Carbromide

Current Scheduling Status
None
Year(s) and type of review / ECDD meetings
Drug Class

Recommendation (from TRS)

Substance identification
Carbromide (INN, CAS 511-70-6), chemically 2-bromo-2-ethylbutyramide, is also known as diethylbromoacetamide. No stereoisomeric forms are possible.

Similarity to known substances and effects on the CNS
Carbromide is the primary active metabolite of carbromal. It is therefore assumed to have the pharmacological properties of a non-barbiturate sedative—hypnotic of the bromoureide class. The parent compound, carbromal, was reviewed by the Expert Committee on Drug Dependence at its. twenty-fourth meeting in April 1987 and was not recommended ‘for placing under international control (2). Like carbromal, carbromide produces dose related barbiturate like sedative and hypnotic effects such as drowsiness, confusion and motor incoordination, and must be assumed to exhibit all the known pharmacological and toxic properties of carbromal. In the process of metabolism, the compound is debrominated. The bromide ion

is excreted at a much slower rate than the organic component of the molecule. Consequently, with repeated use, bromide ion can accumulate and cause the signs and symptoms of bromism, including memory loss, confusion, inability to concentrate, hallucinations, delusions and delirium.

Dependence potential
Although there are very few clinical case reports of carbromide abuse, there is extensive literature on the dependence potential of the parent compound, carbromal, and of the related bromoureide acecarbromal, both of which are associated with a pattern of drug dependence similar to that.seen-with the barbiturates.

Actual abuse and or/evidence of likelihood of abuse
Very few cases of carbromide abuse have been documented and, at present, no major abuse problems appear to exist. In the past, its precursor, carbromal, was associated with public health problems in certain countries, e.g. the Federal Republic of Germany. Carbromide is no longer marketed. With the ready availability of newer anxiolytics and hypnotics, the reappearance of carbromide as a therapeutic agent is unlikely.

Therapeutic usefulness
Carbromide now has extremely limited use as a therapeutic agent.

Recommendation
On the basis of the available data concerning its pharmacological profile, dependence potential and actual abuse, the Committee rated the likelihood of abuse of carbromide as moderate and the therapeutic usefulness as very low. Very few public health and social problems have been found to be associated with the substance, and the Committee considered that they were not serious enough to warrant placing it under international control. The Committee did not recommend scheduling of carbromide.

ECDD Recommendation

Scheduling/control not currently recommended