What is the reversing agent for benzodiazepines?

• A. Flumazenil
• B. Naloxone
• C. Midazolam
• D. Diazepam

Answer: (B)

When benzodiazepines cause oversedation or respiratory depression, the antidote is flumazenil. It acts as a competitive antagonist at the benzodiazepine binding site on the GABA-A receptor, displacing the benzodiazepine and allowing GABA to stimulate the receptor again. This reverses the sedative and breathing-suppressing effects.

Naloxone, in contrast, targets opioid receptors and does not affect the GABA-A benzodiazepine site, so it won’t reverse a benzodiazepine overdose. Midazolam and diazepam are benzodiazepines themselves and would not reverse their effects; they would keep the sedation and respiratory depression ongoing.

Keep in mind flumazenil can precipitate withdrawal or seizures in someone who chronically uses benzodiazepines or has co-ingestants that lower seizure threshold, and its shorter duration means re-sedation can occur, so monitoring is important.