Benzodiazepine Toxicity Clinical Presentation

Updated: Jan 23, 2020
  • Author: Chip Gresham, MD, FACEM; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Presentation

History

Information to elicit when taking the history in cases of possible benzodiazepine (BZD) overdose includes the following:

  • Time of ingestion
  • Dose
  • Co-ingestants, if any
  • Whether the overdose was accidental or intentional
  • In patients prescribed BZDs, the duration of 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 and cardiorespiratory and neurologic function. "Classic" isolated benzodiazepine 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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