Benzodiazepine overdose

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Benzodiazepine overdose
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Drowsiness, confusion, dizziness, blurred vision, unresponsiveness, anxiety, agitation, hallucinations, slurred speech, ataxia, coma
Complications	Respiratory depression, hypotension, cardiac arrest
Onset	Rapid
Duration	Variable
Types	N/A
Causes	Benzodiazepine overdose
Risks	Polypharmacy, substance use disorder, alcohol use disorder
Diagnosis	Clinical assessment, toxicology screen
Differential diagnosis	Opioid overdose, alcohol intoxication, barbiturate overdose
Prevention	Prescription monitoring, patient education, substance abuse treatment
Treatment	Supportive care, flumazenil
Medication	N/A
Prognosis	Variable, depending on severity and treatment
Frequency	Increasing
Deaths	N/A

Overview of benzodiazepine overdose

Timeline of benzodiazepine-related deaths in the United States.

Timeline of opioid involvement in benzodiazepine overdose deaths in the United States.

Flumazenil, a benzodiazepine antagonist used in the treatment of overdose.

Benzodiazepine overdose occurs when a person takes an excessive amount of benzodiazepines, a class of psychoactive drugs used primarily for treating anxiety, insomnia, and seizures. Overdose can lead to severe central nervous system depression, respiratory depression, and in some cases, death.

Signs and Symptoms

The symptoms of benzodiazepine overdose can vary depending on the amount ingested and whether other substances were also taken. Common symptoms include:

• Drowsiness
• Confusion
• Dizziness
• Blurred vision
• Weakness
• Slurred speech
• Lack of coordination
• Difficulty breathing
• Coma

Causes

Benzodiazepine overdose can occur due to:

• Intentional misuse or recreational use
• Accidental overdose, often in the elderly or those with cognitive impairments
• Combination with other central nervous system depressants, such as opioids or alcohol

Diagnosis

Diagnosis of benzodiazepine overdose is primarily clinical, based on the history of ingestion and presenting symptoms. Laboratory tests may include:

• Blood tests to measure benzodiazepine levels
• Toxicology screening for other substances

Treatment

The primary treatment for benzodiazepine overdose is supportive care, which may include:

• Monitoring of vital signs
• Ensuring adequate airway and breathing
• Intravenous fluids

In some cases, the use of flumazenil, a benzodiazepine antagonist, may be considered. However, flumazenil is used cautiously due to the risk of seizures, especially in patients with a history of long-term benzodiazepine use or co-ingestion of tricyclic antidepressants.

Prognosis

The prognosis for benzodiazepine overdose is generally good with appropriate medical care, especially if the overdose is not complicated by the use of other substances. However, the risk of fatality increases significantly when benzodiazepines are combined with other depressants like opioids.

Prevention

Preventive measures include:

• Educating patients on the risks of overdose
• Prescribing the lowest effective dose
• Monitoring for signs of misuse or abuse
• Avoiding concurrent use of other central nervous system depressants

Epidemiology

Benzodiazepine overdoses have been increasing, particularly in combination with opioids. The

Timeline of opioid involvement in benzodiazepine overdose deaths in the United States.

shows the growing concern of opioid involvement in these cases.

Also see

• Benzodiazepine withdrawal syndrome
• Opioid overdose
• Substance use disorder
• Central nervous system depression