Addiction Treatment Blog

Barbiturates

Concerns about the over-prescription of benzodiazepines in recent years have led some prescribers to look at alternative hypnotic agents – either older compounds such as members of the barbiturate or chloral families, antidepressants, or neuroleptics with a sedative profile. There are a number of problems with such prescriptions as will become clear.

Chloral Compounds

Chloral compounds (see the table below) were first produced in 1869. Their sedative effects were quickly recognised, leading to their use as hypnotics among other things. A number of factors militated against their widespread use. One was the difficulty in making them in other than foul tasting liquid formats. The subsequent discovery of the barbiturates, just before the First World War, largely put paid to them. Before that, however, many patients admitted to mental hospitals were treated with chloral draughts and would appear to have done well. Read more…

As with almost any other pills, antidepressants has their own side effects.

For the first 2 weeks of taking an antidepressant, there may be little other than side effects. Generally, these will be mild. In some cases, however, they may be irritating or even intolerable. The first point to be made is that an antidepressant should only cause tolerable side effects. If treatment makes someone clearly worse, it should be stopped until advice has been sought and until that advice addresses the problem in hand.

Where side effects are more tolerable, there can be a great problem in distinguishing the effects of treatment from some of the symptoms of the illness. Both drugs and illness may cause a dry mouth, headache, indigestion, increased anxiety, sleeplessness or sedation for example.

There is a further unusual aspect to antidepressant side effects. When individuals are depressed, they are often much less sensitive to the effects of anything. They can’t smell, taste or hear as acutely before, for example. It is also common to find that sleeping pills don’t help the insomnia that goes with depression – even three to four times the recommended dose may not bring about sleep. After recovery, some people may be knocked by a low dose of the same sleeping pill that appeared inactive several weeks previously.

However, while some people are less sensitive to side effects when they are depressed, others seem more sensitive. It is very difficult, therefore, to predict the side effects that an antidepressant will have.

The side effects listed are typical. Some occur in everyone to some extent, depending on the particular compound, but they are usually mild and wear off after a few days. Even if they are severe, it should be noted that these side effects are reversible and will halt almost immediately on stopping the drugs.

As with the neuroleptics, there are two sorts of side effects to note. There are those which may feel like a worsening of the illness, like feeling more nervous, feeling strange or unreal, or even hearing voices. These latter side effects are the ones that need careful judgement. Read more…