A 24-year-old woman is brought to the emergency department with confusion, blurred vision, dizziness, and somnolence. Her friend states that the woman is generally healthy but is taking medication for occasional episodes of intense fear, sweating, nausea, and abdominal and chest pain. Physical examination reveals a respiratory rate of 8/min.
What is the most likely diagnosis?
Benzodiazepine toxicity, as characterized by respiratory depression, confusion, and other symptoms of central nervous system depression.
What class of drugs might be responsible for this patient’s symptoms?
Her friend’s description is consistent with a diagnosis of panic disorder. Benzodiazepines (such as
clonazepam, lorazepam, and alprazolam) are commonly used in the short-term treatment of panic disorder.
What treatment was likely administered to this patient in the emergency department?
Flumazenil, a competitive antagonist at the γ-aminobutyric acid (GABA) receptor, is effective in reversing symptoms of benzodiazepine overdose.
