Acute overdosage with benzodiazepine derivatives

Abstract

A total of 773 admissions to Massachusetts General Hospital between 1962 and 1975 were due to acute overdosage with one or more psychotropic drugs. Benzodiazepine overdosage, particularly with diazepam, increased relative to other psychotropic drugs over the years. Only 12 admissions were due to benzodiazepine overdosage alone, and none of these patients were seriously ill or had significant complications. Multiple drugs were ingested in the other 87 cases, and the frequency and severity of complications among these individuals depended upon the type and quantity of other nonbenzodiazepines taken. For example, 21 of 31 patients who ingested benzodiazepines together with barbiturates experienced severe central nervous system (CNS) depression, and 14 of 31 required assisted ventilation. However, the frequency of such complications was nearly identical in a group of patients who ingested barbiturates alone. This report and a review of the literature suggest that serious intoxication following overdosage with a benzodiazepine derivative alone is unusual. Ingestion of benzodiazepines together with other drugs appears to be considerably more common than benzodiazepine overdosage alone as a cause of intoxication. The severity of intoxication in such cases of multiple drug ingestion probably depends largely on the type and quantity of nonbenzodiazepines.

Effect of an anxiolytic botanical containingSouroubea sympetalaandPlatanus occidentalisonin-vitrodiazepam human cytochrome P450-mediated metabolism

“…Many common anxiolytic medications may cause serious adverse effects such as benzodiazepine overdose . Accordingly, the administration of these medications is often based on the risk to benefit ratio, which can be narrow in certain if not many populations.…”

Hypothermia: An Unusual Indication for Gastric Lavage

“…Normally, lorezapam toxicity is treated with supportive care alone (17). However, it is known that benzodiazapenes inhibit the thermoregulatory center of the brain (18).…”

Synaptic pharmacology of barbiturates and benzodiazepines

“…These findings in animals are confirmed in everyday experience in man. Within a large range of doses, benzodiazepines produce their desired therapeutic actions with only mild side-effects; lethal doses in man (in the absence of other agents or special circumstances) are unknown, since they exceed the amounts that can be ingested for practical reasons [1 ]. With incremental doses of barbiturates the intensity of central nervous system depression increases very steeply, and accidental and suicidal overdosage frequently results in death.…”