meprobamate

Meprobamate is a sedative and anxiolytic compound in the carbamate class that was developed in the mid-20th century. It became widely prescribed under brand names such as Miltown and Equanil for the treatment of anxiety, tension, and, in some cases, short-term insomnia. Over time its use declined as safer and more tolerable options became available, and concerns about dependence and withdrawal emerged.

Pharmacology and use: Meprobamate acts as a central nervous system depressant. It is thought to enhance gamma-aminobutyric acid (GABA) activity at GABA-A receptors, producing calming, sedative, and muscle-relaxant effects. It is administered orally and is metabolized in the liver, with elimination via the kidneys. The drug’s effects can be intensified by alcohol and other central nervous system depressants, and it carries risks of drowsiness, dizziness, and impaired coordination.

Safety and regulation: Prolonged use can lead to tolerance and physical dependence; withdrawal after extended use can be challenging and may include anxiety, insomnia, and tremor. Because of these risks, meprobamate is generally prescribed with caution and is restricted or controlled in many jurisdictions. It is usually avoided in pregnancy unless the potential benefits outweigh risks.

Current status: Today meprobamate is prescribed infrequently in many regions, often replaced by benzodiazepines and other anxiolytics with more favorable safety profiles. When used, therapy is typically short-term and carefully monitored to minimize adverse effects and dependence.