Barbiturates and Benzodiazepines Psychology 3506

Introduction Along with methaqualone and meprobamate, they are in the sedative- hypnotic and tranquilizer category Along with methaqualone and meprobamate, they are in the sedative- hypnotic and tranquilizer category Basically they are tranquillizers Basically they are tranquillizers Like drinks and gas sniffing, they facilitate the functioning of GABA, the universal inhibitory neurotransmitter. Like drinks and gas sniffing, they facilitate the functioning of GABA, the universal inhibitory neurotransmitter.

Introduction Barbiturates basically replaced things like opium and brandy for MDs Barbiturates basically replaced things like opium and brandy for MDs Phenobarbital is still used to prevent seizures Phenobarbital is still used to prevent seizures Sternback et al discovered the benzodiazepines by brute force. Sternback et al discovered the benzodiazepines by brute force. Discovered diazepam (Valium) Discovered diazepam (Valium) Rohypnol Rohypnol

Administration Rapid effect, go with IV Rapid effect, go with IV Long term, oral better Long term, oral better Diazepam is the quickest, 30 min peak Diazepam is the quickest, 30 min peak Absorption from digestive system is GREATLY increased by taking alcohol Absorption from digestive system is GREATLY increased by taking alcohol Superadditive Superadditive Great deal of variability Great deal of variability

Distribution More lipid soluble ones go through BB barrier more quickly More lipid soluble ones go through BB barrier more quickly Redistributed to fat cells Redistributed to fat cells Biphasic curve Biphasic curve Many metabolites are also psychoactive Many metabolites are also psychoactive Also cross the placental barrier too… Also cross the placental barrier too…

Neurophysiology Modifies the effect of GABA Modifies the effect of GABA GABA lets Cl- in GABA lets Cl- in Harder to fire Harder to fire Positive GABA modulators Positive GABA modulators Make GABA more effective Make GABA more effective Barbiturates can open ion channel all by themselves at higher levels Barbiturates can open ion channel all by themselves at higher levels

Effects Barbiturates affect blood pressure, benzodiazepines do not. Barbiturates affect blood pressure, benzodiazepines do not. Both have anti convulsant properties Both have anti convulsant properties Benzodiazepines are good muscle relaxants Benzodiazepines are good muscle relaxants REM effects REM effects REM rebound REM rebound Euphoria, ‘liking’ and fatigue Euphoria, ‘liking’ and fatigue

More effects Confusion Confusion Decrease in visual acuity Decrease in visual acuity Divided attention becomes more difficult Divided attention becomes more difficult Reaction time Reaction time Acquisition but not recall effects Acquisition but not recall effects Hangover Hangover DO NOT DRIVE DO NOT DRIVE

Even more effects More exploration in lab animals More exploration in lab animals Huh? Huh? Disinhibition? Disinhibition? Less anxiety probably Less anxiety probably Increase FR responding, decrease FI Increase FR responding, decrease FI Timing effect? Timing effect? Increase in punished behaviour Increase in punished behaviour Dissociation effects Dissociation effects

Tolerance Acute tolerance develops virtually right away Acute tolerance develops virtually right away Chronic tolerance seems first to develop to the depressant effects Chronic tolerance seems first to develop to the depressant effects Next to the antianxiety effects Next to the antianxiety effects Cross tolerance within benzodiazepines Cross tolerance within benzodiazepines Some cross tolerance to barbiturates and alcohol Some cross tolerance to barbiturates and alcohol

Withdrawal Barbiturates Barbiturates REM Rebound REM Rebound Tremors Tremors Insomnia Insomnia Nausea Nausea Seizures Seizures Hallucinations Hallucinations

Withdrawal Benzodiazepines Benzodiazepines Agitation Agitation Depression Depression Pain Pain DTs DTs REM rebound REM rebound Two stage withdrawal Two stage withdrawal

Self-administration Most people will NOT choose to take these Most people will NOT choose to take these Some will, but usually if they have a history of alcohol or sedative use Some will, but usually if they have a history of alcohol or sedative use If you like alcohol, you will like these! If you like alcohol, you will like these! Iatrogenic use and doctor shopping Iatrogenic use and doctor shopping Street use, smoothing out a speed rush and as a substitute for Heroin Street use, smoothing out a speed rush and as a substitute for Heroin

Bad stuff Birth defects (barbiturates for sure, maybe benzodiazepines) Birth defects (barbiturates for sure, maybe benzodiazepines) Newborns go through withdrawal Newborns go through withdrawal Demasculanizing effects Demasculanizing effects Aggression and violence Aggression and violence LD shows no tolerance but ED does, so….. LD shows no tolerance but ED does, so….. OD OD

Treatment Have to get over the withdrawal first Have to get over the withdrawal first Detox in other words Detox in other words Under a Doc’s care Under a Doc’s care 12 step programs 12 step programs Contracting Contracting Tough with people using it illegally, hard to get them to admit to it etc Tough with people using it illegally, hard to get them to admit to it etc