Prevalence of Patients Admitted to Intensive Care After Administration of Chlordiazepoxide in the Emergency Room

Jakob Nørgaard Henriksen; Sara Buttrup Rosenquist; Dorte Goldbækdal Illum; Charlotte Uggerhøj Andersen

doi:10.1111/bcpt.70018

Prevalence of Patients Admitted to Intensive Care After Administration of Chlordiazepoxide in the Emergency Room

Jakob Nørgaard Henriksen, Sara Buttrup Rosenquist, Dorte Goldbækdal Illum, Charlotte Uggerhøj Andersen

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

1 Citation (Scopus)

Abstract

Chlordiazepoxide is effective in treating alcohol withdrawal syndrome, but it poses a risk of long-term sedation. The prevalence of this side effect and its risk factors remain uncertain. This retrospective cross-sectional study aimed to estimate both using data from Aarhus University Hospital's BI portal. We identified and manually reviewed patient records from 1 September 2019 to 31 August 2021, including the treating physicians' conclusions on ICU admissions to determine whether they were likely due to chlordiazepoxide toxicity. Chlordiazepoxide was administered to 1363 unique patients in the study period. We identified 32 ICU admissions preceded by chlordiazepoxide administration, 5 of which (16%) were likely related to chlordiazepoxide toxicity. Patients with chlordiazepoxide-induced admissions received higher cumulative doses compared to other admissions (425 mg vs. 150 mg, p = 0.01), had longer ICU stays (median 8 vs. 2 days, p = 0.01) and required higher doses of flumazenil (p = 0.04). Their median age was above 60 years, and not all had known liver disease. The overall incidence of long-term chlordiazepoxide toxicity was approximately 0.35%, with risk factors including higher doses and age above 60. Our findings suggest increased caution when treating not only patients with liver disease but also elderly patients with chlordiazepoxide for alcohol withdrawal symptoms.

Original language	English
Article number	e70018
Journal	Basic & Clinical Pharmacology & Toxicology
Volume	136
Issue	4
Pages (from-to)	e70018
ISSN	1742-7843
DOIs	https://doi.org/10.1111/bcpt.70018
Publication status	Published - Apr 2025

Keywords

Adult
Aged
Aged, 80 and over
Chlordiazepoxide/administration & dosage
Critical Care/methods
Cross-Sectional Studies
Emergency Service, Hospital/statistics & numerical data
Female
Flumazenil/therapeutic use
Humans
Hypnotics and Sedatives/adverse effects
Intensive Care Units/statistics & numerical data
Length of Stay
Male
Middle Aged
Patient Admission/statistics & numerical data
Prevalence
Retrospective Studies
Risk Factors
Substance Withdrawal Syndrome/epidemiology
chlordiazepoxide
alcoholism
poisoning
abstinence
liver cirrhosis

Access to Document

10.1111/bcpt.70018

OpenUrl availability

Full text

Cite this

@article{b1482a8a27624cfb9bd374cb3946e8a3,

title = "Prevalence of Patients Admitted to Intensive Care After Administration of Chlordiazepoxide in the Emergency Room",

abstract = "Chlordiazepoxide is effective in treating alcohol withdrawal syndrome, but it poses a risk of long-term sedation. The prevalence of this side effect and its risk factors remain uncertain. This retrospective cross-sectional study aimed to estimate both using data from Aarhus University Hospital's BI portal. We identified and manually reviewed patient records from 1 September 2019 to 31 August 2021, including the treating physicians' conclusions on ICU admissions to determine whether they were likely due to chlordiazepoxide toxicity. Chlordiazepoxide was administered to 1363 unique patients in the study period. We identified 32 ICU admissions preceded by chlordiazepoxide administration, 5 of which (16%) were likely related to chlordiazepoxide toxicity. Patients with chlordiazepoxide-induced admissions received higher cumulative doses compared to other admissions (425 mg vs. 150 mg, p = 0.01), had longer ICU stays (median 8 vs. 2 days, p = 0.01) and required higher doses of flumazenil (p = 0.04). Their median age was above 60 years, and not all had known liver disease. The overall incidence of long-term chlordiazepoxide toxicity was approximately 0.35%, with risk factors including higher doses and age above 60. Our findings suggest increased caution when treating not only patients with liver disease but also elderly patients with chlordiazepoxide for alcohol withdrawal symptoms.",

keywords = "Adult, Aged, Aged, 80 and over, Chlordiazepoxide/administration & dosage, Critical Care/methods, Cross-Sectional Studies, Emergency Service, Hospital/statistics & numerical data, Female, Flumazenil/therapeutic use, Humans, Hypnotics and Sedatives/adverse effects, Intensive Care Units/statistics & numerical data, Length of Stay, Male, Middle Aged, Patient Admission/statistics & numerical data, Prevalence, Retrospective Studies, Risk Factors, Substance Withdrawal Syndrome/epidemiology, chlordiazepoxide, alcoholism, poisoning, abstinence, liver cirrhosis",

author = "Henriksen, {Jakob N{\o}rgaard} and Rosenquist, {Sara Buttrup} and Illum, {Dorte Goldb{\ae}kdal} and Andersen, {Charlotte Uggerh{\o}j}",

