A Two-year Retrospective Observational Cohort Study of Benzodiazepine Overdose Cases in the Emergency Department.

Abstract

Background: Deliberate self-harm (DSH) is a significant health concern in developing countries, associated with high morbidity and mortality. Several factors influence patient outcomes. This study aimed to better understand the profile and outcomes of patients with benzodiazepine (BZD) overdose.

Materials and methods: This two-year analysis conducted in the Emergency Department (ED) focused on patients with DSH and BZD toxicity. Key factors and outcomes were recorded and analyzed.

Results: The study included 95 patients with BZD overdoses, some of whom had also taken other drugs. The mean age was 36.52 (SD: 14.2) years, with a female predominance (59.9%). The most common reasons for DSH were interpersonal issues, such as relationship failure (n = 48; 50.5%) and domestic fights or abuse (n = 37; 38.9%). Single-drug BZD overdose was more frequent among individuals aged 46-60 years. The predominant symptoms were drowsiness (n = 45; 47.4%) and nausea or vomiting (n = 32; 33.7%). Six patients (6.3%) required definitive airway stabilization in the ED, while two patients (2.1%) required inotropic support. Flumazenil was administered to 19 (20%) patients with no reported side effects. A majority (n = 49; 51.6%) of patients were admitted to the hospital, of whom 30 (61.2%) were discharged in stable condition, while 19 (38.8%) left against medical advice. No deaths were reported.

Conclusion: Middle-aged females were most frequently involved in DSH cases. Single-drug BZD overdose was more common in this age-group. The predominant symptoms included drowsiness and gastrointestinal complaints. Most patients required hospital admission.

How to cite this article: Giftson J, Hazra D, Chandy GM. A Two-year Retrospective Observational Cohort Study of Benzodiazepine Overdose Cases in the Emergency Department. Indian J Crit Care Med 2025;29(3):230-235.