase of chloride despite only a low level of GABA. Hence, this nonspecific action has caused benzodiazepine to be preferred as it targets the GABA binding site and not the chloride.

Despite the use of barbiturate that is limited, there is still room for barbiturate to work in medical treatment. Barbiturate is known to be a good medicine for treating status epilepticus, which is a form of seizure that is considered as severe. It is also used for general anaesthesia in cases where administration of anaesthesia through intravenous is difficult. Barbiturate has been proven to help with sleeping disorders and anxiety. Barbiturates is also used in cases of traumatic brain injury as it is able to reduce the high pressure inside the head (intracranial pressure) and to protect the brain from further damage. High levels of bilirubin in the newborn may also be treated with barbiturates. Combination of barbiturate with other medications may be used for headache and muscle pain.

Now, is barbiturate a psychoactive drug? Yes, barbiturate is a psychoactive drug. Psychoactive drugs are substances that can affect mental processes significantly. Barbiturate is a psychoactive drug as it is able to alter consciousness and sanity. Past history has shown that the use of barbiturate to schizophrenic patients can mimic psychotic-induced sedation which causes them to relax and sleep. Just imagine if people who do not have a diagnosed mental disorder as severe as schizophrenia use barbiturates? It breeds tragedy. Due to the fact that it is a psychoactive drug, the usage of barbiturate must be under supervision of medical personnel and it is considered as a controlled drug.

Barbiturate usage has been abused in some people. This drug abuse is certainly a big problem, especially with the fact that barbiturate in small doses can already be lethal. As little as 2 to 3 grams of barbiturates can already lead to death. This can be made worse due to its long-lasting nature of staying in the human body for a long period of time. This will lead to toxic buildup. Furthermore, the more barbiturate is taken, the higher a person is to tolerate the mind-altering effects, making them more intrigued to take barbiturates. Barbiturate abuse can occur by swallowing pills or injecting liquid aiming to reduce anxiety and to treat unwanted effects of drugs. Mixing barbiturates with other substances such as alcohol can further increase risk of dying from respiratory and heart low functions.

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It can be concluded that barbiturates are psychoactive drugs that are controlled as the risk for this drug abuse is high. Barbiturates can only be used under supervision of healthcare professionals. This ensures that barbiturate is only used for the right indication with the right dosage and duration. The overdose or misuse of barbiturates can be lethal even in small amounts. If you or someone you know experiences drug abuse or needs help, do get the care and support needed by visiting the closest healthcare facility or National Anti-Drugs Agency (NADA) for more information and support.