Viktorija Antonova-Šiaudvytė¹                      

¹Vilnius University, Faculty of Medicine, Vilnius, Lithuania

Abstract

Benzodiazepines are psychotropic drugs whose indications for use include short-term anxiety or insomnia, withdrawal syndrome, etc. Benzodiazepines selectively act on the central nervous system by causing depression. Benzodiazepine intoxication is manifested by increased sedation, sluggishness, dysarthria, ataxia, diplopia, tachycardia, and at higher doses may cause coma, respiratory depression or death. Flumazenil is administered only in cases of accidental poisoning, otherwise life support is used. Gastric lavage should be performed no more than 1 hour after ingestion. Activated charcoal or haemodialysis shows no signifficant effect. Due to the frequent prescription of these drugs and the development of dependence, it is necessary to have a good knowledge of the clinical signs of poisoning caused by these drugs and to be able to administer treatment.

Aim: review the mechanisms of action, signs of intoxication and treatment tactics as described in the scientific literature.

Conclusions: Benzodiazepines have become one of the most commonly prescribed group of psychotropic drugs in recent years. Although the use of these drugs has significantly decreased in Lithuania, irrational prescribing and use of anxiolytics is still observed. The mechanism of action of benzodiazepines is CNS depression, and intoxication is manifested by increased sedation, sluggishness, dysarthria, ataxia, diplopia, tachycardia, and at higher doses can cause coma, respiratory depression or death. Flumazenil is administered only in cases of unintentional poisoning, otherwise life support is used. Gastric lavage is possible less than one hour after ingestion. Activated charcoal or haemodialysis is not significantly affected.

Methods: the international databases Pubmed and UpToDate were used for literature search. The following keywords or a combination of keywords were used in the search: benzodiazepines, indications for benzodiazepines, pharmacology of benzodiazepines, toxicity of benzodiazepines, benzodiazepine poisoning and treatment. Although every effort was made to analyse publications from the last 5 years, the citation period was not restricted. The results of the analysis of 19 articles out of 274 selected are presented in this article.  Keywords: benzodiazepines, poisoning, flumazenil.