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Flumazenil's short half-life requires multiple doses. Because of the potential risks of withdrawal symptoms and the drug's short half-life, patients must be carefully monitored to prevent recurrence of overdose symptoms or adverse side effects. Flumazenil is also sometimes used after surgery to reverse the sedative effects of benzodiazepines.
A study into the effects of the benzodiazepine receptor antagonist, flumazenil, on benzodiazepine withdrawal symptoms persisting after withdrawal was carried out by Lader and Morton. Study subjects had been benzodiazepine-free for between one month and five years, but all reported persisting withdrawal effects to varying degrees.
Post-acute withdrawal syndrome (PAWS) is a hypothesized set of persistent impairments that occur after withdrawal from alcohol, [1] [2] opiates, benzodiazepines, barbiturates, and other substances. [ 3 ] [ 4 ] [ 5 ] Infants born to mothers who used substances of dependence during pregnancy may also experience a PAWS.
Flumazenil is a benzodiazepine receptor antagonist that can reverse the effects of benzodiazepines, although its use following benzodiazepine overdose is controversial. Medical observation and supportive care are the mainstay of treatment of benzodiazepine overdose. [16]
Flumazenil is an imidazobenzodiazepine that can help mediate and antagonize the effects of benzodiazepines. It can be used in anaesthesia as well as intensive care. [6] Flumazenil raises concerns with its tendency to induce benzodiazepine withdrawal, and symptoms include seizures and agitation.
Long-acting benzodiazepines with long-acting active metabolites, such as diazepam and chlordiazepoxide, are often prescribed for benzodiazepine or alcohol withdrawal as well as for anxiety if constant dose levels are required throughout the day. Shorter-acting benzodiazepines are often preferred for insomnia due to their lesser hangover effect.
Long-term use of benzodiazepines can induce perceptual disturbances and depersonalization in some people, even in those taking a stable daily dosage, and it can also become a protracted withdrawal feature of the benzodiazepine withdrawal syndrome. [54] In addition, chronic use of benzodiazepines is a risk factor for blepharospasm. [55]
Non-medical benzodiazepine use is mostly limited to individuals who use other substances, i.e., people who engage in polysubstance use. [223] On the international scene, benzodiazepines are categorized as Schedule IV controlled drugs by the INCB , apart from flunitrazepam , which is a Schedule III drug under the Convention on Psychotropic ...