Posted by yxibow on February 17, 2006, at 3:07:42
In reply to Re: Secobarbitural Sodium! » yxibow, posted by ed_uk on February 16, 2006, at 13:36:41
> Hi J
>
> >It's just that I dont think people, especially those depressed, etc.. need to have their sleep "induced in 10 minutes."
>
> Clealy, barbiturates are not appropriate for the treatment of insomnia unless it is associated with severe distress. Rapid-acting sedatives can be useful in numerous situations. I never said anything about depression! Seconal Sodium works fast. It can treat a severe panic attack for example. It can calm an intensely agitated manic individual. It can be used as a sedative premedication prior to anesthesia or other medical procedures.Yes -- again, those are inpatient medical procedures. Severe panick attacks can also be solved by a 1mg or more of Xanax, which is also fast acting and safer, but not as cheap.
>
> >I don't need Versed or IV pentothal every night to go to sleep.
>
> Thiopental (Pentothal) is only used by anesthetists ;-)I know, I was putting a bit of this humour in the UK-US barbiturate argument. I assure you, they're not used as much here.
Midazolam (Versed) is a short acting benzodiazepine. It is active orally and by injection. It has similar effects to triazolam (Halcion). Midazolam is preferred to other benzos for IV/IM use because it is much less irritant to the vein/muscle. Apart from this, it is not at all unique.
Yes, they're all presugery prep agents with the exception of Halcion, here, or conscious sedation, which has been banned most places.>
> >Its dangerous and far too artificial.
>
> I don't believe I suggested anything dangerous. Barbiturates are safe when used under appropriately controlled conditions. Up to 200mg Seconal Sodium or Sodium Amytal can be safely administered to patients who do not have any contra-indications. The barbiturate hypnotics are faily well tolerated in the short term, the risk of serious adverse effects is low in properly selected patients.> Barbiturate treatment of insomnia should normally be limited to a few days.
I'll agree with you there....
>
> The barbiturates have numerous indications....
>
> 1. Phenobarbital remains a valuable treatment for epilepsy. It is as effective as the newer anticonvulsants in the treatment of grand mal epilepsy and partial seizures. The low price of phenobarbital is particularly important in developing countries. Many elderly people still take pheno for epilepsy. Younger patients may benefit from pheno when other drugs have been ineffective or poorly tolerated. Pheno is also useful in the management of resistant status epilepticus.I wasn't referring to special situations... I know that certain epileptic disorders are very hard to control.. and you've hit the point right square that barbiturates are just plain cheap. But benzodiazepines here aren't all that much more expensive. Trust me, a **** load of Valium is $20.
>
> 3. Low doses of primidone (Mysoline) are used to treat essential tremor.Here, after experimenting with propranolol, which is a first line, and pindolol and nadolol. Then such agents might be used.
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> 4. Intermediate-acting barbiturates (eg. Seconal) can be useful in hospitalised patients.......as descrived above.agreed
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> 5. Very small quantities of Seconal or Amytal can be prescribed to carefully selected outpatients eg. for the treatment of acute panic attacks or severe insomnia.Very small. A script for 0.5 Xanax is equally effective.
>
> 6. Barbiturates (or benzodiazepines) are used every day/night by elderly people who have been dependent on them for many years, despite the fact that the original indication has long since disappeared. Several weeks supply can normally be prescribed at once.Dependent is the problem.... I don't advocate taking people off of things that work for them but I saw the mismanagement of medications by my grandmother and if she had a barbiturate in her hands instead of Xanax..... oh, never mind.
>
> Kind regards
>
> Ed
>Kind regards to you too Eddy. Write me sometime even if we disagree on the NHS use of barbs. :) Although I really wish I could have a prescription for Soma instead of gargantuan gobs of its weak cousin generic Robaxin that I am prescribed. But of course Soma is a barb cousin, so I'm making a double standard... ah anyhow.... can't mix it with high dose benzos even though a weak 250mg of Soma does more wonders for my back and neck....
Cheers
-- Jay
poster:yxibow
thread:609056
URL: http://www.dr-bob.org/babble/20060212/msgs/610533.html