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Increasing numbers of nonbarbiturate sedative drugs are being introduced into medical practice. Despite their nonbarbiturate chemical structure and regardless of designations other than “sedative‐hypnotic,” at least six of the newer depressant drugs can cause states of intoxication and physical dependence that are clinically similar to those induced by barbiturates. These drugs are meprobamate (Miltown, Equanil), glutethimide (Doriden), ethinamate (Valmid), ethchlorvynol (Placidyl), methyprylon (Noludar), and chlordiazepoxide (Librium). The behavioral effects of these drugs and their combination with ethanol may become an increasingly important public hazard. The abstinence syndromes that can result from the abrupt withdrawal of excess dosages of these drugs include convulsions and psychotic behavior. Death has been attributed to withdrawal of meprobamate and methyprylon. Office or ambulatory withdrawal of any of these drugs after use in large dosage is not recommended. Gradual dosage reduction or barbiturate substitution prior to its gradual withdrawal during hospitalization is suggested. Substitution of diphenylhydantoin (Dilantin) or any of the phenothiazines as the sole means of support during sedative‐hypnotic drug withdrawal is a questionable practice.
Carl F. Essig (Fri,) studied this question.