Most patients with pure benzodiazepine overdose will usually only exhibit these mild CNS symptoms. Clonazepam works by increasing the effects of a brain chemical known as gamma-amino-aminobutyric acid GABA , which helps create a feeling of calmness. According to the FDA, when benzodiazepines are taken in combination with opioid medications or alcohol, adverse reactions may include 4: Ingestion of relatively small amounts of commonly used perfumes, cosmetics, cleaning solutions, alcoholic beverages, and other products may cause serious injury or death. There is an antidote, flumazenil , but its use is controversial. Treatment may include addiction recovery therapies that can also help people learn how to manage their anxiety without medication.
Drug works: Clonazepam overdose in children
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As a person builds a tolerance to Klonopin, he or she may need to take increasingly higher doses to feel the desired effects of the drug. This behavior increases the chance that a person will overdose. Most people can be discharged between hours if symptoms have resolved. Klonopin overdose treatment includes: Monitoring of respiration, pulse, and blood pressure. Gastric lavage stomach pumping.
Flumazenil is a drug that can reverse the effects of a Klonopin overdose. However, it comes with its own risks, including seizures in people who are dependent on the drug. The medical professional treating you will have to decide whether to use it. Most people can be discharged or transferred for psychiatric assessment after 4 to 6 hours if symptoms have resolved and the person's coordination has improved. Get help before an overdose occurs.
Overdosing on Klonopin is rarely lethal. If the person overdoses on Klonopin alone, they will likely experience the effects outlined above and require medical treatment and monitoring. Most deaths from overdose on Klonopin and other benzodiazepines are the result of taking the medication with alcohol or other drugs that depress the central nervous system. This combination can lead to fatal suppression of breathing. A person who overdoses on Klonopin should talk to his or her physician about whether to continue taking the medication.
In addition, many people who abuse Klonopin may be abusing other drugs and should seek help from a substance abuse program. Outpatient rehab programs allow you to live at home while receiving treatment at a rehab facility. Most programs consist of individual and group therapy, but some may include medical supervision and detox. Inpatient or residential programs help people uncover the reasons behind their addiction and avoid relapse.
People recovering from Klonopin abuse or dependence may participate in individual and group therapy sessions, step meetings, art or music therapy, addiction education sessions, and recreational activities. These are self-help programs in which people with similar addictions support each other in recovery. Twelve-step programs offer a more spiritual approach, while nonstep programs are more secular and evidence-based. The relatively lipophilic BZDs eg, diazepam usually have a faster onset of effect than the relatively water-soluble BZDs eg, lorazepam.
BZD effects can be potentiated when ethanol is present as a coingestant. Peak blood concentrations of most agents occur within hours. After a single dose, the lipophilic agents can have a shorter duration of action shorter CNS effect than water-soluble agents because rapid redistribution from the CNS to peripheral sites eg, adipose tissue ; thus, lorazepam has a longer CNS duration of action than diazepam.
However, diazepam metabolizes to active intermediates with prolonged half-lives, which extend its therapeutic effects. Most BZDs are broken down into pharmacologically active metabolites, which may have longer half-lives than the parent compounds. However, no short-term increases were noted between and Records did not always specify the BZD involved, but alprazolam was indicated in about a third of these ED visits, and in approximately a third of BZD-related suicide attempts [ 3 ].
DAWN was discontinued in ED data from the new data collection system are expected in Of these, 1. Although BZDs taken alone are relatively safe in overdose, the combination of BZDs and opioid analgesics can produce significant respiratory depression. In particular, the combination of alprazolam with opioids may be fatal. Deaths attributed to BZDs increased fivefold from to During to , death rates from alprazolam increased Similarly, an Australian study reported that alprazolam-positive cases of sudden or unnatural death increased from three cases in to 86 cases in The increase was driven mostly by accidental toxicity in people with known drug and alcohol problems.
Drugs other than alprazolam and its metabolites were present in The most commonly detected drugs, in order of decreasing frequency, were opioids, other BZDs, and alcohol. The most reported BZD use is in persons older than 19 years. Elderly individuals and very young persons are more susceptible to the CNS depressant effects of BZDs than people in other age groups. Oral benzodiazepine BZD overdoses, without co-ingestions, rarely result in significant morbidity eg, aspiration pneumonia, rhabdomyolysis or mortality, although in mixed overdoses they can potentiate the effect of alcohol or other sedative-hypnotics.
Overdose of ultrashort-acting BZDs eg, triazolam [Halcion] is also more likely to result in apnea and death than overdose with longer-acting BZDs. Of individual BZDs, alprazolam is relatively more toxic than others in overdose. Antidotes for toxicological emergencies: Am J Health Syst Pharm. Drug Abuse Warning Network, April 4, ; Accessed: Characteristics of alprazolam-related deaths compiled by a centralized state medical examiner.
Circumstances and toxicology of sudden or unnatural deaths involving alprazolam. Alprazolam is relatively more toxic than other benzodiazepines in overdose. Br J Clin Pharmacol. Treatment of patients with substance use disorders, second edition. Basic Clin Pharmacol Toxicol. Treatment of benzodiazepine overdose with flumazenil. J Toxicol Clin Toxicol. Michael J Burns, MD is a member of the following medical societies: David C Lee, MD is a member of the following medical societies: