Seconal (secobarbital) is no longer prescribed in any practical sense. The brand-name product was discontinued by its sole manufacturer, Bausch Health, in January 2022, and no other company currently markets secobarbital capsules in the United States. While secobarbital technically remains an FDA-approved substance with a valid DEA classification, you cannot walk into a pharmacy and fill a prescription for it.
Why Seconal Disappeared From Pharmacies
Seconal was once one of the most widely prescribed sleeping pills in America. It belonged to the barbiturate class of drugs, which dominated insomnia and anxiety treatment from the mid-20th century through the 1970s. That changed when benzodiazepines arrived on the market with significantly better safety profiles. Barbiturates have a narrow therapeutic index, meaning the difference between an effective dose and a dangerous one is uncomfortably small. Physical dependence develops quickly, tolerance to the sleep benefits builds over time, and overdose can occur even at relatively low doses.
By the time Bausch Health pulled Seconal from the market in 2022, prescriptions had dwindled to near zero for sleep or sedation. The American Association of Sleep Medicine does not endorse barbiturates for insomnia. The American Geriatrics Society’s 2023 Beers Criteria explicitly discourages barbiturate use in older adults due to the high risk of dependence and overdose. In modern clinical practice, barbiturates for sleep have been fully replaced, first by benzodiazepines and then by newer non-benzodiazepine sleep aids.
The Safety Risks That Drove the Shift
Barbiturate toxicity affects nearly every major system in the body. Even at prescribed doses, secobarbital could cause dangerous respiratory depression, slowing breathing to the point of apnea. It suppressed cardiovascular function by dilating blood vessels, lowering blood pressure, and directly weakening the heart’s contractions. Confusion, loss of coordination, slurred speech, and hypothermia were all documented effects.
Certain groups faced even greater danger. People with chronic lung disease were vulnerable to respiratory failure on therapeutic doses. Those with heart failure were more susceptible to cardiovascular collapse. Liver disease slowed the drug’s metabolism, allowing it to accumulate to toxic levels. Combining secobarbital with other sedatives, opioids, or certain other medications compounded all of these risks. These problems made barbiturates increasingly difficult to justify when safer alternatives existed.
Its Role in Medical Aid in Dying
The last significant use of secobarbital was in medical aid in dying programs. In states like Oregon, where terminally ill patients can legally request life-ending medication, high-dose barbiturates became the standard protocol. Secobarbital was prescribed at doses of 9 to 15 grams for this purpose, far beyond anything used for sleep.
Even this use has largely ended. According to Oregon’s 2020 Death with Dignity Act report, secobarbital became unavailable for assisted dying in 2019, several years before the brand was formally discontinued. Pentobarbital, another barbiturate used in these protocols, had already become unavailable in 2015. Aid-in-dying programs have since shifted to alternative drug combinations.
Could You Still Get It Somehow?
Secobarbital remains classified as a Schedule II controlled substance under federal law, which means it carries the strictest prescribing requirements: no refills, a new written prescription each time, and tight monitoring. Combination products containing secobarbital alongside other active ingredients fall under the slightly less restrictive Schedule III. But classification is irrelevant when there is no product to dispense. The American Society of Health-System Pharmacists confirms that no presentations of secobarbital capsules are currently being marketed.
Before the discontinuation, Seconal had already become extraordinarily expensive. A bottle of 100 capsules cost between $3,200 and $3,700, putting each pill at roughly $32 to $37. That price reflected the drug’s near-total obsolescence for mainstream medical use, with a sole manufacturer serving a tiny market.
What Replaced It
If you’re dealing with insomnia, the medications your doctor is likely to consider fall into entirely different drug classes. Non-benzodiazepine sleep aids (sometimes called “Z-drugs”) target sleep-specific receptors with far less risk of fatal overdose. Newer options that work on different brain pathways, including orexin receptor antagonists, have expanded the choices further. Cognitive behavioral therapy for insomnia is now considered the first-line treatment by most sleep medicine guidelines, often recommended before any medication.
For preoperative sedation, another historical use of Seconal, short-acting benzodiazepines took over decades ago and remain the standard. There is no clinical scenario in current practice where a provider would reach for secobarbital over available alternatives.