The most common symptom of withdrawal from normal clinical doses of barbiturates is:
a. hallucinations.
b. convulsions.
c. disorientation.
d. sleeplessness.
The correct answer and explanation is:
The correct answer is: d. sleeplessness.
Barbiturates are central nervous system depressants commonly used for sedation, anesthesia, and seizure control. When a person who has been taking barbiturates regularly at clinical doses suddenly stops or reduces the drug, withdrawal symptoms can occur because the brain has adapted to the presence of the drug.
The most common symptom of withdrawal from normal clinical doses of barbiturates is sleeplessness, also called insomnia. This happens because barbiturates depress the central nervous system and promote sleep and relaxation. When the drug is stopped, the nervous system becomes hyperactive due to the removal of the sedative effect, leading to difficulty falling asleep and maintaining sleep.
Other withdrawal symptoms may include anxiety, irritability, tremors, and increased sensitivity to stimuli. More severe symptoms such as hallucinations, convulsions, and disorientation can also occur, but these are typically seen in cases of withdrawal from very high or chronic barbiturate use, not from normal clinical doses. These severe symptoms result from extreme central nervous system hyperexcitability as the brain tries to rebalance itself after prolonged depression.
The risk of convulsions during withdrawal makes barbiturate cessation potentially dangerous and often requires careful medical supervision with gradual dose reduction or use of alternative medications to ease symptoms.
In summary, sleeplessness is the most common and earliest symptom when normal clinical doses of barbiturates are withdrawn. It reflects the central nervous system’s rebound excitability after the removal of the sedative effects of the drug. Recognizing and managing this symptom is important to support patients safely through withdrawal and prevent progression to more serious complications.