Continuous Intravenous Flumazenil Infusion Used in Iatrogenic Chlordiazepoxide Overdose in the Setting of Alcoholic Withdrawal Syndrome Management

Chlordiazepoxide is a benzodiazepine that is widely used in the treatment of alcohol withdrawal syndrome (AWS). Flumazenil is a competitive antagonist at the benzodiazepine receptor site and is the drug of choice for the treatment of benzodiazepine overdose. Reversal of benzodiazepine overdose is usually achieved by the use of a flumazenil bolus; however, the continuous infusion has been used when concomitant medical conditions may lead to delayed metabolism of the benzodiazepine involved. We present a patient with AWS, with inadvertent chlordiazepoxide overdose treated effectively with a prolonged flumazenil infusion.