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  1. 1. Barbiturates andBarbiturates and BenzodiazepinesBenzodiazepines Psychology 3506Psychology 3506
  2. 2. IntroductionIntroduction  Along with methaqualone andAlong with methaqualone and meprobamate, they are in the sedative-meprobamate, they are in the sedative- hypnotic and tranquilizer categoryhypnotic and tranquilizer category  Basically they are tranquillizersBasically they are tranquillizers  Like drinks and gas sniffing, they facilitateLike drinks and gas sniffing, they facilitate the functioning of GABA, the universalthe functioning of GABA, the universal inhibitory neurotransmitter.inhibitory neurotransmitter.
  3. 3. IntroductionIntroduction  Barbiturates basically replaced things likeBarbiturates basically replaced things like opium and brandy for MDsopium and brandy for MDs  Phenobarbital is still used to preventPhenobarbital is still used to prevent seizuresseizures  Sternback et al discovered theSternback et al discovered the benzodiazepines by brute force.benzodiazepines by brute force. Discovered diazepam (Valium)Discovered diazepam (Valium)  RohypnolRohypnol
  4. 4. AdministrationAdministration  Rapid effect, go with IVRapid effect, go with IV  Long term, oral betterLong term, oral better  Diazepam is the quickest, 30 min peakDiazepam is the quickest, 30 min peak  Absorption from digestive system isAbsorption from digestive system is GREATLY increased by taking alcoholGREATLY increased by taking alcohol SuperadditiveSuperadditive  Great deal of variabilityGreat deal of variability
  5. 5. DistributionDistribution  More lipid soluble ones go through BBMore lipid soluble ones go through BB barrier more quicklybarrier more quickly  Redistributed to fat cellsRedistributed to fat cells Biphasic curveBiphasic curve  Many metabolites are also psychoactiveMany metabolites are also psychoactive  Also cross the placental barrier too…Also cross the placental barrier too…
  6. 6. NeurophysiologyNeurophysiology  Modifies the effect ofModifies the effect of GABAGABA  GABA lets Cl- inGABA lets Cl- in  Harder to fireHarder to fire  Positive GABAPositive GABA modulatorsmodulators  Make GABA moreMake GABA more effectiveeffective  Barbiturates can openBarbiturates can open ion channel all byion channel all by themselves at higherthemselves at higher levelslevels
  7. 7. EffectsEffects  Barbiturates affect blood pressure,Barbiturates affect blood pressure, benzodiazepines do not.benzodiazepines do not.  Both have anti convulsant propertiesBoth have anti convulsant properties  Benzodiazepines are good muscleBenzodiazepines are good muscle relaxantsrelaxants  REM effectsREM effects  REM reboundREM rebound  Euphoria, ‘liking’ and fatigueEuphoria, ‘liking’ and fatigue
  8. 8. More effectsMore effects  ConfusionConfusion  Decrease in visual acuityDecrease in visual acuity  Divided attention becomes more difficultDivided attention becomes more difficult  Reaction timeReaction time  Acquisition but not recall effectsAcquisition but not recall effects  HangoverHangover  DO NOT DRIVEDO NOT DRIVE
  9. 9. Even more effectsEven more effects  More exploration in lab animalsMore exploration in lab animals Huh?Huh? Disinhibition?Disinhibition? Less anxiety probablyLess anxiety probably  Increase FR responding, decrease FIIncrease FR responding, decrease FI Timing effect?Timing effect?  Increase in punished behaviourIncrease in punished behaviour  Dissociation effectsDissociation effects
  10. 10. ToleranceTolerance  Acute tolerance develops virtually rightAcute tolerance develops virtually right awayaway  Chronic tolerance seems first to developChronic tolerance seems first to develop to the depressant effectsto the depressant effects  Next to the antianxiety effectsNext to the antianxiety effects  Cross tolerance within benzodiazepinesCross tolerance within benzodiazepines  Some cross tolerance to barbiturates andSome cross tolerance to barbiturates and alcoholalcohol
  11. 11. WithdrawalWithdrawal  BarbituratesBarbiturates REM ReboundREM Rebound TremorsTremors InsomniaInsomnia NauseaNausea SeizuresSeizures HallucinationsHallucinations
  12. 12. WithdrawalWithdrawal  BenzodiazepinesBenzodiazepines AgitationAgitation DepressionDepression PainPain DTsDTs REM reboundREM rebound Two stage withdrawalTwo stage withdrawal
  13. 13. Self-administrationSelf-administration  Most people will NOT choose to takeMost people will NOT choose to take thesethese  Some will, but usually if they have aSome will, but usually if they have a history of alcohol or sedative usehistory 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 shoppingIatrogenic use and doctor shopping  Street use, smoothing out a speed rushStreet use, smoothing out a speed rush and as a substitute for Heroinand as a substitute for Heroin
  14. 14. Bad stuffBad stuff  Birth defects (barbiturates for sure, maybeBirth defects (barbiturates for sure, maybe benzodiazepines)benzodiazepines)  Newborns go through withdrawalNewborns go through withdrawal  Demasculanizing effectsDemasculanizing effects  Aggression and violenceAggression and violence  LD shows no tolerance but ED does,LD shows no tolerance but ED does, so…..so…..  ODOD
  15. 15. TreatmentTreatment  Have to get over the withdrawal firstHave to get over the withdrawal first  Detox in other wordsDetox in other words  Under a Doc’s careUnder a Doc’s care  12 step programs12 step programs  ContractingContracting  Tough with people using it illegally, hard toTough with people using it illegally, hard to get them to admit to it etcget them to admit to it etc