Diazepam Overdose

March 19, 2012 by fortox in Toxins with 0 Comments

Diazepam, also known as Valium or Valrelease, is a benzodiazepine and is known on the streets as “V”. Diazepam can be used to treat anxiety, seizures, insomnia, restless leg syndrome, alcohol withdrawal, Ménière’s disease and benzodiazepine withdrawal. It’s properties include the following;

  • Anticonvulsant
  • Hypnotic
  • Sedative
  • Anxiolytic
  • Amnestic
  • Skeletal muscle relaxant


Symptoms of an overdose of diazepam can include the following;

  • Confusion
  • Drowsiness
  • Impaired coordination
  • Impaired reflexes
  • Dizziness
  • Hypotension
  • Impaired balance
  • Impaired motor functions
  • Nausea
  • Depression
  • Blurred vision
  • Bluish coloured lips and fingernails
  • Hiccups
  • Excitability
  • Rash
  • Weakness
  • Coma
  • Death


These symptoms can be displayed over an approximate period of four hours after taking the drug. Overdoses of diazepam with alcohol, opiates or other depressants may be fatal and the antidote for an overdose is flumazenil (Anexate). Flumazenil is only given when severe respiratory depression or cardiovascular complications arise. Sudden withdrawal from diazepam can lead to anxiety, seizures and death. Tolerance of the drug can develop and should be considered by a forensic toxicologist when interpreting drug concentrations. Diazepam is metabolised by CYP 2C19 and 3A and its active metabolite is nordiazepam.



Biological samples which can be taken by the forensic toxicologist for detection of diazepam can include the following;

  • Urine
  • Blood
  • Liver
  • Bile
  • Skeletal muscle


Lethal levels which can be detected within these biological samples by the forensic toxicologist are outlined in the table below;


Source Lethal Level
Urine 3mg/L
Blood 5-30mg/L
Liver 16mg/kg
Bile 0.8mg/L
Skeletal muscle 16mg/kg


(Adapted from Molina 2010:89)




Molina, D.K. (2010) Handbook of Forensic Toxicology for Medical Examiners. CRC Press : Boca Raton





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