Tuinal

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Tuinal
Secobarbital and amobarbital.svg
structure
Combination of
secobarbital short-acting barbiturate
amobarbital intermediate-acting barbiturate
Clinical data
Routes of
administration
oral

Tuinal was the brand name of a discontinued combination drug composed of two barbiturate salts (secobarbital sodium and amobarbital sodium) in equal proportions.

Contents

Tuinal was introduced as a sedative-hypnotic (sleeping pill) medication in the late 1940s by Eli Lilly. It was also used in obstetrics for childbirth. [1] [2] It was produced in brightly colored half-reddish orange and half-turquoise blue gelatin capsule form (bullet-shaped Pulvules) for oral administration. Individual capsules contained 50 mg, 100 mg, or 200 mg of barbiturate salts. The combination of a short-acting barbiturate, Secobarbital, with an intermediate-acting barbiturate, Amobarbital, aimed to provide "a rapid yet prolonged hypnotic action". [3]

Eli Lilly has discontinued the manufacture of Tuinal in the United States due to the diminishing use of barbiturates (replaced by the benzodiazepine family of drugs) in outpatient treatment, and its widespread abuse. [4] Currently, Valleant Labs markets Secobarbital capsules only. Flynn Pharma of Ireland no longer manufactures Tuinal, Seconal or Amytal (amobarbital). Amytal has been discontinued, though sodium amytal injection form remains.

Abuse

Tuinal DOJ.jpg

Tuinal saw widespread abuse as a recreational drug from the 1960s through the 1980s. The pill was known colloquially under the street names "tuies", "tumies", "double trouble", "blue tips", " F-66's" (which were the markings on Lilly's capsule), "rainbows", "beans", "nawls" and "jeebs". [5] It came in the form of bullet-shaped capsules, half-reddish orange and half-turquoise blue. Like other barbiturate depressants, Tuinal promotes physical and psychological dependency beginning after one week of regular use and carries a high risk of overdose. [6] It was reported in the 1980s as one of the most common ways of self-poisoning. [7] Abuse of this particular drug tapered off after it was discontinued by manufacturers in the late 1990s.

Tuinal is classified as a Schedule II drug under the Controlled Substances Act in the United States, meaning it requires a prescription from a licensed practitioner.

Arthur Koestler and his wife Cynthia jointly committed suicide on March 1, 1983, by swallowing lethal quantities of Tuinal capsules at their London home.

Related Research Articles

<span class="mw-page-title-main">Hypnotic</span> Drug whose use induces sleep

Hypnotic, or soporific drugs, commonly known as sleeping pills, are a class of psychoactive drugs whose primary function is to induce sleep and to treat insomnia (sleeplessness).

<span class="mw-page-title-main">Truth serum</span> Class of psychoactive drug

"Truth serum" is a colloquial name for any of a range of psychoactive drugs used in an effort to obtain information from subjects who are unable or unwilling to provide it otherwise. These include ethanol, scopolamine, 3-quinuclidinyl benzilate, midazolam, flunitrazepam, sodium thiopental, and amobarbital, among others.

<span class="mw-page-title-main">Temazepam</span> Insomnia medication

Temazepam is a medication of the benzodiazepine class which is generally used to treat severe or debilitating insomnia. It is taken by mouth. Temazepam is rapidly absorbed, and significant hypnotic effects begin in less than 30 minutes and can last for up to eight hours. Many studies, some going as far back as the early 1980s out of Australia and the United Kingdom, both of which have had serious temazepam abuse epidemics and related mortality, have all mostly corroborated each other and proven that the potential for abuse and physical dependence is very high, even in comparison to many other benzodiazepines. As a result, prescriptions for hypnotics such as temazepam have seen a dramatic decrease since 2010, while anxiolytics such as alprazolam (Xanax), clonazepam, and lorazepam (Ativan) have increased or remained stable. Temazepam and similar hypnotics, such as triazolam (Halcion) are generally reserved for severe and debilitating insomnia. They have largely been replaced by z-drugs and atypical antidepressants as first line treatment for insomnia.

