The diagnostic utility of flumazenil (a benzodiazepine antagonist) in coma of unknown etiology.

The use of flumazenil, a benzodiazepine antagonist, was studied in two patients with coma of unknown etiology. One patient ingested 20.5 mg alprazolam before crashing his truck into parked automobiles. The patient was awakened by flumazenil administration, and the severity of his injuries was evaluated reliably. A second patient ingested 7.5 mg triazolam and attempted suicide with carbon monoxide from car exhaust. His coma resolved completely after the administration of the double-blind study drug, obviating treatment with hyperbaric oxygen. Flumazenil had a clear diagnostic and therapeutic role in the treatment of these patients and should be a useful tool for emergency physicians and toxicologists.