Barbiturates for Tinnitus

at a glance these appear to be widely available and trivially easy to obtain in the US, but also appear to be illegal in the US. Strange...
From what I can find you're not allowed to have them without a doctor prescription.

"The Misuse of Drugs Act classes barbiturates as class B drugs, which means they can be bought in accordance with a doctor's prescription, but any other form of possession or supply counts as an offence. The maximum penalty a person can receive for any unauthorised possession is 5 years in prison and a fine for possession. For supply, the maximum penalty is 14 years in prison and a fine."
 
@undecided I guess we have very different cats; a staggered dose of 5 capsules (Corvalol) seemed to exacerbate my cat's ringing and had some other undesirable effects so she did not proceed with any dose escalation from there.

It's also worth noting that, worrying side effects of barbiturates in general aside, Corvalol is clearly unsuitable for regular use because it's other active ingredient is a bromide and has been shown to lead to neurotoxic effects with continued administration....
 
Are there any Mexicans here? Is it true you can buy barbiturates (the strong version) at veterinary stores there?
you can buy straight up narcotics at human pharmacies within a mile of the border, so I would imagine that barbs would be even easier. Of course, if you don't have a valid prescription, you're flirting with spending 15 years in a mexican jail, regardless of whether you bought it from a vet or a human pharmacist.

Again, barbs are really, really unlikely to be helpful to people who are not also helped by benzos, and benzos are so much safer and trivially easy to obtain legally in the US that I don't think this is a very useful line of inquiry.
 
Again, barbs are really, really unlikely to be helpful to people who are not also helped by benzos, and benzos are so much safer and trivially easy to obtain legally in the US that I don't think this is a very useful line of inquiry.
Hi @linearb, I'm a bit of a dunce when it comes to pharmacology / how drugs work in the body, etc., and I have a lot of respect for your knowledge/experience in this field. Would you be willing to expand a little bit on why you think this, without getting too technical?

Let's hypothetically assume I might be able to safely access a small quantity of nembutal. Let's also assume that I am not interested in temporary management of symptoms, only in achieving a lasting reduction of volume. In your opinion, is there any realistic chance that this could be achieved? Conversely, do you think that there is any likelihood that a lasting worsening of tinnitus might occur (as occasionally happens with benzos) as a result of being on this drug for a few weeks?

Sorry to ask so many questions, and thanks in advance for any thoughts you have. I am asking specifically because of the section below from the link that was provided in the original post, which seems to reference a seemingly respectable study. No worries if you have nothing to add, I just thought I would ask.
Sodium Amylobarbitone
Noting a relationship between drugs that are effective on trigeminal neuralgia and on tinnitus (e.g., carbamazepine), Donaldson (1978) selected this fast-acting barbiturate, known for its effectiveness on trigeminal neuralgia, for a study on tinnitus. Forty patients with tinnitus of varying severity were randomly assigned to the experimental or control groups. Prior to treatment, all patients were assessed audiometrically, were asked to match the pitch and loudness of their tinnitus, and were asked to rate their tinnitus on a four-point scale (from "only noticeable in quiet environments" to "interferes with sleep, and patient engages in some activity to distract attention from it"). The experimental group was then put on a regimen of 50 mg in the morning, 50 mg in the early afternoon, and 80 mg at night; tinnitus was reassessed after 6 and 12 weeks. The drug was withdrawn after 12 weeks, and a final assessment was made at 18 weeks. Apparently the control group received absolutely nothing, but these subjects were reassessed at 6 and 12 (but not 18) weeks. Thus, the study was not "blind,'' and the control group was primarily a control for the passage of time (and for the spontaneous remissions that might occur in that time). Prior to treatment, the majority (70 percent) of both the experimental and control groups matched their tinnitus to frequencies of 400–10,000 Hz, and 78 percent matched to intensities of 20 dB SL or less (in good accord with Reed, 1960). After 12 weeks, the control group changed very little on these measures, but marked changes occurred in the experimental group. Thirteen (of 20) in the experimental group (compared with 2 in the control group) matched to lower intensities—this included 4 subjects for whom the tinnitus was abolished—and many now matched to a lower frequency, a fact that stands unexplained (but was also obtained by Martin and Colman, 1980). Perhaps most important is the fact that, of the 12 experimental subjects who, prior to treatment, rated their tinnitus as being in one of the two most severe categories, only 1 persisted in this rating at the 12-week reassessment. That is, 11 of the 12 most severe cases (92 percent) benefitted from the amylobarbitone regimen, and, for 2 of these, the tinnitus was abolished.

