Zolpidem Intoxication Mimicking Narcotic Overdose: Response to Flumazenil

@article{Lheureux1990ZolpidemIM,
  title={Zolpidem Intoxication Mimicking Narcotic Overdose: Response to Flumazenil},
  author={Philippe Lheureux and G Debailleul and Olivier De Witte and Robert Askenasi},
  journal={Human \& Experimental Toxicology},
  year={1990},
  volume={9},
  pages={105 - 107}
}
Zolpidem is a recently introduced sleep-inducer which is thought to act on the central-type benzodiazepine receptors. This observation is the first report of drug poisoning with this compound. The toxic response was characterized by the development of a profound but short-lasting coma, associated with pin-point pupils and respiratory depression, as observed in a narcotic overdose. These clinical signs were not influenced by the administration of naloxone, but responded dramatically to… 
Use and misuse of flumazenil in clinical toxicology.
TLDR
Although flumazenil was initially considered as a pure antagonist, high doses have been reported to have intrinsic effects: especially, a slight anticonvulsant activity could be a significant residual BZD-like property of this substance, but is usually not clinically important with usual doses.
Coma with absent brainstem reflexes resulting from zolpidem overdose.
TLDR
A young woman with depression who developed deep coma with respiratory failure and a loss of brainstem reflexes as a result of zolpidem overdose is reported, leading to a complete recovery of neurologic function.
HPLC quantification of zolpidem and prothipendyl in a voluntary intoxication.
TLDR
HPLC with UV detection methods after selective extraction were developed to measure simultaneously prothipendyl and zolpidem without flumazenil interaction, which could be applied in drug monitoring and in emergency toxicology.
Flumazenil—Treatment or Toxin
  • D. Seger
  • Medicine
    Journal of toxicology. Clinical toxicology
  • 2004
Flumazenil is frequently administered to the poisoned patient. Seizures may be precipitated and resedation may occur in patients who awakened following flumazenil administration. Seizures may
Benzodiazepine Antagonists
TLDR
Because of its high therapeutic index, the administration of flumazenil is usually not accompanied by serious adverse effects and its effectiveness in cases of alcohol (ethanol) poisoning is questionable and should be further investigated.
Efficacy of Flumazenil in Acute Alcohol Intoxication: Double Blind Placebo-Controlled Evaluation
TLDR
Flumazenil, administered at a dose usually active against BZD sedation, does not improve CNS depression induced by ALC intoxication and could be more effective in some patients, but it should also be verified in a placebo-controlled trial.
Zaleplon-Induced Coma and Bluish Green Urine: Possible Antidotal Effect by Flumazenil
TLDR
Two cases of zaleplon overdose with coma and bluish-green urine discoloration are reported, and flumazenil had a clear antidotal effect on the CNS depression.
Delayed-Onset Hepatic Encephalopathy Induced by Zolpidem: A Case Report
TLDR
A patient with CLD is reported with a rapidly induced grade IV HE attributed to zolpidem that was promptly reversed by flumazenil, making it a reasonable choice for subjects withCLD.
Acute zolpidem poisoning--analysis of 344 cases.
TLDR
Zolpidem acute overdose is generally benign and requires no specific therapeutic measures, and symptoms of intoxication rapidly remitted in 91% of cases.
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