Fatal Poisonings Attributed to Benzodiazepines in Britain during the 1980s

  title={Fatal Poisonings Attributed to Benzodiazepines in Britain during the 1980s},
  author={Marc A Serfaty and George Masterton},
  journal={British Journal of Psychiatry},
  pages={386 - 393}
The fatal toxicity indices of benzodiazepines during the 1980s were calculated from national prescribing data and mortality statistics. The overall rate was 5.9 deaths per million prescriptions for benzodiazepines taken alone or with alcohol only, anxiolytics being less toxic than hypnotics. Diazepam appeared more toxic than average among anxiolytics (P<0.05), and flurazepam and temazepam more toxic than average among hypnotics (both P<0.001). It was shown that the finding for diazepam was… 

Sudden death and benzodiazepines.

Relating these deaths to prescription rates in Victoria suggest that flunitrazepam may be inherently more toxic if misused than other benzodiazepines currently available on the Australian market.

Changes in Fatalities Due to Overdose of Anxiolytic and Sedative Drugs in the UK (1983–1999)

Deaths would be expected to be further reduced if there were reduced prescriptions of high toxicity drugs — and the continuing need for short-acting barbiturates, clomethiazole and chloral hydrate should be questioned.

Alcohol and benzodiazepines in fatal poisonings.

Diazepam and chlordiazepoxide pose a smaller risk of death by poisoning than does temazepam when given as a hypnotic to patients suffering from alcoholism.

Relative toxicity of benzodiazepines in overdose

Evidence is provided that there are differences, both before and after adjustment for a number of potential confounders, between benzodiazepines in the incidence with which they cause major sedation in overdose.

Relative toxicity of benzodiazepines and hypnotics commonly used for self-poisoning: An epidemiological study of fatal toxicity and case fatality

Overdoses of temazepam and zopiclone/zolpidem are considerably more likely to result in death than overdoses of diazepam, and practitioners need to exercise caution when prescribing these drugs, especially for individuals at risk of self-harm.

Benzodiazepine self-poisoning in Pakistan: implications for prevention and harm reduction.

  • M. M. KhanH. Reza
  • Medicine, Psychology
    JPMA. The Journal of the Pakistan Medical Association
  • 1998
The pattern of all index admissions for benzodiazepine self-poisoning to a university hospital in Karachi, Pakistan are described and Diazepam was the preferred drug in 69% of these cases.

Comparison of the Fatal Toxicity Index of Zopiclone with Benzodiazepines

The fatal toxicity for zopiclone was not significantly different from that for benzodiazepines as a group when adjusted for usage, whereas alprazolam and chlormethiazole had greater toxicity.

Use and abuse of the benzodiazepines.

  • A. Fraser
  • Medicine, Psychology
    Therapeutic drug monitoring
  • 1998
Benzodiazepines will continue to have an important role in clinical medicine, however, their clinical use should be monitored more closely because of the greater awareness of their adverse effects after long-term use andBecause of the potential for misuse and abuse.

Fatal toxicity of drugs used in the treatment of psychotic illnesses.

  • N. BuckleyP. Mcmanus
  • Psychology, Medicine
    The British journal of psychiatry : the journal of mental science
  • 1998
In overdose presentations to hospitals low-potency antipsychotics, such as thioridazine and chlorpromazine, have greater cardiotoxicity and sedative effect respectively than more potent antipsychotic drugs when taken in overdose.

The role of benzodiazepines in elderly suicides

Benzodiazepines, especially the hypnotics flunitrazepam and nitrazepams, are common in drug poisoning suicides in the elderly and should be prescribed with caution for this age group.



Changing pattern of drugs used for self-poisoning.

The change in drugs taken has not yet reduced the percentage of unconscious patients needing endotracheal intubation or assisted ventilation, and hypothermia remains as common, but only hypotension has become less frequent as antidepressants replace barbiturates as the main cause of drug-induced coma.

Self-poisoning with barbiturates in England and Wales during 1959-74.

  • M. Johns
  • Medicine
    British medical journal
  • 1977
There is now little to justify prescribing barbiturate hypnotics or sedatives for anyone, because patients for whom these drugs are still being prescribed would, in the event of an overdose, be unlikely to be found and admitted to hospital in time owing to their age and social circumstances.

The Place of Benzodiazepines in Psychiatric Practice

The benzodiazepine era began almost 30 years ago, in style; the drugs were safe in overdose, had greater efficacy than the barbiturates, and had virtually no unwanted effects, apart from sedation when given in excessive dosage.

Fatal toxicity of antidepressant drugs in overdose.

Of these newer drugs, maprotiline had a fatal toxicity index similar to that of the older tricyclic antidepressants, while the other newly introduced drugs had lower toxicity indices, with those for mianserin, nomifensine, trazodone, and viloxazine reaching significance.

Patterns of Benzodiazepine use in Great Britain as Measured by a General Population Survey

In a general population survey by Gallup in Great Britain of 4148 subjects, 7.7% had taken benzodiazepines within the last year, and a substantial proportion of current users had experienced difficulty in stopping their medication.

Coma caused by trivial triazolam overdose.

Fatal Self-poisoning in the UK and the Paracetamol/Dextropropoxyphene Combination

The total number of cases where the paracetamol/dextropropoxyphene combination can be considered as ingested in the self-poisoning episode is underestimated and the number of Cases involving alcohol and/or other drugs taken together with the combination product is particularly underestimated.

Diazepam and drug-associated deaths. A survey in the United States and Canada.

This study describes a population of deceased persons in which death was generally caused by ingestion of numerous drugs, of which diazepam was only one agent. This drug occurred with high frequency

Long-term therapeutic use of benzodiazepines. I. Effects of abrupt discontinuation.

A short half-life and higher daily doses were associated with greater withdrawal severity, as were personality traits, such as dependency and neuroticism, less education and higher baseline levels of anxious and depressive symptoms.

Psychotropic drug-related suicides

It is found that traumatic suicides were more prevalent among the tranquilizer victims and that tranquilizers were combined more often with alcohol and other drugs.