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Phenobarbital overdose

Phenobarbital is a medicine used to treat epilepsy (seizures), anxiety, and insomnia. It is in a class of medicines called barbiturates. Phenobarbital overdose occurs when someone takes too much of this medicine. Barbiturates are addictive, producing physical dependence and a withdrawal syndrome that can be life threatening.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Phenobarbital

Where Found

Other names for this drug are:

  • Barbital
  • Luminal
  • Solfoton

Note: This list may not be all-inclusive.

Symptoms

Symptoms of a phenobarbital overdose may include:

  • Blurred or double vision, rapid side-to-side movement of eyes (nystagmus)
  • Coma (decreased level of consciousness and lack of responsiveness)
  • Confusion
  • Dizziness
  • Drowsiness, tiredness, fainting
  • Nausea
  • Rash
  • Shock (extremely low blood pressure)
  • Slowed or absent breathing
  • Stupor (decreased level of alertness)
  • Slurred speech
  • Weakness, uncoordinated movement, staggering gait (ataxia, seen commonly in children)

Before Calling Emergency

The following information is helpful for emergency assistance:

  • The person's age, weight, and condition
  • Name of product (as well as the ingredients and strength if known)
  • The time it was swallowed
  • The amount swallowed
  • If the medicine was prescribed for the person

However, DO NOT delay calling for help if this information is not immediately available.

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the pill container with you to the hospital, if possible.

What to Expect at the Emergency Room

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Symptoms will be treated as appropriate. The person may receive:

  • Activated charcoal
  • Blood and urine tests
  • Breathing support, including oxygen, tube through the mouth (intubation), and breathing machine (ventilator)
  • Chest x-ray
  • CT (computerized axial tomography) scan
  • ECG (electrocardiogram, or heart tracing)
  • Fluids through the vein (intravenous or IV)
  • Laxative
  • Medicines to treat symptoms

This list may not be all inclusive.

People who have persistent symptoms after initial treatment may need to be admitted to the hospital for further care.

Outlook (Prognosis)

How well the person does depends on the severity of the overdose and how quickly treatment is received. With proper treatment, people can recover in 1 to 5 days.

People who are in a prolonged coma or who have respiratory complications, or those who develop shock may have permanent disability.

Alternative Names

Luminal overdose

References

Aronson JK. Phenobarbital. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:678-687.

Overbeek DL, Erickson TB. Sedative-hypnotics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 154.

Review Date 1/2/2023

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.