Talk:Butalbital

Butalbital a DEA scheduled drug?
Butalbital is NOT a DEA scheduled drug, I would change it but I'm not quite sure how to do it correctly on that sidebar thing. Butalbital is widely available from US based online pharmacies (like this one http://www.doctorscripts.com/index.php?prod=butalbital) and scheduled drugs require a face-to-face consultation to be perscribed. -Dann
 * Assuming that site you reference is legal and accurate, the guidelines do specify they don't provide DEA scheduled drugs, linking to the DEA's own online list. Sure enough, on that list under Schedule III, you will find butalbital, as indicated before on this discussion page and referenced on the actual article page. Unless an online consultation service is right and the DEA is wrong about DEA scheduled drugs, butalbital IS a DEA scheduled drug.


 * There's a chance that Fioricet, which contains three different drugs including butalbital, doesn't fall under the Schedule III guidelines. The link you provided has a header of butalbital, but the drug it appears to be selling is (generic) Fioricet. David DiBattiste (talk) 20:05, 16 October 2008 (UTC)

Is butalbital really scheduled in the U.S.? I thought it wasn't but maybe I'm wrong.

I'm not sure if it's scheduled or not. It is a barbiturate, and lots of them are scheduled, so I'm guessing it has a fair chance of being scheduled. I don't have a source for that at the moment though. David DIBattiste 08:11, 24 December 2006 (UTC)
 * Finally found a source on that. None other than the DEA itself. Turns out it is... as for odd facts, on Fioricet atm, lol David DiBattiste 19:33, 13 January 2007 (UTC)

Yep butalbital solo is scheduled higher than the combo APAP/caffiene/Butalbital compo (Fioricet). This is bc you will kill yourself with tylenol and caffiene before you get a good enough dose to get your rocks off from the butalbital. Gizmo.AT (talk) 02:18, 25 June 2012 (UTC)

Fioricet Image
I'm debating adding Image:Fioricet.jpg to this article, but I'm thinking it might not be appropriate, as this is a photograph of a specific preperation, and not 'Butalbital' itself. I'd love to hear comments. --Overand 17:39, 20 February 2006 (UTC)
 * Well, the article does say that it "is often combined with other medications" and in fact, it doesn't list a brand name for the "pure" drug. I think that as long as the caption says "Fioricet tablets", then it is clear to everyone and very welcome! --Colin 19:56, 20 February 2006 (UTC)
 * Wow, I added this comment to the wrong page, it was supposed to to on Fioricet:Talk. But, the accepting attitude is nice, and I'll add it and see what the response is.
 * Agreed. I think many readers, like me, will be people who are taking Fioricet - and it definitely adds to the article. ToriWalsh (talk) 10:22, 25 August 2012 (UTC)

Article Expansion and De-Expansion
The article was recently expanded to include a lot of information that was both not sourced and in my opinion, not required (such as defining a half life and the active effects of a drug), and repeated side effects that were already neatly listed below. The edit was done above what had been there before, so I removed a portion of it, moved the half-life to the table to the right, and re-phrased the opening paragraph to incorporate some of the new information, which remains unsourced. Blahity 00:05, 29 November 2006 (UTC)

Blahity here - This is a follow up - I've changed and sourced the half-life of butalbital information, but the article is still short and a lot of it is in question, as can be seen above. I don't have too much time right now, considering it's Christmas Eve... and I'm not a complete expert on the subject anyway. Is there nobody who knows more about this stuff who can help out this article? David DIBattiste 08:12, 24 December 2006 (UTC)

Does anyone know if it's used recreationally?
 * Not a clue... the barbiturates article says overall recreational use has gone way down in the past few decades, maybe that applies to this as well? David DiBattiste 20:25, 27 January 2007 (UTC)


 * It most def is, though popularity has gone down due to less availability since safer benzo's replaced barbs. --68.45.219.63 (talk) 01:13, 6 March 2008 (UTC)

Barbituates as a class you are referring to User. The US preparation has only a small amount in combination with tylenol and caffiene which makes it an effective headache pill. This drug has little recreational value (which is a good thing). You'll get more mileage from a shot of whiskey. Its not commonly used anymore, but is pretty cheap. Gizmo.AT (talk) 02:22, 25 June 2012 (UTC)


 * It's not commonly used (recreationally) because of its relative obscurity and niche application. A couple of pills will still give a pleasant buzz, though, similar to benzos. Mixing with alcohol will give a STRONG buzz, and that would I not recommend (still not likely to kill you, though). Firejuggler86 (talk) 03:44, 19 March 2021 (UTC)

pronunciation
How is butalbital pronounced? Can someone add a pronunciation please? byoo-TAL (as in taliban)-bit-all, byoo-TAL (as in taliban)-bi-tall, byou-tul-bit-ull, byou-tul-bit-all? SLATE (talk) 05:39, 18 October 2008 (UTC)

Should butalbital-containing analgesics be banned? Yes.
Should butalbital-containing analgesics be banned? Yes.

