🌿 Folk Prescriptions

Elderly individuals often experience varying degrees of difficulty falling asleep, frequent nighttime awakenings, or early morning awakenings. Theoretically, long-acting phenobarbital should be used. However, clinical experience shows elderly patients should avoid barbiturate drugs—including phenobarbital—due to the following reasons:
First, some elderly people have poor tolerance to barbiturates, often causing severe drowsiness and mental dullness.
Second, elderly patients with chronic obstructive pulmonary disease (emphysema, bronchial asthma) often have significant lung dysfunction. Even small doses of barbiturates can lead to severe hypoxia and carbon dioxide retention, potentially causing pulmonary edema or respiratory paralysis—strict contraindication.
Third, elderly individuals commonly have reduced renal function. Phenobarbital is excreted unchanged via kidneys, leading to slowed drug elimination and prolonged plasma half-life. Thus, elderly people using barbiturates are prone to toxic symptoms such as confusion and ataxia.
Fourth, a few elderly individuals develop abnormal reactions after taking these drugs—manifesting as excitement rather than inhibition—such as agitation, insomnia, nightmares, or even delirium.
In summary, elderly people should use barbiturate drugs cautiously or avoid them altogether. In fact, insomnia has many causes. Addressing the underlying cause of insomnia is the fundamental treatment. Compared to barbiturates, drugs like diazepam and nitrazepam are safer and more effective for treating insomnia in the elderly and can replace barbiturates.
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