![]() ![]() ![]() Fatal overdoses can occur at relatively low doses in these individuals. Additionally, the elderly and those with chronic illnesses are much more vulnerable to lethal overdose with benzodiazepines. In the case of alcohol and barbiturates not only do they have an additive effect, they also increase the binding affinity of benzodiazepines to the benzodiazepine binding site which results in a very significant potentiation of the CNS and respiratory depressant effects. Taken in overdose in combination with alcohol, barbiturates, opiates, tricyclic antidepressants, or sedating antipsychotics, anticonvulsants, or antihistamines are particularly dangerous. They are, however, not devoid of serious toxicity and case of severe coma or fatality have been reported. Toxicityīenzodiazepines have a wide therapeutic index and taken alone in overdose rarely cause severe complications or fatalities. Zopiclone, a benzodiazepine receptor agonist has similar overdose potential as benzodiazepines. However, in countries where alprazolam is commonly prescribed, alprazolam is found to be the most dangerous in overdose, causing more fatalities, higher rates of admission to ICU and higher rates of mechanical ventilation. Temazepam is more frequently involved in drug-related deaths causing more deaths per million than other benzodiazepines. The various benzodiazepines differ in their toxicity since they produce varying levels of sedation in overdose, with oxazepam being least toxic and least sedative and alprazolam, flunitrazepam and temazepam the most toxic and most sedative in overdose. Worldwide benzodiazepines are commonly used in overdose situations.Īs benzodiazepines are one of the most highly prescribed class of drugs they are commonly used in self-poisoning by drug overdose. There is an antidote, flumazenil, but its use is controversial. Supportive care is the mainstay of treatment of benzodiazepine overdose. Severe symptoms include coma and respiratory depression. The most common symptoms of overdose include central nervous system (CNS) depression and intoxication with impaired balance, ataxia, and slurred speech. However, combinations of high doses of benzodiazepines with alcohol, barbiturates, opiates or tricyclic antidepressants are particularly dangerous, and may lead to severe complications such as coma or death. When taken alone in overdose they rarely cause severe complications or fatality, and deaths after hospital admission are rare. Since it reverses the sedative and other actions of benzodiazepines, it has been suggested as an antidote to benzodiazepine overdoses.Benzodiazepine overdose describes the ingestion of one of the drugs in the benzodiazepine class in quantities greater than are recommended or generally practiced. As a result, flumazenil reverses benzodiazepine-induced effects including sedation, psychomotor deficits, amnesia, and hypoventilation in a dose-dependent manner.Ī potent benzodiazepine receptor antagonist. ![]() Flumazenil antagonizes the benzodiazepine binding site of the gamma-aminobutyric acid (GABA)/benzodiazepine receptor complex in the central nervous system (CNS), thereby preventing the chloride channel opening events and inhibiting neuronal hyperpolarization. An imidazo-benzodiazepine derivative, effective in reversing benzodiazepine-induced activities. ![]()
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