Young WB, Siow HC.

Jefferson Headache Center, Department of Neurology, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA. William.B.Young@mail.tju.edu

Curr Pain Headache Rep. 2002 Apr;6(2):151-5.

Abstract

In the United States analgesic-overuse headache is often caused by butalbital-containing analgesics. These agents can cause physical and psychological dependency, and dangerous withdrawal syndromes. Butalbital-containing analgesics have already been banned in several European countries. They are proven effective in tension-type headache, but not in migraine; there are many alternative treatments for migraine and tension-type headache. In the 20 years since analgesic overuse headache was widely recognized, butalbital overuse has remained distressingly common. It is time to ban these agents.

— Preceding unsigned comment added by 99.190.133.143 (talk) 17:58, 23 October 2011 (UTC)


 * This is a load of garbage, and it's sad, because as a knee-jerk reaction resulting from the era when doctors would prescribe nearly anything under the sun FOR anything under the sun, often with little regard to whether or not it would be effective for a particular condition, this kind of narcotic-demonising hysteria gets unquestioningly accepted by many folks.


 * I was prescribed butalbital for a period of about 6 months ago, for tension headache. There was NO withdrawal after I stopped taking it. (I did only take it around 2-4 times a week). It was also my experience that it had long term benefits as well: it reduced tension in the neck/jaw area, which remained less tense even after the drug wore off. (muscle relaxers DO NOT work for this purpose, btw). Firejuggler86 (talk) 03:36, 19 March 2021 (UTC)

Do butalbital-containing products have a role in the management of migraine? [No]
Do butalbital-containing products have a role in the management of migraine?

Pharmacotherapy. 2002 Aug;22(8):1029-35.

Wenzel RG, Sarvis CA. Diamond Headache Clinic Inpatient Unit, St. Joseph Hospital, Resurrection Health Care, Chicago, IL 60657, USA. rwenz@hotmail.com

http://www.ncbi.nlm.nih.gov/pubmed/12173787 — Preceding unsigned comment added by 99.190.133.143 (talk) 18:00, 23 October 2011 (UTC)

Butalbital in the treatment of headache: history, pharmacology, and efficacy.
Butalbital in the treatment of headache: history, pharmacology, and efficacy.

Headache. 2001 Nov-Dec;41(10):953-67.

Silberstein SD, McCrory DC.

Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

Abstract

Analgesics containing butalbital compounded with aspirin, acetaminophen, and/or caffeine are widely used for the treatment of migraine and tension-type headache. The butalbital-containing compounds are efficacious in placebo-controlled trials among patients with episodic tension-type headaches. Despite their frequent clinical use for migraine, they have not been studied in placebo-controlled trials among patients with migraine. Barbiturates can produce intoxication, hangover, tolerance, dependence, and toxicity. Butalbital can result in intoxication that is clinically indistinguishable from that produced by alcohol. Butalbital-containing analgesics can produce drug-induced headache in addition to tolerance and dependence. Higher doses can produce withdrawal syndromes after discontinuation. Butalbital-containing analgesics may be effective as backup medications or when other medications are ineffective or cannot be used. Because of concerns about overuse, medication-overuse headache, and withdrawal, their use should be limited and carefully monitored.

— Preceding unsigned comment added by 99.190.133.143 (talk) 18:01, 23 October 2011 (UTC)

Analgesics with barbiturates such as Butalbital are banned in Germany
… The use of analgesics containing Butalbital is controversial to say the least. Analgesics with barbiturates such as Butalbital are banned in Germany, and expert advisory panels elsewhere have warned of their potential for abuse.2,3 Some experts warn that butalbital is particularly likely to lead to rebound (analgesic overuse) headache and/or dependence and question whether their benefit outweighs these problems.3 The authors comment:

http://headaches.about.com/cs/druginfo/a/fiorinal_care.htm

[Part of a larger article] — Preceding unsigned comment added by 99.190.133.143 (talk) 18:04, 23 October 2011 (UTC)

Citation of a number of scientific authorities emphasizing risk of drug dependence and abuse posed by barbiturate-containing analgesics
Resources:

Silberstein, Stephen D. & McCrory, Douglas C. (2001) "Butalbital in the Treatment of Headache: History, Pharmacology, and Efficacy." Headache: The Journal of Head and Face Pain 41 (10), 953-967. Available from: http://dx.doi.org/10.1046/j.1526-4610.2001.01189.x [$] [Free synopsis http://www.ncbi.nlm.nih.gov/pubmed/11903523]

2 Sellers EM, Hoornweg K, Busto UE, Romach MK. Risk of drug dependence and abuse posed by barbiturate-containing analgesics. Can J Clin Pharmacol. 1999;6:18-25.

