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Phenobarbital is a drug classified as a barbiturate. It is a substance that acts as a central nervous system depressant.

11 Minutes Read | Published Jan 22 2024 | Updated Mar 07 2024 Expert Verified
Emma Collins
Written by
Dameisha Gibson
Reviewed by
Emma Collins
Written by
Dameisha Gibson
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Common Trade Names: Luminal, Bellergal-S

Other Names: Barbs, Goof Balls, Purple Hearts, Red Devils, Yellow Jackets 

As a drug that is used in the treatment of seizures, phenobarbital works by controlling the activities in the brain responsible for effecting seizures. As a drug of abuse, it is commonly taken to reduce anxiety and to induce sleep.

The US Drug Enforcement Administration has classified phenobarbital as a Schedule IV drug. This means that although phenobarbital has accepted therapeutic uses, it still carries a potential for abuse and a risk for either physical or psychological dependence.

Why People Use Phenobarbital

Phenobarbital is approved for medical use in the treatment of seizures, as well as relief of anxiety. However, some doctors are wary about prescribing the drug due to potential side effects. In addition, as a barbiturate, phenobarbital has the potential to be habit-forming. After prolonged consumption of phenobarbital at high doses, the patient may develop a tolerance as well as physical and psychological dependence.

How Phenobarbital Is Abused

Phenobarbital commonly comes in the form of a white pill and is taken orally. It is most often sought by illicit users for its ability to calm the body, induce feelings of euphoria, and reduce the sensation of pain.

Though phenobarbital is sometimes sold on the streets, it is more common for the drug to be involved in prescription abuse or misuse. This involves either taking the substance in ways other than prescribed by a doctor, using someone else’s prescription, or using the drug for the express purpose of getting high.

Drugs That Interact with Phenobarbital

Phenobarbital may induce adverse side effects when it interacts with other drugs. Some of the drugs that phenobarbital is known to interact with are the following:

  • Contraceptives. As a cytochrome p450 inducer, phenobarbital can lower the efficacy of contraceptives. For women, there is a risk of unwanted pregnancy if phenobarbital is taken with oral contraceptive pills.
  • Anticoagulants. Phenobarbital is also known to interact adversely with anticoagulant drugs like dicumarol. Like other barbiturates, it may cause hepatic microsomal enzymes to form and decrease the anticoagulant drug’s response.
  • Monoamine oxidase inhibitors (MAOIs). Pairing phenobarbital with MAOIs, such as those used as antidepressants, can prolong its barbiturate effect. This is thought to be a consequence of the inhibition of barbiturate metabolism.
  • Other central nervous (CNS) depressants. If phenobarbital is coupled with other CNS depressants like ethanol, hypnotics, or tranquilizers, the result may be a heightened depressant effect on the brain.

Immediate Side Effects of Taking Phenobarbital

The most common short-term side effects of taking phenobarbital include the following:

  • Dizziness
  • Headaches
  • Drowsiness
  • Nausea
  • Vomiting
  • Slurred speech
  • Impaired judgment
  • Loss of coordination
  • Loss of inhibition

There are also some serious side effects associated with phenobarbital abuse, and these include:

  • Difficulty breathing
  • Rashes
  • Blistered skin
  • Swelling in the eyes, cheeks, or lips
  • Fever

Long-Term Side Effects of Taking Phenobarbital

Researchers have also identifies the following as complications of long-term phenobarbital abuse include:

  • Irritability
  • Depression
  • Body aches (in muscles, joints, or bones
  • Loss of appetite
  • Liver damage (in rare cases)
  • Steven-Johnson Syndrome (in rare cases)

What Are the Symptoms of Phenobarbital Overdose?

It is possible to overdose on phenobarbital. In addition, there is a higher risk of fatal overdose with barbiturates like phenobarbital compared to other drugs because there is a smaller window between a safe dose and a deadly one.

The telltale symptoms of phenobarbital overdose include:

  • Blisters
  • Mydriasis (unusually dilated pupils)
  • Involuntary eye movements
  • Polydipsia or excessive thirst
  • Nausea
  • Weakened muscles
  • Loss of coordination
  • Shallow or slowed breathing
  • Low body temperature
  • Decreased heart rate

Signs of Phenobarbital Addiction

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) serves as the framework for diagnosing substance use disorders like phenobarbital addiction. Fulfillment of these 11 criteria may indicate that someone is suffering from phenobarbital use disorder: 

  1. Consumption of larger amounts of phenobarbital or consumption of phenobarbital for longer than one intends
  2. Difficulty when trying to stop phenobarbital use, even if one intends to
  3. Excessive time spent either buying phenobarbital, using phenobarbital, or recovering from phenobarbital use
  4. Experiencing strong cravings for phenobarbital
  5. Inability to manage one’s personal commitments of responsibilities because of phenobarbital use
  6. Repeated use of phenobarbital despite negative effects on personal relationships
  7. Forgoing important activities because of phenobarbital use
  8. Continued use of phenobarbital even if it puts the person in danger
  9. Continued use of phenobarbital despite physical or psychological issues being made worse by drug use
  10. Developing a tolerance for phenobarbital, or needing more of the substance in order to achieve the same effect as before
  11. Developing withdrawal symptoms upon suddenly stopping phenobarbital use

