Anti-Anxiety Pharmacology: Benzodiazepines & Barbiturates

SimpleNursing Editorial Team Feb 23, 2018
Caring, Latin descent home healthcare nurse explains prescription medications to African descent senior adult patient at home, assisted living, or nursing home setting. The patient holds the bottle as the nurse explains dosages and takes notes. Kitchen background. Home healthcare nurse explains medications to senior adult woman.

Let’s settle this confusion once and for all – benzodiazepines versus barbiturates. How are these two anti-anxiety medications the same, and how are they different?

Here are some key points in differentiating between the two:

  1. Benzodiazepines and barbiturates act as CNS depressants, so you have to be mindful of your blood pressure, heart rate, and respiratory rate.
  2. Benzodiazepines (Mercedes Benz) live a fast life with Pam and Lam (suffixes).
  3. Barbiturates (Barbie behind bars) have “-barbital” as a suffix and last three to five days.
  4. Clients taking barbiturates have a higher propensity to addiction and toxicity.

Barbiturates vs Benzodiazepines

Benzodiazepines and barbiturates are both central nervous system (CNS) depressants. These two medications are not the same –  they have some of the same actions.

  • Reduction of client’s anxiety
  • Decreases blood pressure
  • Decreases heart rate
  • Decreases respiratory rate
  • Acts on the central nervous system (CNS)

Take note: benzodiazepines and barbiturates are not opioid receptor pain blockers. Therefore, they do not necessarily block pain.

Read more about Antianxiety pharmacology here.

Benzodiazepines and barbiturates’ mechanisms of actions are entirely different:

  • Benzodiazepines – acts fast, has a quick half-life, and are excreted from the body quickly.
  • Barbiturates – longer duration, has high concentration, stays in the body for two to three days; sometimes, it extends up to five days.

Take note: Regarding addiction, clients have a higher propensity to get addicted to barbiturates than benzodiazepines.

How does one identify benzodiazepines from barbiturates?


Think of benzodiazepines as a Mercedes Benz – flashy, high-end, fast car. When you have a Benz, you typically live a high-profile life with two women riding the fast life – Pam and Lam. This is how you remember the basics of benzodiazepines.

“-Pam” and “-Lam” are usually the two suffixes of benzodiazepines with medications like:

  • Lorazepam (Ativan)
  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Diazepam (Valium)

So remember:

Benzodiazepines = Mercedes Benz = fast life with two women (Pam and Lam)

Benzodiazepines are usually given to clients with high anxiety or those who come in having a seizure. Lorazepam (Ativan) acts on the neurotransmitters and sedate the brain.


Barbiturates act on the central nervous system (CNS), specifically on the GABA alpha receptors.

Barbie behind bars = Barbie is for your “-barbital” while bars or jail is for your time span since barbiturates have a longer duration (three to five days) before it gets expelled from the system. Overdosing and addiction are primary concerns for this kind of medication.

“-Barbital” is the known suffix of barbiturates with medications like:

  • Phenobarbital
  • Amobarbital
  • Pentobarbital

So remember:

            Barbiturates (-barbital) = Barbie behind bars = long duration

GABA the Controller

How is GABA affected when clients are given benzodiazepines and barbiturates? Basically, you just have to remember this:

GABA receptor = controls conscious thoughts (rational thinking)

Barbiturates act on the GABA alpha receptors the same way alcohol does. Alcohol affects GABA because it is considered a depressant, affecting neurotransmitters that excite and inhibit it. On the other hand, benzodiazepines act on the same GABA receptors but at a different receptor site.

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