Thus, Donaldson's study provides evidence that sodium amylobarbitone may be quite effective in diminishing the disturbance caused by tinnitus. Its usefulness as a treatment for episodic or chronic tinnitus is somewhat limited by its potential for damaging the liver, but in the (apparently effective) dosage used by Donaldson, no such problems arose. One curious aspect of Donaldson's report is that at the 18-week reassessment—6 weeks after drug usage had ceased—there were "no significant alteration(s)" in the states of the experimental subjects, including no return of tinnitus in the four subjects who had reported it abolished. This implies a reversal of the conditions initially responsible for the tinnitus—an unlikely event—which makes this an outcome requiring verification through further study.
http://journals.cambridge.org/actio...e=online&aid=1128788&fileId=S0022215100085121
 
Would you be willing to expand a little bit on why you think this, without getting too technical?
Barbs and benzos do something similar through different mechanisms; they have different receptor targets, but both increase the action of GABA, so they both create sedative effects that are broadly similar.

A big difference is in how dangerous the two classes of drugs are. A number that's often used to assess drug danger is the "LD50", the "50% lethal dose" - meaning if I give this dose to 100 people, 50 of them will die. The ratio between that LD50 number and a typical/effective dose, tells us something about how toxic the drug is.

An effective dose of phenobarbital is something like 150-300mg, and for a 150lb human, the LD50 is something like 1200-1400mg. So, taking a 4-5x overdose, is likely to kill you. Benzos on the other hand are astronomically hard to overdose on (unless you've taken other sedatives/alcohol at the same time, in which case they can also become dangerous pretty quickly). I am having a hard time immediately finding an LD50 number for humans, but in rats, it's something like 1400mg/kg for Valium. Even if we assume it's 10 times more lethal in humans than rats, a lethal dose for a 150lb person is something like 10g, which is about a thousand times greater than a typical dose of 10mg.

So, both phenobarbital and diazepam work by doing something pretty similar, but one of them will kill you if you take 3-5x as much as a usual dose, and the other will kill you if you take 500-1000x as much. Very, very significant difference.

Let's hypothetically assume I might be able to safely access a small quantity of nembutal. Let's also assume that I am not interested in temporary management of symptoms, only in achieving a lasting reduction of volume. In your opinion, is there any realistic chance that this could be achieved? Conversely, do you think that there is any likelihood that a lasting worsening of tinnitus might occur (as occasionally happens with benzos) as a result of being on this drug for a few weeks?
I think it's incredibly unlikely that any GABA agonist drug will cause a lasting reduction in volume; these drugs do a good job of limiting hyperactivity while they are in the body, and then they wear off, hyperactivity returns, and may be worse for a while if you have taken the drug for a period of time. I also think that there is some risk of long-term elevation in symptoms from using any GABA drug more than infrequently.
 
I'm just a bit stunned that nobody followed up with a more complete (and actually properly blinded) study as this seemed to actually alleviate tinnitus rather than suppress it for some time.
That was 40 years ago from Manchester Royal Infirmary published through Cambridge...?
I think the answer is all in linearb´s post. As long as you can easily kill yourself on a drug, doctors/community will be very reluctant to prescribe it/give access to it.

I asked my GP for it. Said he had to confere with fellow docs first. Wich means NO!
 
I think it's incredibly unlikely that any GABA agonist drug will cause a lasting reduction in volume; these drugs do a good job of limiting hyperactivity while they are in the body, and then they wear off, hyperactivity returns, and may be worse for a while if you have taken the drug for a period of time. I also think that there is some risk of long-term elevation in symptoms from using any GABA drug more than infrequently.
OK, thanks for your trouble replying. From what you say it doesn't seem worth trying this out. I always resisted using benzos after the things I read about them and have never doubted that decision. I'm not worried about any danger of accidental overdose with barbs, but would only want to spend several weeks on addictive meds if there was a chance of a lasting benefit.

I do wonder what was going on in that study though - the results as described in the article do sound unusually promising as regards the benefit at 18 weeks.

I'm just a bit stunned that nobody followed up with a more complete (and actually properly blinded) study as this seemed to actually alleviate tinnitus rather than suppress it for some time.
That was 40 years ago from Manchester Royal Infirmary published through Cambridge...?
I would guess that it was not followed up because I believe there was a move to reduce use of barbiturates around that time due to the ease of overdose. I guess it was the wrong time to discover new uses for those drugs? Or maybe other studies were done and could not reproduce the results? Just speculating, don't really know. :dunno:
 
@dboy fwiw I would expect that the risk of really long-term harm from ~3 months of use, would probably be quite low. However, I'd be surprised if it did anything beneficial, either. That is an interesting study, but one assumes that if it worked it would have been replicated by others at some point; barbs may have been falling out of favor by the time this work was done, but they're still used to some extent in the US and they're pretty cheap and well understood.
 