A sedative or tranquilliser is a substance that induces sedation by reducing irritability or excitement. They are CNS depressants and interact with brain activity causing its deceleration. Various kinds of sedatives can be distinguished, but the majority of them affect the neurotransmitter gamma-aminobutyric acid (GABA). In spite of the fact that each sedative acts in its own way, most produce relaxing effects by increasing GABA activity.

<span class="mw-page-title-main">Ethchlorvynol</span> Group of stereoisomers

Ethchlorvynol is a GABA-ergic sedative and hypnotic/soporific medication first developed by Pfizer in the 1950s. In the United States it was sold by Abbott Laboratories under the trade name Placidyl. Placidyl was available in 200 mg, 500 mg, and 750 mg strength gel filled capsules. While the 500 mg and 750 mg strength capsules were for use in reducing sleep latency, the 200 mg strength capsules were intended to be used to re-induce sleep in case of early awakening. Abbott discontinued production in 1999, due to it being replaced by the benzodiazepine family and its widespread abuse, after which Placidyl was available for about a year in the United States. Although, theoretically, ethchlorvynol could be manufactured for sale in the United States by another pharmaceutical company, no pharmaceutical company has chosen to do so. Individuals with a valid prescription for the substance may legally transport a reasonable amount of ethclorvynol with them into the United States.

<span class="mw-page-title-main">Flurazepam</span> Hypnotic medication

Flurazepam is a drug which is a benzodiazepine derivative. It possesses anxiolytic, anticonvulsant, hypnotic, sedative and skeletal muscle relaxant properties. It produces a metabolite with a long half-life, which may stay in the bloodstream for days. Flurazepam was patented in 1968 and came into medical use the same year. Flurazepam, developed by Roche Pharmaceuticals was one of the first benzo hypnotics to be marketed.

<span class="mw-page-title-main">Amobarbital</span> Barbiturate

Amobarbital is a drug that is a barbiturate derivative. It has sedative-hypnotic properties. It is a white crystalline powder with no odor and a slightly bitter taste. It was first synthesized in Germany in 1923. It is considered a short to intermediate acting barbiturate. If amobarbital is taken for extended periods of time, physiological and psychological dependence can develop. Amobarbital withdrawal mimics delirium tremens and may be life-threatening. Amobarbital was manufactured by Eli Lilly and Company in the US under the brand name Amytal in bright blue bullet shaped capsules or pink tablets containing 50, 100, or 200 milligrams of the drug. The drug was also manufactured generically. Amobarbital was widely misused, known as "Blue Heavens" on the street. Amytal, as well as Tuinal, a combination drug containing equal quantities of secobarbital and amobarbital, were both manufactured by Eli Lilly until the late-1990s. However, as the popularity of benzodiazepines increased, prescriptions for these medications became increasingly rare beginning in the mid to late-1980s.

<span class="mw-page-title-main">Nonbenzodiazepine</span> Class of psychoactive drugs

Nonbenzodiazepines, sometimes referred to colloquially as Z-drugs, are a class of psychoactive drugs that are benzodiazepine-like in uses, such as for treating insomnia and anxiety.

<span class="mw-page-title-main">Secobarbital</span> Obsolete sedative-hypnotic

Secobarbital is a short-acting barbiturate derivative drug that was patented in 1934 in the United States. It possesses anaesthetic, anticonvulsant, anxiolytic, sedative, and hypnotic properties. In the United Kingdom, it was known as quinalbarbitone. It is the most frequently used drug in physician-assisted suicide within the United States. Secobarbital is considered to be an obsolete sedative-hypnotic, and as a result, it has largely been replaced by the benzodiazepine family. Seconal was widely abused, known on the street as "red devils" or "reds".

Pentobarbital (US) or pentobarbitone is a short-acting barbiturate typically used as a sedative, a preanesthetic, and to control convulsions in emergencies. It can also be used for short-term treatment of insomnia but has been largely replaced by the benzodiazepine family of drugs.

