Response of a promethazine-induced coma to flumazenil.

We report the first case of a patient in a promethazine-induced coma responding to treatment with flumazenil. A literature search conducted to determine the mechanism behind the antagonism of this overdose showed that promethazine interacts with receptors in the central nervous system. Sedative effects may, in fact, be mediated through the benzodiazepine receptor. We concluded that flumazenil can antagonize the sedative effects of promethazine at these receptors to return the patient to a wakeful state.