I guess it is possible that the results of the study were down to placebo effect, since this was not controlled for. I know the placebo effect can do very powerful things. Although it does seem pretty unlikely that it could make a serious case of tinnitus just disappear - if it could then we'd probably all be discovering tinnitus cures all the time whenever we tried something out.

Maybe the importance of tinnitus was so little recognised at the time that nobody thought it worth following up? Maybe it wasn't seen as the potential money-spinner it is starting to be seen as now?

I'm toying with the idea of signing up to pay for access to the paper. Anyone got access to it through a university or similar?
 
I found it
That's great, thanks very much!

...
Edit to add interesting quote from the introduction:
It should be noted from published reports that the most successful medications in the control of tinnitus are barbiturates, meprobomate and reserpine, all of which are drugs which depress the reticular part of the central nervous system.

It seems there might be other reports to track down, unfortunately from before everything was on the internet.
 
I don't see any reason to expect permanent or long-term benefit from that study? They put people on a pretty significant dose of barbs for 12 weeks, and the last assessment was 6 weeks afterwards; amylobarbitone has a shorter half-life than phenobarb, but it's still long enough that you'd want to retest ~3-6 months later to prove that you're not just seeing a long-term reduction in neuronal hyperactivity as a direct result of loading on a long-acting sedative for weeks.
undecided said:
Maybe its time to order some more of that sweet dope.
Just to have around.
I would recommend a pure barb; that Corvalol shit has another active in it, and it's a bromide. Neurotoxicity ahoy, I hope you load on iodine ;) OTOH there's something hilarious about buying Soviet-bloc downers on eBay, so...
 
I wish it wasn't so hard to acquire. Many of us would be trying it...
what's the advantage over benzos, besides the elevated risk of accidental death? I'm pretty confident that if you replicated the study posted here using a long-acting benzo, you'd see a similar effect, which also might persist for a few weeks afterwards (but almost certainly not more than that).

Barbs were likely a front line drug for tinnitus prior to the advent of diazepam; if they were a silver bullet we'd know it...
 
Pentobarbital is seen in films. Barbituates are also used in euthenasia in high doses if I'm correct (>15 gram is lethal). Fine if you possess it: 81.000 euro or 4 years in prison. I'd rather buy myself a gun and say bye bye before spending 4 years in prison with T. Strictly under opium law forbidden. So if this really works there has to be a very good reason that a doctor hands it out.
 
Dignitas gives their clients a phenobarbitol cocktail to make them die. Just one glass of cherry-flavored barbs, and you're dead. 100% guaranteed. It would take several bottles of xanax to achieve the same effect...
Nembutal is the last resort drug for severe tinnitus. Take enough and it will silence your tinnitus permanently...

Dignitas use pentobarbital (not phenobarbital). Both are barbiturates but of different class. Pentobarbital is aka. Nembutal. That was its brand name. In the past it was prescribed for treating insomnia, but nowadays it's only being used by vets for animal euthanasia. It's being considered as the gold standard for a peaceful exit. Super DANGEROUS AND SCARY stuff. An overdose of this will indeed silence tinnitus permanently by putting you in eternal sleep. Phenobarb on the other hand is a totally different story, not so dangerous. It's not by chance the only barb still on the market, being prescribed for seizures.
 
you can buy straight up narcotics at human pharmacies within a mile of the border, so I would imagine that barbs would be even easier. Of course, if you don't have a valid prescription, you're flirting with spending 15 years in a mexican jail, regardless of whether you bought it from a vet or a human pharmacist.
Can they throw you in jail just for trying to buy drugs from let's say a veterinarian store? I mean if you don't have a prescription, they just won't give it to you. Right?
 
I was prescribed phenobarbital and had 2 pills of 100mg, one each night, and I took them since my tinnitus got worse and I was quite distressed.

I can say that they helped me sleep and lowered my tinnitus a bit today. I'll not keep on with this due to the risks and the long half life but it's an absolutely lovely drug :).

In fact so lovely I could get grams of it and silence my tinnitus forever! Yeyyyy!
 

Log in or register to get the full forum benefits!

Register

Register on Tinnitus Talk for free!

Register Now