Antidote

CCP: Benzodiazepine overdose

• Hypersensitivity
• Benzodiazepine reversal in patients requiring benzodiazepines for control of life-threatening conditions.
• Patients who may have ingested or showing signs of cyclic-antidepressant overdose.

Onset: 1-2 minutes

Peak effect: 6-10 minutes

Duration: 19-50 minutes

Half-life: 54 minutes

Gastrointestinal

• Vomiting
• Xerostomia, nausea

Cardiovascular

• Palpitation, flushing, thrombophlebitis, vasodilation
• Atrial tachycardia (paroxysmal), bradycardia, tachycardia, cardiac arrhythmia, chest pain
• Decreased blood pressure, increased blood pressure, ventricular tachycardia

Central nervous system

• Ataxia, dizziness, vertigo, agitation, anxiety, insomnia, nervousness, depersonalization, depression, dysphoria, emotional lability, euphoria, fatigue, headache, hypoesthesia, malaise, paranoia, paresthesia
• Weakness, tremor, confusion, delirium, fear, panic attack, seizures

Dermatologic

• Dermatological disease, diaphoresis, skin rash

Endocrine & metabolic

• Hot flash

Local

• Pain at injection site, injection site reaction

Ophthalmic

• Blurred vision, lacrimation, visual disturbance

Respiratory

• Dyspnea, hyperventilation

Auditory

• Reversible hearing loss, tinnitus

• Does not consistently reverse amnesia.
• May impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness.
• Resedation may occur more frequently in patients where a large single dose or cumulative dose of a benzodiazepine has been administered along with a neuromuscular-blocking agent and multiple anesthetic agents.
• Should not be relied upon to reverse respiratory depression/hypoventilation.
• Benzodiazepine reversal may result in seizures. Seizures may occur more frequently in patients on benzodiazepines for long-term sedation or following tricyclic antidepressant overdose.
• May alter cerebral blood flow or precipitate convulsions in patients receiving benzodiazepines.
• Use with caution in patients with hepatic dysfunction.
• Use with caution in patients with mixed drug overdoses; toxic effects of other drugs taken may emerge once benzodiazepine effects are reversed.

• Amitriptyline
• Clomipramine
• Desipramine
• Doxepin
• Nortriptyline
• Protriptyline
• Trimipramine