Flumazenil in benzodiazepine overdose

An, Howard; Godwin, Jesse

doi:10.1503/cmaj.160357

Cited by 26 publications

(18 citation statements)

References 4 publications

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“…The use of flumazenil has been associated with the occurrence of seizures, particularly in benzodiazepines dependent cases. Furthermore, flumazenil can induce >10% gastrointestinal and 1% to 10% cardiovascular adverse reactions [ 31 ]. Our results identify that greater burden of health impacts in certain populations can be controlled without any harmful adverse effects, simply by using methylphenidate.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Methylphenidate on Reed Scaling in Benzodiazepine Poisoning: A Prospective Trial

Latifi-Pour

Hassanian‐Moghaddam

Mortazavi

et al. 2020

CCP

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Background: Benzodiazepine is one of the most important causes of substance abuse and intoxication throughout the world and Iran. Objective: The aim of our study is to determine the role of stimulants in reversing CNS level in acute Benzodiazepine poisoning patients who were hospitalized at referral poison center. Methods: This was a randomized double-blind placebo-controlled trial study on 32 cases with pure acute Benzodiazepine poisoning from March 2016 to February 2017. Diagnosis of pure acute poisoning was based on history, and laboratory confirmation. We gathered the demographics, clinical data, laboratory data, hospitalization and outcome. Participants were randomized into two groups: Methylphenidate Group (MPH) and Placebo Group (PBO). Results: The randomized sample consisted of 32 participants who were predominately female (83%). The majority of the PBO group and the MPH group reported improvement in their consciousness with a significant difference between the two groups (p = .005). Paired sample t-test analyses on Reed Scale data revealed an increase in the probability of improvement during the trial for the MPH group compared to the PBO group. Furthermore, the HCo3 (bicarbonate) level has a significant p-value with respect to age groups (p = .02). None of our cases required either the ICU facility or intubation. Conclusion: Our study provided the MPH superiority over PBO in reversing CNS symptoms in loss of consciousness in acute BZD poisoned patients. Thus, this trial provides concrete evidence that improvement in consciousness levels (Reed Scale rated) among those patients receiving MPH was associated with a methylphenidate use.

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Section: Discussionmentioning

confidence: 99%

The Effect of Methylphenidate on Reed Scaling in Benzodiazepine Poisoning: A Prospective Trial

Latifi-Pour

Hassanian‐Moghaddam

Mortazavi

et al. 2020

CCP

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“…They were found to have a marked effect on GABA metabolism and extrasynaptic GABA levels and may prove useful in increasing GABA availability [41]. The antiepileptic drugs carbamazepine (CBZ) (Figure 11) and sodium valproate (Figure 12) were found to act almost identically, except that sodium valproate increased GABA levels, while CBZ did not [64,65]. The increased GABA levels and GABAA modulation may make sodium valproate a better candidate for receptor normalization than CBZ.…”

Section: Discussionmentioning

confidence: 99%

Restoration Of GABAA Receptor Function After Benzodiazepine Use: A Meta-Analysis

Warlick¹,

Souza²,

Gallicchio³

2020

Journal of Stem Cell Research

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Benzodiazepines (BZDs) are some of the most commonly prescribed medications in the United States and are currently classified as schedule IV-controlled substances. Originally patented in 1958, Librium became the first BZD synthesized and set the stage for what would become a major change in medical practice. Since their introduction, BZDs were meant to replace barbiturates, a precursor family with highly addictive properties and lethal overdose consequences. Within the past twenty years, it has been found that BZDs can also cause physical dependence, sometimes in as little as two weeks, and addiction because of their strong relaxant and euphoric properties. Research has hypothesized that dependency occurs because of GABA A receptor desensitization and functional down regulation. This meta-analysis compiles multiple literature sources to determine novel ways to restore GABA A receptor function so that recovering patients can maintain long-term abstinence from BZDs. Selected psychiatric medications and their pharmacology are discussed to determine potential combinations that may normalize GABA A receptor activity after chronic BZD use.

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“…Interestingly, we found that flumazenil, a diazepam antidote, induces an increase in larval activity. It is notable that flumazenil is used as an antidote to treat benzodiazepine overdoses in humans, but can lead to various complications that are in part due to its short half-life 20 . We propose that the developed imaging system may be used in high-throughput screens for novel sedatives and antidotes that are both safe and effective.…”

Section: Discussionmentioning

confidence: 99%

Analysis of vertebrate vision in a 384-well imaging system

Thorn

Dombroski

Eller

et al. 2019

Sci Rep

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Visual impairment affects 253 million people worldwide and new approaches for prevention and treatment are urgently needed. While small molecules with potential beneficial effects can be examined in various model systems, the in vivo evaluation of visual function remains a challenge. The current study introduces a novel imaging system for measuring visually-guided behaviors in larval zebrafish. The imaging system is the first to image four 96-well plates with a single camera for automated measurements of activity in a 384-well format. In addition, it is the first system to project moving visual stimuli and analyze the optomotor response in the wells of a 96-well plate. We found that activity is affected by tricaine, diazepam and flumazenil. Surprisingly, diazepam treatments induce a loss of visual responses, at concentrations that do not affect activity or induce hyperactivity. Overall, our studies show that the developed imaging system is suitable for automated measurements of vertebrate vision in a high-throughput format.

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Flumazenil in benzodiazepine overdose

Cited by 26 publications

References 4 publications

The Effect of Methylphenidate on Reed Scaling in Benzodiazepine Poisoning: A Prospective Trial

The Effect of Methylphenidate on Reed Scaling in Benzodiazepine Poisoning: A Prospective Trial

Restoration Of GABAA Receptor Function After Benzodiazepine Use: A Meta-Analysis

Analysis of vertebrate vision in a 384-well imaging system

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