Causes of Mental and Behavioral Disorders Due to the Use of Sedatives and Hypnotics
In large doses, benzodiazepines, barbiturates produce a narcotic effect. They interact with gamma-aminobutyric acid (GABA) receptors. This leads to hyperpolarization of the cell and reduces the threshold of convulsive activity.
Symptoms of Mental and Behavioral Disorders Due to the Use of Sedatives and Hypnotics
Slurred speech, unstable gait, persistent nystagmus, narrowing or expansion of the pupils, respiratory depression.
Somatic and psychopathological consequences are characteristic. Somatic effects include pneumonia, pulmonary edema, renal failure, hypotension, and blisters on the skin. By psychopathological – episodes of excitement, constant drowsiness, tendency to affective reactions.
With the syndrome, anxiety resumes, insomnia, panic reactions occur.
Feeling of anxiety, pain, myoclonic convulsions, ataxia, tinnitus, panic attacks, autonomic hyperactivity, tremor, nausea and vomiting, malaise and weakness, orthostatic hypotension, insomnia, seizures, ataxia.
During the period of withdrawal, the development of hallucinatory, delusional disorders, depersonalization and agoraphobia, depression and dysphoria is possible. Sometimes psychotic disorders occur against the background of diplopia, hypersensitivity to light, sound and touch.
Weakening of memory and impaired ability to concentrate. Retrograde amnesia after convulsive seizures.
Residual state and psychotic disorder with delayed debut
In the long term, episodes of withdrawal syndrome, paranoid and hallucinatory disorders, depression and seizures occur.
Diagnosis of Mental and Behavioral Disorders Due to the Use of Sedatives and Hypnotics
The diagnosis is made on the basis of a clinical description of intoxication, medical history and laboratory identification of drugs in serum.
The cause of intoxication with bartiburates and benzodiazepines may be a suicidal attempt in case of affective disorders, psychosis, or with the combined use of alcohol and these drugs. It should also be differentiated from mental and behavioral disorders when using other psychoactive drugs.
Treatment of Mental and Behavioral Disorders Due to the Use of Sedatives and Hypnotics
Emergency treatment of an overdose consists in the introduction of a specific benzodiazepine antagonist, flumazenil, diuresis is forced and fluid is injected, vomiting is caused, or activated charcoal is taken. Complications in the form of respiratory depression, aspiration and pulmonary edema are prevented. Withdrawal syndrome is treated with detoxification and a gradual reduction in the dose of benzodiazepines.