Using Phenobarbital For Alcohol Withdrawal

Phenobarbital is a prescription medication that is used to treat withdrawal seizures, effects of hallucinatory drugs, symptoms of acute alcohol withdrawal, and more. It belongs to the barbiturate class of drugs and is used primarily as an anticonvulsant.

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Phenobarbital is a drug that has seen increasing use as one of the possible medications used in treating alcohol withdrawal thanks to its powerful sedative anti-seizure effects.

Unlike lorazepam (Ativan) and diazepam (Valium) — which belong to the benzodiazepine drug class — phenobarbital has less of an addictive nature. But there is still the potential for dependence.

One of the most severe withdrawal symptoms that phenobarbital can treat is delirium tremens (DTs), which is characterized by altered mental states and respiratory depression.

This medication, however, can also treat a number of far more minor symptoms that may not warrant intensive care unit (ICU) admission, such as tremors, nausea, and headaches.

How Phenobarbital Treats Alcohol Withdrawal

Phenobarbital acts as a barbiturate medication to calm and sedate the brain while reducing neurotransmitter activity.

It produces this depressive and calming effect through actions on the gamma-aminobutyric acid neuroreceptors, reducing the dispersion of stress chemicals.

Similar to benzodiazepine therapy, doses of phenobarbital act on the central nervous system (CNS), depress the sensory cortex, and decrease motor activity.

Management Of Alcohol Withdrawal Symptoms With Phenobarbital

The treatment of alcohol withdrawal syndrome using phenobarbital follows a specific set of administration guidelines to ensure the person’s health and safety.

Studies have found that the best initial loading dose of phenobarbital, at least for adults, is between 30 and 60 milligrams.

However, IV phenobarbital doses are generally begun at lower amounts, due to the direct bloodstream injection process that is proprietary to intravenous administration.

Advantages Of Using Phenobarbital For Alcohol Withdrawal

There are many advantages to using phenobarbital in the treatment of alcohol abuse.

Phenobarbital has a long history of use and effectiveness — combined with a low cost and reduced addictive nature, making it a respectable option.

Randomized controlled trials using phenobarbital with placebo and non-barbiturate medications have found it to be an extremely effective pharmacokinetic treatment option.

The following are some other benefits of using phenobarbital to treat symptoms of alcohol withdrawal.

Longer Half-Life Than Benzodiazepines

Phenobarbital has a long half-life. This means that a single dose, administered either in pill form or through intravenous injection, can last in the blood up to 24 hours, as opposed to six to 12 hours like benzodiazepines.

Can Be Combined With Benzodiazepines

Phenobarbital protocol states that it can be combined with benzodiazepines and other medications upon the medical advice of a healthcare professional.

Side Effects Of Phenobarbital Use

Like many other medications, phenobarbital has a number of side effects, some of which can be potentially life-threatening.


Over-sedation is a potential side effect of phenobarbital use, as it causes the medication to prevent excitatory chemicals from being released from GABA receptors in the brain.

Respiratory Depression

Another potential side effect of phenobarbital use is respiratory depression, wheezing, and other breathing problems.

If you experience any kind of adverse event stemming from phenobarbital use, immediately call 911 to seek critical care help from an intensive care unit.

Fortunately, respiratory depression is treatable through intubation, but calling 911 to request ICU admission is the most important preliminary step to seeking treatment.

Nausea And Vomiting

Clinicians have reported that some people who have been prescribed phenobarbital to treat severe alcohol withdrawal symptoms have experienced nausea and vomiting.

This, alongside other potential side effects, is a result of the glutamate receptors—which manage a number of central nervous system processes—being sanctioned by phenobarbital.

Treatment Options For Alcohol Use Disorder

Fortunately, there are a number of substance use disorder treatment programs and services currently employed to treat the symptoms of alcohol withdrawal.

Some of these alcohol abuse treatment protocols and programs include:

  • inpatient and outpatient treatment
  • prescription of symptom control medications
  • alcohol detoxification programs
  • monotherapy with alternative medications, such as dexmedetomidine
  • a systematic review of all patients alongside case management to best facilitate recovery
  • psychiatry and mental health services
  • mechanical ventilation for respiratory problems induced by alcohol withdrawal
  • residential treatment programs with individual hospital length-of-stays

Find Substance Use Disorder Treatment At Bedrock Recovery Center

If you or a loved one are looking for alcohol withdrawal treatment using medications such as phenobarbital and other evidence-based treatment, we can help.

Give our free helpline a call today to discuss enrollment at Bedrock Recovery Center and our alcohol and drug treatment plans.

  1. National Institute of Health: PubMed
  2. National Institute of Health: PubMed

Written by Bedrock Recovery Center Editorial Team

© 2023 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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