Oral phenobarbital loading: a safe method of barbiturate and nonbarbiturate hypnosedative withdrawal.

We tested the efficacy and safety of oral phenobarbital loading, 120 mg/h until the end-point of mild intoxication is reached, for the treatment of hypnosedative withdrawal in 48 physically dependent patients, 14 of whom had a history of withdrawal seizures. None of the patients experienced seizures or any other symptoms of withdrawal during the study period, regardless of the phenobarbital half-life. The phenobarbital loading technique can be used in any hospital, not only those with access to specialized drug analysis laboratories. The method of treatment we describe allows the clinician to focus on issues such as rehabilitation instead of drug administration and manipulation of doses.