How Can You Reverse the Action of Sedatives?

The most common use of oral sedation in adults is for the reduction of anxiety preceding and during the dental appointment. For some, the use of oral sedation the night before their dental appointment can ensure a more restful sleep leading to a more pleasant and relaxed patient for the dental procedure.

 According to Anethesia Progress, a Journal for Pain and Anxiety Control in Dentistry, the most common non-prescription drugs used for sedation are; Diphenhydramine (Benadryl), Hydroxyzine (Atarax, Vistaril), and Promethazine (Phenergan), the most common benzodiazepines prescription drugs are; Triazolam  (Halcion), Lorazepam (Ativan) and Diazepam (Valium) while the most common nonbenzodiazepines drugs are Eszopiclone (Lunesta), Ramelteon (Rozerem) Zolpidem (Ambien) and Zaleplon (Sonata).

Massachusetts General Hospital, located in Boston, Massachusetts; stated that it was initially thought to be virtually free of negative effects, benzodiazepines are now known to carry risks of dependence, withdrawal, and negative side effects.

Flumazenil is an intravenous drug that is beneficial to patients who become excessively drowsy after taking benzodiazepines, which are used for either diagnostic or therapeutic procedures.  As benzodiazepines are one of the most highly prescribed class of drugs, they are commonly used in self-poisoning by drug overdose. Flumazenil is structurally related to benzodiazepines, but acts as an antagonist to reverse the sedative effects of these agents, states SGNA, the Society of Gastroenterology of Nurses and Associates, Inc.

Flumazenil can be used to reverse the action of all of the following sedatives EXCEPT:

• Triazolam
• Diazepam
• Zolpidem
• Hydroxyzine

Substitution of diazepam for another benzodiazepine can be helpful, at least logistically, as diazepam is available in a liquid formulation, according to the Institute of Psychiatry, King's College London, London, England.  They do, however, state that care must be taken not to substitute one drug dependence problem for the original one.

I believe the answer to the above question is hydroxyzine, however, I can't find the answer anywhere.  Maybe someone else knows the answer.  Hydroxyzine is just an antihistamine with sedative side effects, so that's my thought.

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