3 McLean W, Boucher EA, Brennan M, et al. Is there an indication for the use of barbiturate-containing analgesic agents in the treatment of pain? Guidelines for their safe use and withdrawal management. Can J Clin Pharmacol. 2000;7:191-197.

4 Ciraulo DA & Greenblatt DJ. Sedative-, hypnotic-, or anxiolytic-related disorders. In: Kaplan HI, Sadock BJ, eds. Comprehensive Textbook of Psychiatry. 6th ed. Baltimore: Williams & Wilkins; 1995:872-887.

5 Sullivan JT & Sellers EM. Treatment of the barbiturate abstinence syndrome. Med J Aust. 1986;145:456-458.

6 Fraser HF, Wikier A, Essig CF, Isbell H. Degree of physical dependence induced by secobarbital or pentobarbital. JAMA. 1958;166:126-129.

7 Sullivan JT & Sellers EM. Treatment of the barbiturate abstinence syndrome. Med J Aust. 1986;145:456-458. — Preceding unsigned comment added by 99.190.133.143 (talk) 18:06, 23 October 2011 (UTC)

PMC article examining failure to follow evidence-based guidelines relegating butalbitol to 2d tier or below for migraine
Am J Pharm Educ. 2010 February 10; 74(1): 4.

Didactic Migraine Education in US Doctor of Pharmacy Programs

...


 * CONCLUSIONS

"Although the majority of PharmD programs teach information consistent with the US Consortium's recommendations, opportunities exist to improve didactic migraine education. Particular attention should be directed towards expanded dissemination of evidence-based care, the rational selection of nonprescription versus prescription products, risks of butalbital-containing products and narcotics, and tools to assess migraine-related debilitation.

Full article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829152/?tool=pubmed

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829152/?tool=pubmed — Preceding unsigned comment added by Ocdnctx (talk • contribs) 13:20, 15 August 2012 (UTC)

Silberstein, ... evidence-based guidelines for migraine ... (evidence butalbital does more harm than good)
Silberstein SD.

Neurology. 2000 Sep 26;55(6):754-62.

'''Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.

Source

American Academy of Neurology, St. Paul, MN 55116, USA.

Erratum in

Neurology 2000 Jan 9;56(1):142.

— Preceding unsigned comment added by Ocdnctx (talk

Butalbital combinations like Fioricet, Fiorinal and Esgic-Plus pose a "high risk for the development of medication-overuse headache." -- Mayo Clinic Staff
Rebound headaches

Causes

By Mayo Clinic staff © 1998-2011 Mayo Foundation for Medical Education and Research

http://www.mayoclinic.com/health/rebound-headaches/DS00613/DSECTION=causes

•	Combination pain relievers. Over-the-counter pain relievers that contain a combination of caffeine, aspirin and acetaminophen (Excedrin, others) are common culprits. This group also includes prescription medications such as Fioricet, Fiorinal and Esgic-Plus, which also contain the sedative butalbital. All of these medications pose a high risk for the development of medication-overuse headache. Some combination medications have even been withdrawn from the market in certain European countries.

[emphasis supplied]


 * Agree with Mayo Clinic staffs. According to this website report, Firoicet is a combination of caffeine. It has connection to fioricet addiction, see Fioricet addiction report --BrokenShip (talk) 09:33, 31 August 2016 (UTC)

External links modified
Hello fellow Wikipedians,

I have just modified 2 one external links on Butalbital. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
 * Corrected formatting/usage for http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202102.html
 * Added archive https://web.archive.org/web/20070202220447/http://www.deadiversion.usdoj.gov:80/schedules/listby_sched/sched3.htm to http://www.deadiversion.usdoj.gov/schedules/listby_sched/sched3.htm

When you have finished reviewing my changes, please set the checked parameter below to true or failed to let others know (documentation at ).

Cheers.— InternetArchiveBot  (Report bug) 09:09, 11 November 2016 (UTC)

withdrawal symptoms with ER dose
I got this drug from tbe ER for mindgrains and im freaking out. I cant sleep and its 4;35am and i took the pill every 6 hours like the pill container said and i hate it its horrible and i nees to put this here 24.192.203.230 (talk) 08:36, 1 July 2020 (UTC)