List Of Barbiturates From Strongest To Weakest

Barbiturates are a class of sedative medications that were once commonly prescribed for anxiety, insomnia, and seizure disorders before being largely replaced by safer alternatives like benzodiazepines. These drugs work by depressing the central nervous system, producing effects ranging from mild relaxation to deep sedation depending on the specific medication and dosage. While barbiturates are still used in some medical settings today, they carry risks including high potential for overdose, addiction, and interactions with other substances.

Learning about the relative strength of different barbiturates is important for both medical professionals and patients, as these medications vary significantly in their potency, duration of action, and safety profiles. The strength of a barbiturate is measured by how much of the drug is needed to produce sedative effects and how long those effects last in the body. This ranking from strongest to weakest can help people better understand these medications and the serious risks associated with their use, especially outside of proper medical supervision.

List Of Barbiturates From Strongest To Weakest

Listing barbiturates and other prescription drugs from strongest to weakest is a little complex, but brand name barbiturates can generally be listed from strongest to weakest in the following order.

• Penthothal (thiopental sodium)
• Brevital (methohexital)
• Surital (thiamylal)
• Seconal (secobarbital)
• Nembutal (pentobarbital)
• Amytal (amobarbital)
• Butisol
• Burabarb
• Butalan
• Sarisol
• Alurate
• Allonal
• Oramon
• Somnifaine
• Butalbital
• Luminal (phenobarbital)
• Mebaral (mephobarbital)
• Mysoline (primidone)
• Prominol
• Phemiton (methylphenobarbital)

Note: Thiopental sodium (Pentothal) is no longer commercially available in the United States, though it continues to be used in some other countries.

Classes Of Barbiturates

Barbiturates are typically broken into four classifications according to how quickly and strongly they affect the brain and body.

The core classifications are:

• ultra short acting
• short acting
• intermediate acting
• long acting

Ultra-short-acting barbiturates are injected intravenously and used in anesthesia. These drugs are effective within a minute and last a short time. Short and intermediate-acting barbiturates are helpful for sleep disorders and last between three and eight hours. Long-acting barbiturates take about an hour before they take effect and last approximately twelve hours, which makes them useful for treating seizure disorders.

Ultra Short-Acting Barbiturates

The sedative effects of ultra-short-acting barbiturates are almost immediate and render the individual unconscious for 5 to 25 minutes, on average.

Ultra short-acting barbiturates include:

• methohexital (Brevital)
• thiopental sodium (Pentothal)
• thiamylal (Surital)

These drugs have also be used in lethal injection and assisted suicide.

Short-Acting Barbiturates

Short acting barbiturates usually take ten to fifteen minutes to take effect and can last approximately three to four hours. These medications are used for short term sleeping problems and sometimes as a sedative paired with anesthetic during hospitalization for inpatient surgery.

Short-acting barbiturates include:

• pentobarbital (Nembutal)
• secobarbital (Seconal)

Get matched with an affordable mental health counselor

Find a Therapist

Answer a few questions to get started

As a BetterHelp affiliate, we receive commissions if you purchase through the BetterHelp links above.

Ad

Intermediate-Acting Barbiturates

These intermediate-acting barbiturates take about an hour to reach therapeutic levels and typically maintain effectiveness for six to eight hours. These barbiturates are primarily used for treating sleeping disorders, like insomnia, for short periods of time. They may also be used for sedative purposes.

Intermediate-acting barbiturates include:

• amobarbital (Amytal)
• aprobarbital (Alurate, Allonal, Oramon, Somnifaine)
• butabarbital (Butisol, Butabarb, Butalan, Sarisol)
• butalbital (combined with acetaminophen to treat migraines)

Butabarbital and butalbital have a significantly longer half-life than other barbiturates. It takes between 34 and 42 hours for just half the initial dose to leave the body. The strength and duration of these drugs can cause excessive sleepiness lasting into the next day. With regular use, drugs with half-lives this long can accumulate in the body, increasing the risk of toxicity and overdose even when doses remain consistent.

Butabarbital is rarely prescribed today and is not recommended for patients who have not previously taken barbiturates. Taking it without medical supervision is particularly dangerous given its extended half-life.

