Meprobamate
chemical compound
Meprobamate, sold under the brand names Miltown and Equanil, among others, is a carbamate derivative used as an anxiolytic drug. It was the best-selling minor tranquilizer for a time, but has largely been replaced by the benzodiazepines due to their wider therapeutic index (lower risk of toxicity at therapeutically prescribed doses) and lower incidence of serious side effects.
Medical uses
Meprobamate is indicated for the short-term relief of anxiety, although whether the purported anxiolytic effects of meprobamate are separable from its sedative effects is not known. Its effectiveness as a selective agent for the treatment of anxiety has not been proven in humans, and is not used as often as the benzodiazepines for this purpose.
Meprobamate is available in 200- and 400-mg tablets for oral administration. It is also a component of the combination drug Equagesic (discontinued in the UK in 2002), acting as a muscle relaxant.
Overdose
Symptoms of meprobamate overdose include drowsiness, headache, sluggishness, unresponsiveness, or coma; loss of muscle control; severe impairment or cessation of breathing; or shock. Death has been reported with ingestion of as little as 12 g of meprobamate and survival with as much as 40 g. In an overdose, meprobamate tablets may form a gastric bezoar, requiring physical removal of the undissolved mass of tablets through an endoscope; therefore, administration of activated charcoal should be considered even after 4 or more hours or if levels are rising.
Pharmacology
Although it was marketed as being safer, meprobamate has most of the pharmacological effects and dangers of barbiturates and acts at the barbiturate binding site (though it is less sedating at effective doses).
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