An Australian (1995) study found oxazepam less toxic and less sedative, and temazepam more toxic and more sedative, than most benzodiazepines in overdose.įollowing an acute overdose of a benzodiazepine the onset of symptoms is typically rapid with most developing symptoms within 4 hours. Temazepam was shown to be more toxic than the majority of benzodiazepines. Over 10 years in the United Kingdom, 1512 fatal poisonings have been attributed to benzodiazepines with or without alcohol. Benzodiazepines are one of the most highly prescribed classes of drugs, and they are commonly used in self-poisoning. The US Food and Drug Administration (FDA) has subsequently issued a black box warning regarding concurrent use of benzodiazepines and opioids. In 2013, benzodiazepines were involved in 31% of the estimated 22,767 deaths from prescription drug overdose in the United States. However, combinations of high doses of benzodiazepines with alcohol, barbiturates, opioids or tricyclic antidepressants are particularly dangerous, and may lead to severe complications such as coma or death. Deaths from single-drug benzodiazepine overdoses occur infrequently, particularly after the point of hospital admission. 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, impaired balance, ataxia, and slurred speech. Flumazenil injection.Benzodiazepine overdose describes the ingestion of one of the drugs in the benzodiazepine class in quantities greater than are recommended or generally practiced. British Journal of Clinical Pharmacology. Benzodiazepine dependence and its treatment with low dose flumazenil. Flumazenil versus placebo or no intervention for people with cirrhosis and hepatic encephalopathy. Goh ET, Andersen ML, Morgan MY, Gluud LL. Significant and safe shortening of the recovery time after flumazenil-reversed midazolam sedation. Mathus-Vliegen EM, de Jong L, Kos-Foekema HA. Benzodiazepine pharmacology and central nervous system–mediated effects.
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