phenobarbital vs diazepam (anxiolytic-wise)

[Lopez]

anyone know which would be more anxiolytic? especially in an epileptic patient.

which would be less sedating, and which would develop less tolerance considering long term use?

 

[sekio]

Diazepam, benzodiazepines are generally lower-impact than barbiturates.

 

[Nexus298]

I was always under the impression phenobarbital would be more anxiolytic than benzos but after my first experience with phenobarbital 2 week ago i was surprised at its lack of kick. At doses of 30 and 60 mgs i would only equate it to the sedative effect of 5 and 10mg diazepam and the anxiolytic effect of only 2.5 and 5mg diazepam. the rediculously long halflife of phenobarbital only serves to downregulate gabaa from what i could tell. respitory depression off phenobarbital did seem to be MUCH more present than any benzo however. tread with caution anxiolytic doses arent far from dangerously close to od doses.

 

[jeeves]

Phenobarbital actually has shown little efficiency as an anxiolytic. That is not to say it does not posses anxiolytic effects, but generally it pales in comparison to that of other barbiturates. Although barbiturates are generally considered more 'powerful', they actually are less effective anxiolytics than benzodiazepines. Phenobarbital will make you significantly more drowsy than diazepam, and you would develop a more pronounced tolerance to phenobarbital. In regards to epilepsy the drug of choice is dependent on the class of seizures you experience, barbiturates for the treatment of epilepsy have been largely surpassed by benzodiazepines. Phenobarbital is conventionally used as a last resort when benzodiazepines, phenytoin and other anticonvulsants fail. It is incredibly effective in treating seizures, it is just not well tolerated. In short go with diazepam.

 

[Cyanoide]

There are certain benzos which have quite potent anticonvulsive properties, e.g. clonazepam is sometimes prescriped to epileptics. Midazolam is probably the most potent benzo for seizures but far too short-acting and risky (and a profoundly potent hypnotic benzo) to be used regularly, it's very rarely used outside a hospital setting anymore. Diazepam, as mentioned, would also be a suitable benzo for an epileptic. But I'd still go for clonazepam.

 

[Lopez]

i can basically switch between any benzo used for epilepsy in mexico, my doctor isn't very reluctant and knows i wont abuse of them (every time i tried in the past i found nothing but sedation and even mild dysphoria). besides, i still find diazepam calming and mood lifting at a dose of 20 mg per day.

i only used clonazepam recreationally several times in the past at doses of 4 mg or above but it's shorter half life and lack of active metabolites (or info on them) makes me reluctant to use it long term for my anxiety.

 

[Lopez]

come to think of it, the only euphoric reaction was my first benzo experience. 4 mg of clonazepam felt amazing but henceforth benzo's only give me a very anhedonic effect in high doses.