Analgesic Dependence Leading to Intoxication —A Report of Five Cases—

Summary Five cases of dependence on popular analgesics containing barbiturates as the active ingredient have been presented. In all of these cases the patient developed the habit of using the drugs in the second or third decade of life in order to accomplish relief from headache. A rapid increase in tolerance took place in a few months, with most of the patients eventually requiring several times the usual dose. Symptoms of chronic intoxication were often milder than those with other habituating drugs. No antisocial acts as a result of the abuse were observed. Headaches as a manifestation of chronic intoxication may be considered to have played a role in establishing analgesic dependence. The abstinence syndrome developed a few hours after withdrawal: a generalized convulsion occurred first, followed by various disturbances of consciousness and then by a hallucinatory‐delusional state. These symptoms cleared up in three days to a week, while a corresponding course was followed by the EEG findings. Withdrawal symptoms didn't appear at the time when allopyrabital as the active ingredient of popular analgesic preparations was replaced with cyclopyrabital but did appear in four cases at the very time when bromvalerylurea was substituted as the active principle of these preparations. Even at that time such a syndrome was not manifested in one case, suggesting the possibility of a cross‐reaction of allobarbital and cyclo‐barbital and of barbiturate and bromvalerylurea.