Symptoms of Phenobarbital Withdrawal

Chronic users of phenobarbital may develop a dependence on it, meaning that their bodies will adjust to the presence of the drug in order to function. Common phenobarbital withdrawal symptoms include:

  • Uncontrollable shaking
  • Muscle twitching
  • Anxiety
  • Confusion
  • Restlessness
  • Insomnia or trouble sleeping and staying asleep
  • Drastic changes in vision
  • Dizziness or fainting when trying to stand up from a lying position
  • Stomach cramps
  • Convulsions
  • Hallucinations
  • Delirium
  • Suicidal ideation

It is important to distinguish phenobarbital dependence from phenobarbital addiction. While addiction is characterized by compulsive use of the drug despite harmful consequences, dependence simply refers to the body’s adaptation to the frequent presence of the drug.

If you have become dependent on a drug, you should seek help from a medical detox facility that can help you safely and gradually stop your use of the substance to prevent the manifestation of potentially dangerous acute withdrawal symptoms.

Phenobarbital Detoxification

Experiencing phenobarbital intoxication and withdrawal can be very uncomfortable, painful, and emotionally distressing, which is why medical detox is recommended for individuals who have become dependent on the drug. Detoxification is overseen by medical professionals who make use of evidence-based interventions to help patients.

A patient can expect the phenobarbital detoxification process to include the following measures:

  • Medical personnel will screen and monitor the amount of phenobarbital in the patient’s system to determine the risks of further complications.
  • Stabilization of the patient may involve providing supportive treatment for ensuing bradycardia or hypotension. Intravenous fluids and vasopressors may be administered as necessary.
  • Doctors will formulate a plan to safely remove phenobarbital from the patient’s body. This can include methods like gastric irrigation, diuresis, or dialysis.
  • The patient may be required to follow a tapering schedule, which means they will be given successively less amounts of phenobarbital to get them off the drug gradually and safely.
  • The patient will be taken care of in a safe and stable environment, which will mitigate the emotional and mental stress they may endure because of their withdrawal symptoms.

Phenobarbital Addiction: Rehabilitation and Treatment

If you’re exhibiting signs of phenobarbital addiction, it is best to undergo medical treatment as soon as possible. There are typically two treatment models for phenobarbital use disorder, namely inpatient care and outpatient care

  • Outpatient phenobarbital addiction care. Between the two treatment models, this is the less intensive option. It is best suited for patients who have been diagnosed with mild phenobarbital addiction and who have access to supportive healing environments outside of a treatment facility. In an outpatient arrangement, the patient will be able to live at home for the duration of their program. They will only need to go to the facility if they have a medical appointment, therapy session, counseling session, or drug education class scheduled. They will also be allowed to attend school or to report to
  • Inpatient phenobarbital addiction care. This is the more exhaustive option for treatment, and it is the best recourse for those who are suffering from moderate to severe cases of phenobarbital addiction. It is also the recommended model of treatment for those who have a history of non-compliance in their previous treatment programs. For someone who is getting treated for phenobarbital addiction, inpatient care will be just like being checked into a hospital. They will receive round-the-clock medical attention, and they will be in an environment that will help them concentrate on their recovery.

There is currently no specific treatment for phenobarbital addiction available, which means that pharmacological interventions are mostly supportive and symptomatic in nature. All the same, these interventions matter in saving a person’s life and helping them avoid deadly complications of phenobarbital use disorder.

In addition to pharmacological treatment, the patient will also receive appropriate behavioral treatment to help them achieve awareness and mastery over their triggers for drug abuse. This can include contingency management, cognitive behavioral therapy, group or individual therapy, and counseling sessions to help them repair broken relationships with family members or romantic partners.11

Start Your Rehabilitation Journey Today

Someone who is suffering from phenobarbital addiction may feel like they are a lost cause or like they will never be able to regain control of their lives. However, it is never too late to reverse the hold that substance use disorder has over you. With proper treatment, you will be able to vanquish phenobarbital addiction and go back to a happy, healthy, and drug-free life.

For timely help in receiving treatment for your condition, call Better Addiction Care at (800) 429-7690 and speak to one of our trained recovery support advisors. We can recommend to you a local treatment center and verify your insurance status for either inpatient or outpatient addiction care. We can also help you weigh different financing options even if you aren’t currently enrolled in an insurance plan.

The Origins and History of Phenobarbital

Phenobarbital was first synthesized by Heinrich Hörlein in 1912 and introduced as an antiepileptic medicine the following year under the name Luminal. Barbiturates like phenobarbital saw their heyday in the medical field in the 1930s and 1940s. However, by the 1950s, scientific evidence began to emerge about the potential of phenobarbital and other drugs in the barbiturate class to become drugs of abuse.

Abuse of barbiturates was prevalent in the 1960s and 1970s, but factors like stricter regulation of these drugs and the introduction of other sedative-hypnotic substances like benzodiazepines decreased the frequency of abuse. Still, phenobarbital remains a drug to be watched for its abuse potential and the severity of complications associated with withdrawal and overdose.


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