Further, the short half-life of flumazenil necessitates a period of careful supervision after its administration. A normal electrocardiogram recording before the antidote is given will imply a minimal risk of any adverse reactions in cases of combined intake of benzodiazepine and antidepressants. Moreover, some precautions should be taken during administration, such as individual titration of the dosage to minimise the risk of inducing benzodiazepine withdrawal syndrome or unmasking toxic effects of other concurrently ingested drugs. Flumazenil can also be used diagnostically in cases of unclear multiple drug poisoning or coma of unknown aetiology.ĭuring use of flumazenil, consideration should be paid to a few contraindications, including patients with epilepsy who are receiving long term benzodiazepine medication. In self-poisoning, the drugs ingested are frequently a mixture of several compounds and their identity is often unknown. Its use should therefore be considered in all unconscious patients admitted because of benzodiazepine overdosage. However, respiratory depression, hypotension and prolonged coma are often seen in other patient groups with benzodiazepine overdosage, such as the elderly, children and patients with chronic pulmonary disease.įlumazenil, a specific benzodiazepine antagonist, is a valuable and safe diagnostic and therapeutic tool in the short term management of drug poisoning with involvement of benzodiazepines. Fortunately, compared with several other drugs they are relatively safe in overdose, and symptoms of severe poisoning are rarely observed in young adults with pure benzodiazepine overdosage. Today, benzodiazepines are the drugs most commonly involved in cases of self-poisoning.
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