Sedative-Hypnotic Drug Withdrawal Syndrome: Recognition and Treatment

• Sedative-hypnotic agents are the second most frequent drug class to cause an emergency department (ED) visit. This category includes benzodiazepines, barbiturates, baclofen, GHB (gamma-hydroxybutyric acid) and GBL (gamma-butyrolactone).
• Cessation of sedative-hypnotic agents leads to decreased GABA-mediated inhibitory tone and increased NMDA-mediated excitatory tone. This results in autonomic stimulation (tachycardia, hypertension, hyperthermia, diaphoresis), tremors, hallucinations, and seizures.

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