Psycho-pharmacotherapy for anxiety and obsessive-compulsive disorder: the issue of prolonged barbiturate retention.
The authors report the case of a 32-year-old man who had been treated for anxiety and obsessive-compulsive disorder and had received 800 mg methylphenobarbital (MPB). After switching to a barbiturate-free schedule, his condition continued to be unstable for more than 21 MPB half-lives (approx. 30 days) and did not stabilize until MPB-metabolites dropped below their urinary detection limit. Considering that this article provides findings from a single patient, the authors use this experience to discuss and emphasize the importance of clinical control of barbiturates in psychiatry.
Feldmann
Robert E
RE
Department of Physiology and Pathophysiology, Division of Systems Physiology, University of Heidelberg Medical Center, Heidelberg, Germany. robert_feldmann@gmx.li
Kranz
Gottfried
G
Praschak-Rieder
Nicole
N
Kasper
Siegfried
S
D000328:Adult; D001007:Anxiety / Q000188:drug therapy* / Q000378:metabolism / Q000652:urine; D001463:Barbiturates / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008620:Meprobamate / Q000008:administration & dosage; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000378:metabolism / Q000652:urine; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
D001463:Barbiturates; D011619:Psychotropic Drugs; D008620:Meprobamate; C032232:barbituric acid