<span class="mw-page-title-main">Butabarbital</span> Chemical compound

Butabarbital is a prescription barbiturate sleep aid and anxiety medication. Butabarbital has a particularly fast onset of effects and short duration of action compared to other barbiturates, which makes it useful for certain applications such as treating severe insomnia, relieving general anxiety and relieving anxiety before surgical procedures; however it is also relatively dangerous particularly when combined with alcohol, and so is now rarely used, although it is still prescribed in some Eastern European and South American countries. Its intermediate duration of action gives butabarbital an abuse potential slightly lower than secobarbital. Butabarbital can be hydrolyzed to Valnoctamide.

In the post-World War II era, the technique of narcosynthesis was developed by psychiatrists as a means of treating patients who suffered from post-traumatic stress disorder. Narcosynthesis—also called sodium amytal interview, amobarbital interview, or amytal interview—uses a technique of free association as well as dream and transference material during the session as a basis for uncovering relevant topics for later therapeutic discussion.

<span class="mw-page-title-main">Secobarbital/brallobarbital/hydroxyzine</span> Combination drug

Secobarbital/brallobarbital/hydroxyzine was a combination tablet containing 50 mg brallobarbital, 150 mg secobarbital and 50 mg hydroxyzine that was used as a sedative. It was sold under the brand name Vesparax. This drug has been withdrawn from the market in most countries.

Dexamyl was a brand name combination drug composed of sodium amobarbital and dextroamphetamine sulfate (Dexedrine) within the same pill. It was widely abused, and is no longer manufactured.

Blue 88 was a blue-colored pill that was a mix of calming drugs, mainly barbiturates such as sodium amytal, used to treat American soldiers in the Second World War who suffered from battle fatigue. In most cases, it was used to induce sleep.

<span class="mw-page-title-main">Brallobarbital</span> Chemical compound

Brallobarbital was a barbiturate developed in the 1920s. It has sedative and hypnotic properties, and was used for the treatment of insomnia. Brallobarbital was primarily sold as part of a combination product called Vesparax, composed of 150 mg secobarbital, 50 mg brallobarbital and 50 mg hydroxyzine. The long half-life of this combination of drugs tended to cause a hangover effect the next day, and Vesparax fell into disuse once newer drugs with lesser side effects had been developed. Vesparax reportedly was the drug that musician Jimi Hendrix supposedly overdosed on and led to his untimely death. It is no longer made.

Desbutal was a brand name drug by Abbott containing 5 mg methamphetamine hydrochloride (Desoxyn) and 30 mg pentobarbital sodium (Nembutal); a substituted amphetamine and a barbiturate combined within the same pill. Desbutal was marketed as an antidepressant as well as a medication for the treatment of obesity, narcolepsy, parkinsonism, and alcoholism, although it was commonly also prescribed off-label for miscellaneous ailments. It had a high abuse potential and is no longer manufactured.

<span class="mw-page-title-main">Barbiturate</span> Class of depressant drugs derived from barbituric acid

Barbiturates are a class of depressant drugs that are chemically derived from barbituric acid. They are effective when used medically as anxiolytics, hypnotics, and anticonvulsants, but have physical and psychological addiction potential as well as overdose potential among other possible adverse effects. They have been used recreationally for their anti-anxiety and sedative effects, and are thus controlled in most countries due to the risks associated with such use.

<span class="mw-page-title-main">William Bleckwenn</span> American psychiatrist

William Jefferson Bleckwenn was an American neurologist, psychiatrist, and military physician, who was instrumental in developing the treatment known as "narcoanalysis" or "narcosynthesis", also known by the lay term "truth serum".

Barbiturate dependence develops with regular use of barbiturates. This in turn may lead to a need for increasing doses of the drug to get the original desired pharmacological or therapeutic effect. Barbiturate use can lead to both addiction and physical dependence, and as such they have a high potential for excess or non-medical use, however, it does not affect all users. Management of barbiturate dependence involves considering the affected person's age, comorbidity and the pharmacological pathways of barbiturates.

References

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