Observations placeholder
Clomethiazole
Identifier
005584
Type of Spiritual Experience
Background
Clomethiazole (also called chlormethiazole) is a sedative and hypnotic originally developed by Hoffmann-Le Roche in the 1930s. The drug is now used principally in treating and preventing symptoms of acute alcohol withdrawal.
It is a drug which is structurally related to thiamine (vitamin B1) but acts like a sedative, hypnotic, muscle relaxant and anticonvulsant. It is also used for the management of agitation, restlessness, short-term insomnia and Parkinson's disease in the elderly. In the U.K, it is sold under the brand Heminevrin. Another brand name includes Nevrin (in Romania).
Chlomethiazole acts as a positive allosteric modulator at the barbiturate/picrotoxin site of the GABA-A receptor. In some reports it appears to be very successful in this respect……
A retrospective comparison of delirium tremens cases before and after the availability of chlormethiazole - Schied HW, Kimmerle K, Braunschweiger M.
To assess the contribution of chlormethiazole to the treatment of delirium tremens (DT), a retrospective analysis was carried out on cases of DT admitted to the Department of Psychiatry, University of Tübingen, West Germany before and after the introduction of chlormethiazole.
Following the introduction of chlormethiazole, there was a significant reduction in DT mortality and in duration of DTs. The age and sex distribution of cases of DT were compared and were found to be similar before and after the introduction of chlormethiazole.
Although there are some studies that show it affects the liver - as does alcohol – though the effects of clomethiazole seem more serious………..
Hepatotoxic side-effect of clomethiazole - Heinemann F, Assion HJ; Department of Neurology, St-Josef-Hospital, Moers, Germany.
We report on a patient with a history of alcoholism who developed hyperbilirubinemia induced by treatment with clomethiazole during two hospitalizations. After discontinuation of clomethiazole symptoms of cholestasis improved. Clomethiazole is a thiazole analogon and is chemically related to thiamine (vitamin B1). It can be administered as tablets, capsules, mixtures, and a 0.8% solution. Because of its sedative, hypnotic, and anti-convulsive effects it is used in the treatment of alcoholic delirium.
Taking clomethiazole will not give you hallucinations or out of body experience or anything of that sort, but withdrawing from it will.
A description of the experience
Meyler’s side effects of drugs
This sedative-hypnotic has been used extensively in the treatment of alcohol withdrawal, as well as for sedation and sleep induction in the elderly. In addition to GABA-enhancement which it shares with the benzodiazepines, clomethiazole also enhances the activity of another inhibitory amino acid, glycine. Whether this property is clinically important is uncertain. As well as the expected effects of sedation and memory impairment, it produces nasal irritation especially in younger patients, in whom the drug has a shorter half-life. …..
As with other GABA enhancers, clomethiazole is highly abusable in susceptible individuals and should not be used for outpatient detoxication. On the other hand, clomethiazole has been reported to maintain efficacy with apparently less dependence than temazepam during prolonged use
Hypotension, phlebitis, and respiratory depression can occur after intravenous use.
While effects in the elderly may be generally increased, the incidence of side-effects remains similar to that seen in younger subjects.
Clomethiazole, like the benzodiazepines, has an additive effect with other CNS depressants, and may result in profound bradycardia when combined with B-adrenoceptor antagonists. A notable kinetic interaction occurs with cimetidine, which can reduce clomethiazole clearance by 60-70%.
GABA is the major inhibitory neurotransmitter in the brain and produces anxiolytic, anticonvulsant, sedative, and hypnotic effects. But “Long term and frequent use of chlomethiazole can cause tolerance and physical dependence. Abrupt withdrawal may result in symptoms similar to those of sudden withdrawal of alcohol or benzodiazepines”