Thiopental
| Evidence Level: L5 | Predicted Indications: 8 |
Table of Contents
Thiopental: Trichotillomania
One-Sentence Summary
Thiopental is a barbiturate originally listed for epilepsy, pseudotumor cerebri and intracranial hypertension. The TxGNN model predicts it may be effective for trichotillomania, but there are 0 clinical trials and 0 publications supporting this prediction. This is a prediction from the TxGNN model (deep learning) only, and the score may reflect similarities the model learned between related diseases, not biological evidence.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Trichotillomania |
| TxGNN Prediction Score | 0.9995 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (12 of 12) – CDSCO approval status is not included in this data |
| Number of Listed Products | 12 (valid: 12) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on known information, thiopental is a barbiturate that enhances GABA-A receptor activity, and its efficacy in seizure control is established. Mechanistically, however, there is no established rationale linking this to trichotillomania, a compulsive hair-pulling disorder.
The high TxGNN score (0.9995) comes from the TxGNN model (deep learning) and may reflect similarities the model learned between related diseases, not biological evidence. No trials or publications were found for this indication, so the prediction should be treated as a hypothesis only.
Other predictions worth noting:
- Absence epilepsy (L4) has indirect evidence only (mainly status epilepticus protocols and case reports). GABAergic enhancement can also aggravate absence seizures in some settings.
- Substance abuse/dependence (L4): the literature shows that barbiturates cause tolerance and dependence rather than treat it. These are safety signals, not therapeutic evidence, and the indication is not supported.
- Prinzmetal angina, migraine disorder, Tourette syndrome, migraine with brainstem aura, obsolete bundle branch block, and nephrogenic syndrome of inappropriate antidiuresis have no relevant clinical evidence. The few retrieved articles concern other substances or use thiopental only as an anaesthetic in animal experiments.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available for trichotillomania.
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 8223422 | 1993 | Cohort | Epilepsy Research | Thiopental test in 103 epilepsy surgery patients, using EEG beta activity and interictal spiking to localise dysfunction |
| 18759609 | 2009 | Cohort | Journal of Neurosurgery | Seizure occurrence during intracranial pressure-targeted therapy in traumatic brain injury |
| 9805996 | 1998 | Case report | Rinsho Shinkeigaku | Severe status epilepticus of frontal lobe origin treated with corticosteroids |
| 12446223 | 2002 | Case report | Epileptic Disorders | Epilepsy surgery for status epilepticus caused by cortical dysplasia in an infant |
India Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 110258 | Intraval Sodium Injection | Vial of 1 Injection | Not specified |
| 223869 | Thioz 500mg Infusion | Bottle of 1 Infusion | Not specified |
| 226180 | Thioz 1gm Injection | Vial of 1 Injection | Not specified |
| 111797 | Ithiofast Injection | Vial of 1 Injection | Not specified |
| 220518 | Thipen 500mg Injection | Vial of 1 Injection | Not specified |
All 12 registrations are valid single-ingredient injectable or infusion products. The five listed here are the main examples.
Safety Considerations
- Contraindications (from the knowledge graph, not label text): Kidney disease and kidney failure, uraemia, liver disease, gallbladder disease, asthma (including intrinsic and allergic), hypotensive disorder, anaemia, adrenal insufficiency (including Addison disease and congenital adrenal hyperplasia), myasthenia gravis and neuromuscular junction disease, variegate porphyria, acute intermittent porphyria, and myxedema/hypothyroidism.
- Drug Interactions: 45 interactions were identified in total. The main ones are:
- Major: Ethanol, Warfarin
- Moderate: Morphine, Codeine, Hydrocodone, Dextromethorphan, Dronabinol, Nabilone, Cetirizine, Doxycycline, Methylene blue, Nitisinone, Iodide I-131, Iodide I-123, Carbinoxamine, Clemastine
- Dependence liability: The literature retrieved for the dependence indication shows barbiturates can cause tolerance and physical dependence.
Please refer to the package insert for label warnings, which were not available for this report.
Conclusion and Next Steps
Decision: Hold
Rationale: The trichotillomania prediction rests on a model score alone, with no trials, no literature and no plausible mechanistic link. The only direction with some credibility, frontal lobe epilepsy, is essentially an extension of thiopental’s existing anticonvulsant use and is supported only by indirect or anecdotal evidence.
To proceed, the following is needed:
- Package insert warnings and contraindications from the India regulator or manufacturers (currently a blocking gap for safety screening)
- Detailed mechanism of action data (e.g. from DrugBank)
- For frontal lobe epilepsy, a focused review of controlled evidence on thiopental in refractory seizures, which could be treated as a research question
- Confirmation of the approved indications on the India registrations, as the licence records carry no indication text
- Route and dosing compatibility assessment, since all products are injectable and any chronic indication would need a suitable formulation
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.