Meprobamate: uses and side effects of this drug

The high prevalence of anxiety-related problems means that different disciplines seek to develop different ways of addressing them. Among them we can find pharmacology, which throughout history has been discovering and developing different substances that allow treating this type of problem.

Many are highly effective, although some of them, especially the first generations of anxiolytics, have shown that despite this they can also cause dangerous side effects. In some cases, the drug has even been recommended and even ended up being withdrawn in most of the world. A relatively recent case is that of meprobamate, which we are going to talk about throughout this article.

• Related article: "Types of anxiolytics: drugs that fight anxiety"

What is meprobamate?

The name meprobamate refers to an anxiolytic or tranquilizing drug, which through its action on the body generates relief from anxiety and agitation. Within the anxiolytics it is part of the group of propanediols and carbomates.

It is one of the oldest types of tranquilizers or anxiolytic drugs, born in 1950 and applied as a psychotropic drug from 1955. It replaced barbiturates (with whom it shares pharmacological properties), but

with the advent of benzodiazepines their use decreased largely to the replaced by these.

This drug has muscle relaxant, hypnotic and sedative effects, and its effectiveness and half-life is between six and seventeen hours. (although there may be accumulation and prolongation of this in prolonged treatments in excess), similar to that of barbiturates of action intermediate. Its use is usually reserved for the short-term treatment of anxiety, since this substance has a high addictive potential and dangerous side effects. It is metabolized in the liver and excreted through the kidneys, and it comes in tablet, tablet, and solution forms for oral and intravenous administration.

But while it does have a certain level of effectiveness, it also has a very narrow safety margin between therapeutic doses and toxic, being relatively easy to suffer an involuntary overdose that can generate serious repercussions and even death. death. For this reason and given the existence of much safer therapeutic alternatives, in 2012 the Agency for Medicines of the European Union recommended its withdrawal, and today it is withdrawn in a large part of the balloon.

Mechanism of action of this psychoactive drug

Meprobamate works in the body causing changes in the functioning of the nervous system, although the way in which it does so is generally poorly understood. It is a drug that inhibits nerve function and reduces neuronal activation and activity in different brain nuclei.

Thus, it is known that it acts by causing depression in the central nervous system of nuclei such as the limbic system and the thalamus (something that contributes to reducing anxiety), in addition to affecting also to the spinal cord (something that is related to its action as a muscle relaxant) affecting, among others, the interneurons that connect the different neurons that are part of the system engine.

• You may be interested in: "Parts of the human brain (and functions)"

What indications do you have?

As the sedative-hypnotic anxiolytic that it is, meprobamate had as its main indications the short-term treatment of symptoms of anxiety and nervous agitation.

In addition to this, another of the usual indications of this drug has gone through the treatment of conditions linked to spasticity and muscle rigidity, given that, as we have said, it has positive effects on the relaxation of the musculature. Although it is not among its indications, it has anticonvulsant effects, something that can help control seizures typical of different disorders.

It also had as an indication treatment of primary insomnia, but in this aspect its effectiveness is rather limited. Last but not least, it should be noted that it has been used for the treatment of conditions such as high blood pressure, since it has a strong effect on its reduction.

• Related article: "What is anxiety: how to recognize it and what to do"

Side effects

Meprobamate is a drug that may have some effectiveness, but whose consumption may carry a significant risk of generating annoying and even dangerous side effects, to the point of having been withdrawn from many countries due to its low security.

Some relatively frequent side effects are sedation, feeling of fatigue, headache, dizziness and motor incoordination. Vomiting and diarrhea are also possible, along with anorexia or loss of appetite. Other more serious and requiring medical attention are unexplained bleeding, problems and reduced ability to breathe and communicate, tachycardia and arrhythmias.

Likewise, it should be noted that it causes hypotension, something that, although it has come to be used medically, can be problematic and dangerous depending on the sector of the population. It can also cause cognitive impairment and episodes of confusion, urticaria, angioneurotic edema, bronchospasm, or urination difficulties. It can also cause blood-level problems, including anemia, agranulocytosis, leukopenia, and thrombocytopenia.

Among these side effects highlights its addictive potential, something it largely shares with barbiturates and that it can lead to physical and psychological dependence on this substance and to abusive uses, in addition to syndrome of withdrawal after cessation that can cause seizures, hallucinations, anxiety, vomiting, loss of appetite and lethargy. In case of overdose, it can even lead to fatal respiratory arrest or a coma.

contraindications

Although it is a withdrawn drug, it is also interesting to know which sectors of the population have it especially contraindicated, since in some cases its consumption is dangerous and the probability of suffering medical problems is accentuated serious.

In the first place, it is contraindicated for people who are allergic to this drug or its components or to drugs from the carbamate group. It is also contraindicated for those subjects with baseline arterial hypotension, as well as for those who suffer from liver or kidney insufficiency or failure or for those who suffer from porphyria (it can make this condition worse). In epileptic patients it can cause seizures.

It is contraindicated (except in case of necessity) in pregnant and lactating women, since the drug is able to cross the placenta or be transmitted through breast milk and is capable of causing anomalies. Patients with diabetes, the elderly and children should be cautious. Subjects with depression and a history of suicide attempts also have it contraindicated, as well as people with a history of dependence on any substance. It should not be mixed with alcohol or other depressant substances, as well as antidepressants, muscle relaxants, anticonvulsants or narcotics, among others.

Bibliographic references:

• American Society of Health-System Pharmacist (2017). Meprobamate. Medline Plus [Online]. Available in: https://medlineplus.gov/spanish/druginfo/meds/a682077-es.html#special-dietary.
• European Medicines Agency (2012). Questions and answers on the suspension of marketing authorizations for medicinal products containing meprobamate for oral use. Result of a procedure in accordance with article 107 of Directive 2001/83/CE. [On-line]. Available in: https://www.ema.europa.eu/en/documents/referral/questions-answers-suspension-marketing-authorisations-oral-meprobamate-containing-medicines_es.pdf.
• Garcia, A., Fariñas, A.T. & Gálvez, A.M. (2002). Use of meprobamate in the treatment of arterial hypertension. Economic consequences. Rev Cubana Farm v.36 n.3 City of Havana.
• Stolerman, I.P. (2010). History of Psychopharmacology. Encyclopedia of Psychopharmacology. Berlin, Heidelberg: Springer-Verlag Berlin Heidelberg.