Flumazenil: A new benzodiazepine antagonist

Interaction of Flomazenil with Anxiolytic Effects of <i>Citrus aurantium</i> L. Essential Oil on Male Mice

“…Flomazenil antagonizes the benzodiazepine effects in the central nervous system, but it is not able to antagonize the effects of the medicines which are effective on the GABAergic neurons. Also flomazenil is not able to reverse the epioids effects [13]. Some evidences show that flomazenil separates benzodiazepine from the receptor.…”

“…Flomazenil reverses the inhibition effect of benzodiazepines by competing them [12]. Flomazenil leaves its antagonistic effect by attaching on the benzodiazepines on GABA receptors [13]. Flomazenil antagonizes the benzodiazepine effects in the central nervous system, but it is not able to antagonize the effects of the medicines which are effective on the GABAergic neurons.…”

“…Some evidences show that flomazenil separates benzodiazepine from the receptor. Flomazenil attachment to the benzodiazepine place on the receptor will lead to a change in the receptors sensitivity and changes the receptors attachment tendency to benzodiazepines [13]. …”

The Role of Flumazenil in the Management of Patients With Acute Alteration of Mental Status in the Emergency Department

“…In this case flumazenil may reverse the dampening effect of BZ on sympathetic nervous activity and this could result in cardiovascular complications and seizure. 16,21 However, in a recent Scandinavian series,l° 10 patients with mixed BZ/antidepressant overdoses received slow flumazenil administration of 1 mg, and neither seizure nor arrhythmias were reported. In a placebo-controlled study in dogs,31 bolus administration of high dose of flumazenil (0.2 mg kg-1) in mixed intoxication implicating BZ and cyclic antidepressants has the potential to precipitate convulsion and/or arrhythmia, but a slow titrated administration could prevent these effects.…”

“…21 Despite the convenience and relative safety of flumazenil, the physician must still exercise responsible clinical judgement in patient management. Specifically, flumazenil is not recommended to be used routinely and without limits or criteria.22,28 We suggest criteria by which flumazenil can be used cost-effectively.…”