A pilot study of subcutaneous flumazenil infusion in the management of benzodiazepine dependence

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Aim: This project will assess the safety, effectiveness and patient acceptability of administering the medication, flumazenil, to treat benzodiazepine dependence by means of subcutaneous (under the skin) infusion rather than by intravenous infusion. Background: Benzodiazepines are a group of sedative drugs which are commonly prescribed for anxiety and insomnia. Examples include “valium”, “serepax”, and “mogadon”. Dependence on this group of drugs can occur rapidly with regular use, and successful withdrawal and treatment is very difficult. Long-term dependence on benzodiazepines, either prescribed or obtained illicitly through diversion, is therefore recognized as a major public health issue. Current treatment for benzodiazepine dependence usually involves a slow reduction in the benzodiazepine dose over weeks, but is frequently unsuccessful because of the withdrawal symptoms of anxiety and agitation that occur, and so patients remain on benzodiazepines long-term. Flumazenil is a medication that has recently been successfully used to treat benzodiazepine dependence by giving it as an intravenous infusion over several days. Unfortunately, using this method of intravenous infusion is complex and resource intensive, and this limits the availability of this form of treatment for many patients. This project is a pilot study to determine whether giving flumazenil by the simpler subcutaneous route would be an effective alternative that could make treatment available to many more patients.

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