anvuu t1_jegmtti wrote on March 31, 2023 at 9:39 PM

Reply to comment by Youwillgotosleep_ in ELI5: If benzodiazepines are CNS depressants, why is it so hard to die from a overdose of them alone? by psychrolute

Is that why in status seizures - once we hit the midazolam ceiling there's no point giving more and use another drug?

Youwillgotosleep_ t1_jegogd7 wrote on March 31, 2023 at 9:50 PM

I’m not familiar with this particular treatment but drugs are only so effective. Once you hit a particular concentration you are no longer getting meds to the appropriate receptors since they are saturated. Additional medication will just cause side effects since increased concentrations of drugs will just start causing side effects by interacting on other receptors. Using a different medication allows you to get the same action but without the increased drug concentrations.

j_ohnsonson t1_jegr22o wrote on March 31, 2023 at 10:09 PM

I believe that Is tied to the fact that when a status epilepticus goes on for some time, the GABA receptors start being pulled away (in a process called endocytosis) from the synapses. So You Need to rely on drugs that use other mechanisms to get the neurons to stop firing. Happy to be corrected if someone has more up to date or precise info