Neonatal Barbiturate Withdrawal

To the Editor.— In the report by Bleyer and Marshall of neonatal barbiturate withdrawal in a child whose mother was a barbiturate addict (221:185, 1972), the authors believed this to be the first recorded case of neonatal barbiturate withdrawal syndrome. However, Desmond et al in February 1972 reported neonatal withdrawal in 15 infants born to mothers receiving barbiturates.1Of these 15 infants, four were born to mothers receiving physician-prescribed therapy with phenobarbital for anxiety or sedation, and seven infants were born to epileptic mothers who were treated with phenobarbital in combination with other anticonvulsants. The maternal dosage in the first group varied from only 90 to 120 mg of phenobarbital daily. Thus, much smaller doses than those reported by Bleyer and Marshall appear to be capable of causing a barbiturate withdrawal syndrome.