special subjects
Misuse of Antianxiety Medications and Sedatives
Treatment of Sedative Toxicity
Observation and monitoring until the person is sober Breathing assistance for severe overdose Sometimes a benzodiazepine antidote Detoxification and rehabilitation People who have taken an overdose require immediate medical evaluation. An overdose of barbiturates is as dangerous as an overdose of benzodiazepines. If people who take a dangerous overdose of antianxiety medications or sedatives have significant respiratory, heart, or blood pressure problems, they should be hospitalized in an area where they can be monitored (such as an intensive care unit). Supportive care may include fluids given intravenously, medications if blood pressure drops, and a ventilator if the person's breathing is weak. Benzodiazepines have an antidote,flumazenil, which can reverse a serious overdose. However,flumazenilcan trigger benzodiazepine withdrawal and cause seizures in people who have taken benzodiazepines for a long time. Thus, doctors do not routinely giveflumazenilfor an overdose. In the case of an overdose of barbiturates, doctors can givesodium bicarbonateintravenously to help the person excrete the barbiturate in urine. People with mild withdrawal symptoms require social and psychologic support to help them overcome a strong urge to begin using the drug again to stop the feelings of anxiety. People with severe withdrawal symptoms usually need to be treated in a hospital, sometimes in an intensive care unit, and be closely monitored. They are given low doses of the medication intravenously. The dose is decreased gradually over days or weeks and then stopped. Sometimes another similar medication that is easier to gradually withdraw is substituted. Even with the best treatment, people may not feel normal for a month or more. 