Newsgroups: sci.med.pharmacy
Subject: Re: bromides
From: dyer@spdcc.com (Steve Dyer)
Date: Thu, 29 Jul 1999 06:00:22 GMT

In article <379FC74A.DC20A958@pottsville.infi.net>,
Dom D'Alessandro  <domm@pottsville.infi.net> wrote:
  >Are bromides used as sedatives or hypnotics?  What kinds are used?  What
  >are dosage levels?  Thanks all.

They were introduced in the mid-19th century to treat epilepsy and as
general-purpose sedatives in an era when there really hadn't been anything
else available apart from alcohol and opium.  Bromides have been obsolete
for decades, and their use started to decline long, long ago, after drugs
like the barbiturates were introduced in the early part of the 20th century.

The term "bromide" refers to an inorganic salt containing the bromide ion,
analogous to the chloride ion, typically a salt of an alkali metal like
sodium bromide or potassium bromide.  Taken chronically, in sufficent
amounts to overwhelm its excretion by the kidney, bromide ion accumulates
in the body, and exerts a kind of generalized sedative action, though this
is accompanied by rather substantial toxicity, a constellation of symptoms
collectively known as "bromism", not surprisingly similar to "iodism", or
or iodide toxicity--tearing, rashes, acne, excessive sedation, and
occasionally psychotic episodes.

Bromides were also an ingredient in many early patent medicines, such as
the eponymous nostrum "Bromo Seltzer", but this was an irrational use
of a barely-rational substance, since bromide ion has few acute effects,
and is useless as a hypnotic or sleeping aid; its actions depend on its
reaching therapeutic levels after chronic administration.

In the class of obsolete sedatives are also a few organic bromide
compounds like carbromal and bromisoval which are closer to the
barbiturates in their actions, but could also cause bromism, at
least in habituated individuals taking large doses, because they
are debrominated during their metabolism to bromide ion.  These
are not "bromides" as the term is commonly used.

You can see from this explanation how the term "bromide" came to be
used to describe a platitude so tiresome and banal as to induce a
stupor in those hearing it.

--
Steve Dyer
dyer@ursa-major.spdcc.com