Alfred Hauptmann (1881–1948)
The barbiturates were the most versatile nervous system depressants available during the first half of the twentieth century. Unlike the bromides, paraldehyde, and chloral hydrate that preceded them, the degree of central-nervous-system depression produced by barbiturates can be controlled by the dose. Small doses calm and produce sedation, higher doses induce sleep, and still higher doses produce surgical anesthesia. Beyond these doses—and particularly when washed down with alcohol—barbiturates are all too effective in causing irreversible coma.
Phenobarbital, a long-acting barbiturate introduced in 1912 under the trade name Luminal, was initially marketed for sedation and to induce sleep. That same year, German psychiatrist and neurologist Alfred Hauptmann administered phenobarbital to his epileptic patients to enable them (and him) to sleep through the night. It worked, and much to his surprise, they experienced far fewer seizures during the daytime. Moreover, unlike the bromides—the principle antiseizure drugs at that time—phenobarbital did not cause excessive sedation. It was the most effective drug available for tonic-clonic (grand mal) seizures until 1938, when Dilantin, a far less sedating drug, displaced it.
Phenobarbital has low toxicity and continues to be used at a very low cost, but it can modify the effects of other drugs taken at the same time. By increasing the activity of many enzymes—biological catalysts that chemically convert drugs into products that are generally less active and more readily removed from the body—phenobarbital can reduce the plasma concentration and effectiveness of such drugs as oral contraceptives, the blood thinner warfarin, and certain antidepressants.
A MASS SUICIDE DRUG. Heaven’s Gate, a California-based doomsday religious cult that believed they had to evacuate the earth in March 1997 as quickly as possible, used phenobarbital to assist them in their exit strategy. Under the direction of their spiritual leader, Marshall Applewhite, thirty-nine followers committed suicide by ingesting a mixture of phenobarbital and applesauce or pudding, followed by vodka. To ensure the completion of their deadly mission, they placed plastic bags over their heads.
SEE ALSO Alcohol (c. 10,000 BCE), Bromides (1857), Chloral Hydrate (1869), Barbital (1903), Dilantin (1938), Warfarin (1940), Librium (1960), Valproic Acid (1967).
Despite suffering from epilepsy most of his life, Grover Cleveland Alexander (1887–1950) was one of major league baseball’s greatest players, pitching for the Phillies, Cubs, and Cardinals between 1911 and 1930. His epileptic seizures were often mistaken for heavy-drinking behavior, and the film The Winning Team (1952), with Ronald Reagan portraying Alexander, never mentions his epilepsy.