Why Is Phenobarbital Used in Alcohol Withdrawal Treatments?
Phenobarbital is a medication that doctors may prescribe to treat alcohol withdrawal syndrome (AWS) during detox. There are many risks associated with its use, and it’s typically only used in rehab facilities.
Alcohol withdrawal syndrome (AWS) can occur when you stop or limit alcohol use after a period of prolonged and heavy use. This syndrome happens because of alcohol-induced changes to the brain’s neurochemistry over time.
Symptoms are usually mild and may include mild anxiety, headaches, and insomnia. However, AWS can sometimes cause severe and potentially life threatening symptoms, such as delirium and seizures.
Phenobarbital helps reduce the severity of AWS symptoms and complications. That said, its use is limited to those with severe symptoms who are undergoing inpatient care.
We’ll outline alcohol use disorder (AUD) and its relation to AWS and describe how phenobarbital helps to treat AWS.
How does phenobarbital help to treat alcohol withdrawal
Phenobarbital belongs to a class of drugs called barbiturates. These drugs work by slowing activity in the brain.
Doctors may prescribe phenobarbital to treat AWS and reduce the risk of life threatening complications.
In order to understand how phenobarbital helps to treat AWS, it’s important to understand how long-term alcohol consumption affects the brain’s neurochemistry.
The brain produces two neurochemicals that work in harmony to balance the brain’s activity levels:
- Gamma-aminobutyric acid (GABA): This neurochemical works on receptors called GABA receptors to slow brain activity and produce a calming effect.
- Glutamate: This neurochemical works on glutamate receptors to increase brain activity and produce a stimulating effect.
Alcohol acts as a depressant, meaning that it decreases brain activity. If you engage in excessive, long-term alcohol consumption, your brain tries to counteract the depressant effect of the alcohol. It does this by reducing the number of GABA receptors and increasing the number of glutamate receptors.
If you have AUD and suddenly stop consuming alcohol, your brain receptors are not prepared for this change. The low number of GABA receptors and high number of glutamate receptors make your brain overly sensitive to stimulation.
Phenobarbital is a barbiturate medication that works on both GABA and glutamate receptors to help slow brain activity. Therefore, it reduces the severity of AWS symptoms.
Are seizures common during alcohol withdrawal?
Not typically. Seizures only occur in the most severe cases. These cases will also typically require at least some time in a recovery facility where you can be monitored for signs of seizures or other life threatening symptoms.
A 2023 research review lists seizures as a common complication of AWS, noting that alcohol withdrawal seizures typically occur between 8 and 48 hours after quitting alcohol. The review adds that these seizures can occur in the absence of other AWS signs and symptoms.
According to a 2022 systematic review, severe AWS symptoms, such as seizures and delirium, occurred in around 20% of people with AWS.
Moreover, people who experience alcohol withdrawal seizures are at increased risk of developing recurrent seizures.
One of the main uses of phenobarbital is to prevent seizures. If your doctor feels you may be at risk of seizures during your recovery, they may prescribe phenobarbital.
How is phenobarbital used during alcohol withdrawal
Phenobarbital is only used in situations that require partial or constant monitoring to ensure the safety of the person in recovery. It’s typically only used during the first part of detox procedures.
The severity of alcohol withdrawal is labeled in levels 1 through 4. Levels 1 and 2 are the least severe and typically do not require a stay at a recovery facility. Levels 3 and 4 involve more dangerous and require at least a part-time stay at an inpatient facility.
Phenobarbital has many risks for side effects and interference with other medications. It’s typically not used for long periods of time and only under the supervision of specialized healthcare professionals. Your recovery team will discuss the benefits and risks with you whether they feel it’s necessary for your long-term health.
During your recovery, your prescribed phenobarbital dose will gradually decrease over time to prevent phenobarbital withdrawal symptoms, such as anxiety, muscle twitches, and seizures.
Possible side effects of phenobarbital during detox
Phenobarbital may cause side effects, such as:
In some cases, phenobarbital may cause serious side effects. Call a doctor immediately if you experience any of the following:
Consuming alcohol while taking phenobarbital can worsen the side effects of phenobarbital.
Phenobarbital withdrawal symptoms
Suddenly stopping phenobarbital can also cause withdrawal symptoms, such as:
Doctors will taper the phenobarbital dosage over time to reduce the risks of phenobarbital withdrawal.
Resources for alcohol recovery
With the right support and guidance, it’s possible to make a full recovery from AUD. The following resources can help:
You can also talk with a doctor for information, local support centers, and advice on recovering from AUD. In some situations, you may find that an inpatient recovery center to be the best option to support your recovery.
Takeaway
Phenobarbital is a medication that doctors may prescribe to treat alcohol withdrawal syndrome (AWS). It can help reduce the severity of AWS symptoms while also reducing the risk of complications, such as delirium and seizures.