Long-Acting Barbiturates

These types of barbiturates are used for mental health treatment and other healthcare purposes, including anxiety, insomnia, and seizures. They may also be combined with other medications to treat migraines. Because these medications can last up to twelve hours, they can also be used to treat the withdrawal symptoms of barbiturate addiction during a medically supervised detox program.

Long-acting barbiturates include:

• phenobarbital (Luminal)
• mephobarbital (Mebaral)
• primidone (Mysoline)
• methylphenobarbital (Prominal, Mephyltaletten, Phemiton)
• metharbital

Ultra short acting barbiturates, in general, could be considered the strongest barbiturates, as they take effect quickly and result in unconsciousness. The weakest could be considered the long acting barbiturates because they take an hour to take effect and typically do not cause unconsciousness.

Effects Of Barbiturate Abuse

Abusing barbiturates can result in dangerous consequences, as depressing the CNS can cause automatic body functions, such as breathing or heartbeat, to stop. There is no antidote to a barbiturate overdose, and reversing the effects of a barbiturate overdose is quite difficult.

Most individuals who misuse barbiturates take the drug in pill form. However, injecting barbiturates is not unheard of. This form of intravenous misuse can be more noticeable due to larger “track marks.”

Barbiturate abuse comes with a list of side effects, many of which are similar to the effects of alcohol use disorder.

Side effects of barbiturate abuse may include:

• altered judgment
• speech becomes incoherent
• decreased inhibitions
• inability to focus
• difficulty concentrating
• problems with coordination
• vomiting
• slowed reflexes
• problems with sleep
• depression
• sexual dysfunction
• potentially fatal overdose

Because tolerance develops quickly and the difference between an effective dose and a lethal dose is small, people who abuse barbiturates face a high risk of accidental overdose that can be fatal without immediate medical intervention.

People obtaining barbiturates outside of a licensed pharmacy face additional risks from counterfeit or contaminated pills. Illicitly manufactured fentanyl has been detected in a wide range of street drugs. You can use fentanyl test strips to detect fentanyl contamination, and they’re available at many pharmacies and harm reduction organizations.

Barbiturate Overdose

This type of overdose is essentially drug poisoning and is sometimes called barbiturate toxicity. The margin between a regular dose and a deadly dose is extremely narrow, making overdose a serious risk for anyone using these drugs. Recognizing the signs of barbiturate overdose could help save someone’s life.

If someone taking barbiturates shows any of the following symptoms, call 911 immediately:

• excessive confusion
• memory loss
• irritability
• impaired alertness
• overall inability to function
• slowed or stopped breathing
• weak pulse or irregular heartbeat
• loss of consciousness

Time is crucial in barbiturate overdose situations because there is no specific antidote available to reverse the effects. Emergency medical professionals can provide supportive care to help maintain breathing and heart function, but the sooner treatment begins, the better the chances of survival.

While waiting for emergency services, keep the person on their side in the recovery position to reduce choking risk if they vomit. Do not give them food, water, or stimulants. Monitor their breathing as well. If breathing stops, be prepared to begin CPR if you are trained to do so. Inform paramedics of what drug was taken, the approximate dose, and the time of last use.

Treatment For Barbiturate Abuse Or Addiction

Substance use disorder treatment centers are equipped to help individuals struggling with barbiturate abuse. These programs can assess and determine what services are necessary to achieve sobriety. Addiction treatment programs may use intervention techniques like medically assisted detoxification programs to help the person safely adjust to functioning without drugs.

Stopping barbiturates cold turkey is not advisable, and medical detox is often necessary to prevent potentially deadly withdrawal symptoms. Detoxification is typically followed by several months of behavioral therapy as well as continuing aftercare. People who were using barbiturates for a medical condition can work with their doctor to find an alternative therapy while in treatment for a substance use disorder.

Browse our directory to find substance use disorder treatment options near you, or call SAMHSA’s National Helpline at 1-800-662-4357 for free, confidential support available 24 hours a day, 7 days a week.

Written by the Addiction Resource Editorial Staff