Sudden withdrawal from chronic heavy barbiturate use would most likely result in which outcome?

• A. Marked discomfort, but no serious problems.
• B. Convulsions and/or death.
• C. Psychological discomfort.
• D. Vomiting and/or diarrhea.

Answer: (B)

Severe withdrawal from chronic heavy barbiturate use is driven by a rebound increase in CNS excitability after the drug is stopped. Barbiturates enhance GABA-A receptor activity, producing powerful CNS depression. With long-term use, the brain adapts, and removing the drug abruptly can unleash widespread neuronal firing, leading to seizures and, in some cases, death if not medically managed. This risk makes convulsions and/or death the most likely and dangerous outcome, far outweighing milder symptoms like psychological discomfort or GI upset. In practice, careful medical detox with gradual tapering (often using a longer-acting sedative) is essential to prevent those life-threatening seizures.