Acute tolerance from benzodiazepine night sedation.
The hypothesis that benzodiazepine night sedation causes acute tolerance to benzodiazepine sedation given the following morning was examined in six volunteers in a double blind, randomised, crossover study. Before each of three study days, subjects received midazolam 15 mg or flunitrazepam 2 mg or placebo as oral night sedation. They were then given intravenous midazolam 5 mg the following morning and the resulting sedative effects examined, using an observers sedation scale and a psychomotor test battery (critical flicker fusion frequency, digit-symbol substitution, reflex time, tapping test and a visual analogue sedation scale). Although a consistent pattern emerged with the greatest degree of sedation following the placebo night sedation and the least degree of sedation following the midazolam, with flunitrazepam intermediate, no statistically significant differences were present between the three treatment groups. The results indicate that single use of benzodiazepine night sedation is not an important influence on benzodiazepine requirements for intravenous sedation.
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Wellington Clinical School of Medicine, Wellington Hospital, New Zealand.
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D000328:Adult; D004311:Double-Blind Method; D004361:Drug Tolerance / Q000502:physiology; D005260:Female; D005445:Flunitrazepam; D006801:Humans; D008297:Male; D008874:Midazolam; D011292:Premedication; D011597:Psychomotor Performance / Q000187:drug effects*; D012894:Sleep Stages / Q000187:drug effects; D013997:Time Factors
D005445:Flunitrazepam; D008874:Midazolam