Benzodiazepine Toxicity Clinical Presentation

Updated: Jan 03, 2018
  • Author: Chip Gresham, MD, FACEM; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Presentation

History

The history should include the time, dose, any co-ingestants, and whether the overdose was accidental or intentional. It is also important to determine the duration of benzodiazepine (BZD) use.

Symptoms of BZD overdose may include the following:

  • Dizziness

  • Confusion

  • Drowsiness

  • Blurred vision

  • Unresponsiveness

  • Anxiety

  • Agitation

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Physical Examination

Focus the physical examination on the patient's vital signs, cardiorespiratory and neurologic function. "Classic" isolated benzodiazepine (BZD) overdose presents as coma with normal vital signs.

Findings on physical examination may include the following:

  • Nystagmus

  • Hallucinations

  • Slurred speech

  • Ataxia

  • Coma

  • Hypotonia

  • Weakness

  • Altered mental status, impairment of cognition

  • Amnesia

  • Paradoxical agitation

  • Respiratory depression

  • Hypotension

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