Excessive, long-term alcohol consumption causes changes in the brain. Specifically, it reduces the number of receptors for “calming” neurochemicals and increases the number of receptors for excitatory neurochemicals.
If you have AUD and suddenly stop drinking alcohol, these brain changes lead to a surge in excitatory brain activity. Phenobarbital works by decreasing this activity.
With the right support and guidance, it’s possible to make a full recovery from AUD. Recovery programs that can help include Alcoholics Anonymous, SMART Recovery, and more. You can also talk with a doctor for further information and advice on quitting alcohol.
Here’s an explanation of Phenobarbital for a 5-year-old:
You know how sometimes people like to have fun with their friends and family by playing games or eating yummy treats? But, sometimes, grown-ups drink a special liquid called alcohol and this can make their brain get mixed up. This leads to something called “Alcohol Withdrawal Syndrome” when they stop drinking it. It’s like when you eat too much candy and your body might feel sick.
Phenobarbital is like a special kind of medicine that doctors might give to grown-ups to help make the bad feelings go away. It helps by taking care of the brain and making it feel calm again. Like how you take a nap when you’re feeling tired, Phenobarbital helps their brain take a nap.
When people drink a lot of alcohol over time, their brains get used to it and it makes their brains work really fast. Like when you play a game too many times and it feels like it’s not fun anymore, sometimes the brain gets too used to alcohol and it doesn’t like when it stops. This can make people feel really sick and might even have seizures, which are like having a big scary fit. But, with Phenobarbital, it helps make those sick feelings go away!
Doctors usually only give Phenobarbital when someone is in a special place where people watch over them, called a “recovery center.” They give it to them for a little bit of time and then stop so they don’t get super sick from the medicine too. Sometimes, people might have some yucky side effects like feeling really tired or getting a headache. But, if they do, they can talk to a doctor about it to make it feel better.
There are many special places that help people stop drinking alcohol too much and they can talk to people who understand, like “Alcoholics Anonymous” or “SMART Recovery.” These places have lots of people who know how to make it feel better to stay healthy! And, doctors can give advice and help too!
So, remember, Phenobarbital is like a special helper that makes the brain feel calm while it’s getting used to not drinking alcohol. And there are lots of people who can help if someone needs it.
What is Phenobarbital?
Phenobarbital is a long-acting barbiturate medication primarily used for its sedative and anticonvulsant properties. It helps manage seizures and anxiety by slowing down brain activity.
Why is Phenobarbital Used in Alcohol Withdrawal Treatments?
Phenobarbital is used in alcohol withdrawal treatments because it helps alleviate severe withdrawal symptoms such as seizures, agitation, and anxiety. Its long-acting nature provides a stable and prolonged effect, reducing the risk of complications during withdrawal.
How Does Phenobarbital Work in Treating Alcohol Withdrawal?
Phenobarbital works by depressing the central nervous system, which eases withdrawal symptoms by calming the nervous activity. This helps reduce the risk of seizures and stabilizes an individual’s condition during detoxification from alcohol.
Is Phenobarbital Safe for Alcohol Withdrawal Symptoms?
Phenobarbital is considered safe when administered under medical supervision for treating severe alcohol withdrawal symptoms. Its dosage needs careful management by healthcare professionals to avoid potential side effects and complications.
What Are the Side Effects of Using Phenobarbital in Alcohol Withdrawal?
Possible side effects of phenobarbital include drowsiness, dizziness, and impaired coordination. Long-term use can lead to dependency, so it is generally used only in the short term for alcohol withdrawal management.
Can Phenobarbital Be Used for All Patients With Alcohol Withdrawal?
Phenobarbital may not be suitable for everyone. Its use depends on the severity of the withdrawal symptoms and the patient’s medical history. A healthcare provider decides on its usage based on individual assessments.
What Makes Phenobarbital Different from Other Alcohol Withdrawal Medications?
Phenobarbital’s long duration of action distinguishes it from other alcohol withdrawal medications like benzodiazepines. Its ability to stabilize patients over a more extended period with fewer doses is often preferred in severe cases.
How is Phenobarbital Administered During Alcohol Withdrawal?
Phenobarbital is typically administered orally or intravenously in a clinical setting. The dosage is carefully adjusted to manage symptoms effectively while minimizing side effects.
What Should Patients Expect When Taking Phenobarbital for Alcohol Withdrawal?
Patients can expect relief from severe withdrawal symptoms like seizures and anxiety when under medical supervision. Regular monitoring ensures the medication is working correctly and adjustments can be made as necessary.
Is Medical Supervision Necessary When Using Phenobarbital for Alcohol Withdrawal?
Yes, medical supervision is crucial when using phenobarbital for alcohol withdrawal to ensure safe and effective treatment. Healthcare providers monitor patient responses and adjust treatment as needed.
