[Major points]

1. Benzodiazepines are one type of sedative-hypnotic drugs
2. Benzodiazepines overdose can cause confusion; inducing vomiting should be avoided.
3. Patients with benzodiazepine poisoning need to be turned over regularly to avoid limb compression.
   

Benzodiazepine (BZD) is one of the sedative-hypnotics that can release anxiety, help one to sleep easily, relax the muscle, prevent and treat epileptic seizures. Benzodiazepine poisoning cases are mainly due to overdose, and a few are due to abnormal metabolism of drugs.

 

What are the symptoms of Benzodiazepine Poisoning?

1. Central nervous system (CNS): Benzodiazepines act on the central nervous system (CNS). The symptoms include sedation, drowsiness, fatigue, slurred speech, unstable gait and amnesia. Not causing actual damage to CNS.
2. Cardiovascular system: Inhibit the central nervous system may lead to cardiovascular impairment. For instance, decreasing contractility, low blood pressure and heart rate, even cardiac arrest.
3. Respiratory system: There is a greater chance via venous injection in respiratory arrest, especially for those with heart and lung disease. Aspiration pneumonia is one of main complications by benzodiazepine poisoning.
4. Gastrointestinal system: Nausea and vomiting may occur, but these are relatively rare in clinical practice.

Those who have the above symptoms are not necessarily Benzodiazepine Poisoning. If you have the above symptoms, please go to the toxicology department.

 

How to treat benzodiazepine poisoning?

1. Monitor changes in consciousness, ensure airway patency, observe respiratory patterns, and assess whether nasogastric tube lavage is required based on physician evaluation. Administer activated charcoal treatment. If poisoning symptoms are mild, the patient may be discharged for outpatient follow-up once their condition stabilizes.
2. Supportive care: central nervous system suppression or respiratory depression can be treated with detoxifying agents and respiratory support. If low blood pressure or slow heartbeat occurs, pressors and fluid supplements can be used to correct it. If necessary, endotracheal tubes should be placed to maintain breathing and nasogastric tubes should be placed to prevent aspiration pneumonia.
3. Anexate, whose scientific name is Flumazenil, is an antidote to benzodiazepine, which can weaken the effect of benzodiazepine; However, this antidote has a short drug effect and is mainly used for diagnosis in clinic.
4. Avoid long-term compression of the limbs, and provide comfortable positioning to facilitate blood circulation.
   

 

How to care for someone benzodiazepine poisoning?

1. Because coma can easily lead to aspiration pneumonia, it is necessary to maintain a clear airway, prevent the tongue from tilting backward, and encourage deep breathing and coughing to promote sputum expectoration.
2. Since the patient is unconscious and unable to move, pressure sores are prone to develop. It is necessary to ensure limb comfort and proper positioning, with assistance for repositioning every 2 hours.
3. Moderate exercise and massage can improve local blood circulation.
4. Maintain a balanced diet, consuming foods high in protein, calories, and vitamins, such as fish, meat, eggs, milk, beans, vegetables, and fruits. Weak patients and the elderly are prone to dehydration, so pay attention to replenishing fluids.

1. Hsieh, C.-Y., Hsu, J.-Y., & Yang, C.-C. (2023). Predictive factors for severe outcomes in substance abuse-related emergency visits: A 5-year retrospective analysis at a Medical Center in Taiwan. Journal of the Chinese Medical Association, 87(1), 40–47. https://doi.org/10.1097/jcma.0000000000001020
2. Humphries, C., Eddleston, M., & Dear, J. (2024). The emergency treatment of poisoning. Medicine, 52(1), 56–61. https://doi.org/10.1016/j.mpmed.2023.10.004
3. Morrison, C., Natale, I., Branchflower, A., Harvey, C., & Lundin, R. M. (2025). Harm reduction approaches for the use of benzodiazepines: A scoping review. Harm Reduction Journal, 22(1). https://doi.org/10.1186/s12954-025-01310-z.