80 Chloral Hydrate
doses gastrointestinal distress may occur, and persons suffering from stomach
irritation are supposed to avoid the compound. A case report notes a delib-
erate overdose that destroyed part of a patient’s stomach. Heart attack has
occurred from chloral hydrate overdose, but that is unusual. In high quantities
the compound interferes with heart rhythm and reduces blood pressure and
breathing; seizures are possible. Experiments using chloral hydrate on rats and
mice have injured the liver, and inhaling the drug’s vapor has caused lung
damage in mice. Human physical contact with the compound can irritate the
skin, lungs, and eyes. The substance is suspected of causing kidney damage
and colon cysts and of aggravating a disease called porphyria. Reduction may
occur in the number of white blood cells. Although the substance is a de-
pressant, some persons are stimulated by the drug.
Abuse factors.In the 1800s a number of prominent persons became addicted
to chloral hydrate: English poet and painter Dante Gabriel Rossetti, German
literary figure Karl Ferdinand Gutzkow, and renowned German philosopher
Friedrich Wilhelm Nietzsche. Such addiction grew uncommon in the twentieth
century as the drug itself grew less common. As is so often the case with drug
abuse, chloral hydrate addicts were typically polydrug abusers, often using
alcohol,opium,ormorphineas well. Today chloral hydrate does not seem to
be a popular recreational intoxicant, quite possibly because the kind of person
who would enjoy chloral hydrate may instead be attracted to barbiturates, a
type of drug that was unavailable in the nineteenth century.
No dependence developed after experimenters gave chloral hydrate to mon-
keys twice a day for six weeks, but tolerance and dependence can develop in
humans. The most common origin of dependence is medical usage. Chloral
hydrate withdrawal symptoms include tremors, worry, sleeping difficulty,
confusion, delirium, hallucinations, and convulsions. Some authorities de-
scribe the syndrome as delirium tremens. Withdrawal may have a fatal out-
come.
Drug interactions.Actions of anti–blood clotting medicines may be tem-
porarily boosted by chloral hydrate, but the amount of change and its medical
significance are disputed. The drug may reduce blood levels of the epilepsy
medicine phenytoin, thereby impeding phenytoin’s therapeutic actions. In
mice experimentation chloral hydrate had inconsistent impact on alcohol
blood level (sometimes raising it, sometimes reducing it) but extended the
time that intoxication lasted. In humans the combination produces changes in
heart rate and blood pressure that might harm cardiac patients (the face and
neck of one volunteer turned reddish purple from the combination). Alcohol
and chloral hydrate are both depressants, and taking them together is like
taking an extra dose of one or the other. Injectingmarijuana’s main active
ingredient THC (tetrahydrocannabinol) into animals increases chloral hy-
drate’s potency.
Cancer.Lab tests of chloral hydrate’s potential for causing cancer have pro-
duced mixed results. The compound has increased the liver cancer rate in
mice, but skepticism exists about human relevance of those mice results be-
cause dosage was long term and so high as to be poisonous—circumstances
not at all similar to an occasional normal therapeutic dose. Experimenters
administered the substance to hundreds of rats every day for over two years