note = "{\textcopyright} 2025 The Author(s). Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).",

year = "2025",

month = apr,

doi = "10.1111/bcpt.70018",

language = "English",

volume = "136",

pages = "e70018",

journal = "Basic & Clinical Pharmacology & Toxicology",

issn = "1742-7843",

publisher = "Wiley-Blackwell Publishing Ltd.",

number = "4",

}

Prevalence of Patients Admitted to Intensive Care After Administration of Chlordiazepoxide in the Emergency Room. / Henriksen, Jakob Nørgaard ; Rosenquist, Sara Buttrup; Illum, Dorte Goldbækdal et al.
In: Basic & Clinical Pharmacology & Toxicology, Vol. 136, No. 4, e70018, 04.2025, p. e70018.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Prevalence of Patients Admitted to Intensive Care After Administration of Chlordiazepoxide in the Emergency Room

AU - Henriksen, Jakob Nørgaard

AU - Rosenquist, Sara Buttrup

AU - Illum, Dorte Goldbækdal

AU - Andersen, Charlotte Uggerhøj

N1 - © 2025 The Author(s). Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

PY - 2025/4

Y1 - 2025/4

N2 - Chlordiazepoxide is effective in treating alcohol withdrawal syndrome, but it poses a risk of long-term sedation. The prevalence of this side effect and its risk factors remain uncertain. This retrospective cross-sectional study aimed to estimate both using data from Aarhus University Hospital's BI portal. We identified and manually reviewed patient records from 1 September 2019 to 31 August 2021, including the treating physicians' conclusions on ICU admissions to determine whether they were likely due to chlordiazepoxide toxicity. Chlordiazepoxide was administered to 1363 unique patients in the study period. We identified 32 ICU admissions preceded by chlordiazepoxide administration, 5 of which (16%) were likely related to chlordiazepoxide toxicity. Patients with chlordiazepoxide-induced admissions received higher cumulative doses compared to other admissions (425 mg vs. 150 mg, p = 0.01), had longer ICU stays (median 8 vs. 2 days, p = 0.01) and required higher doses of flumazenil (p = 0.04). Their median age was above 60 years, and not all had known liver disease. The overall incidence of long-term chlordiazepoxide toxicity was approximately 0.35%, with risk factors including higher doses and age above 60. Our findings suggest increased caution when treating not only patients with liver disease but also elderly patients with chlordiazepoxide for alcohol withdrawal symptoms.

AB - Chlordiazepoxide is effective in treating alcohol withdrawal syndrome, but it poses a risk of long-term sedation. The prevalence of this side effect and its risk factors remain uncertain. This retrospective cross-sectional study aimed to estimate both using data from Aarhus University Hospital's BI portal. We identified and manually reviewed patient records from 1 September 2019 to 31 August 2021, including the treating physicians' conclusions on ICU admissions to determine whether they were likely due to chlordiazepoxide toxicity. Chlordiazepoxide was administered to 1363 unique patients in the study period. We identified 32 ICU admissions preceded by chlordiazepoxide administration, 5 of which (16%) were likely related to chlordiazepoxide toxicity. Patients with chlordiazepoxide-induced admissions received higher cumulative doses compared to other admissions (425 mg vs. 150 mg, p = 0.01), had longer ICU stays (median 8 vs. 2 days, p = 0.01) and required higher doses of flumazenil (p = 0.04). Their median age was above 60 years, and not all had known liver disease. The overall incidence of long-term chlordiazepoxide toxicity was approximately 0.35%, with risk factors including higher doses and age above 60. Our findings suggest increased caution when treating not only patients with liver disease but also elderly patients with chlordiazepoxide for alcohol withdrawal symptoms.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Chlordiazepoxide/administration & dosage

KW - Critical Care/methods

KW - Cross-Sectional Studies

KW - Emergency Service, Hospital/statistics & numerical data

KW - Female

KW - Flumazenil/therapeutic use

KW - Humans

KW - Hypnotics and Sedatives/adverse effects

KW - Intensive Care Units/statistics & numerical data

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Patient Admission/statistics & numerical data

KW - Prevalence

KW - Retrospective Studies

KW - Risk Factors

KW - Substance Withdrawal Syndrome/epidemiology

KW - chlordiazepoxide

KW - alcoholism

KW - poisoning

KW - abstinence

KW - liver cirrhosis

UR - http://www.scopus.com/inward/record.url?scp=105000109958&partnerID=8YFLogxK

U2 - 10.1111/bcpt.70018

DO - 10.1111/bcpt.70018

M3 - Journal article

C2 - 40070362

SN - 1742-7843

VL - 136

SP - e70018

JO - Basic & Clinical Pharmacology & Toxicology

JF - Basic & Clinical Pharmacology & Toxicology

IS - 4

M1 - e70018

ER -

Prevalence of Patients Admitted to Intensive Care After Administration of Chlordiazepoxide in the Emergency Room

Abstract

Keywords

Access to Document

OpenUrl availability

Other files and links

Fingerprint

Cite this