title: [Benzodiazepines, alcohol and effects on vigilance].
abstract: It is evident, and has been confirmed by epidemiological and experimental data, that ingestion of alcohol can reduce alertness and disturb the concentration of drivers. However, there is still some confusion on this question, since it is impossible to predict what will be the exact level of alcoholemia following ingestion of a given quantity of alcohol, and because disturbances in alertness vary greatly from one individual to another for the same level of alcoholemia . The essential distinction between acute alcoholisation and chronic alcoholisation (due to notions of alcohol tolerance and dependance ) must also be taken into account. Similar difficulties exist in interpreting the relation between ingestion of benzodiazepines and vehicule driving, but they are further complicated by other factors, notably the large number of drugs. Of course, it is possible to show by laboratory experiments, that some benzodiazepines (dipotassium clorazepate, for example) do not disturb the concentration of drivers when given alone, in normal doses and for the recommended indications. But in reality, epidemiological data show that, statistically speaking, drivers taking benzodiazepines have a higher risk of accident than the average drivers. It would appear from this that, for a driver ingesting both alcohol and benzodiazepines, the risk of accident is greatly enhanced. It is also clear that the difficulties in interpreting this risk are multiplied. To summarize very briefly, it appears that there is potentiation when the two substances are ingested together in cases of acute alcoholisation (with an increase in benzodiazepine blood levels), and attenuation in cases of chronic alcoholisation (due to acceleration in clearance provoked by hepatic microsomial induction).
mesh_terms: D000063:Accidents, Traffic; D000435:Alcoholic Intoxication / Q000150:complications*; D000437:Alcoholism / Q000378:metabolism; D014151:Anti-Anxiety Agents / Q000009:adverse effects* / Q000378:metabolism; D001143:Arousal / Q000187:drug effects*; D001569:Benzodiazepines; D003072:Cognition Disorders / Q000139:chemically induced*; D003244:Consciousness Disorders / Q000139:chemically induced*; D004357:Drug Synergism; D005602:France; D006801:Humans; D008099:Liver / Q000378:metabolism
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines
vernacular_title: Benzodiazépines, alcool et effets sur la vigilance.