Flunitrazepam

Flunitrazepam, commonly known by its brand name Rohypnol among others, is a potent benzodiazepine used in the treatment of severe insomnia and for inducing anesthesia. Due to its strong sedative, hypnotic, and amnesic properties, it has gained notoriety as a drug of abuse and has been implicated in numerous instances of drug-facilitated sexual assault. Its use is highly regulated, and it is not available legally in some countries, including the United States.

Medical Uses

Flunitrazepam is primarily prescribed for the short-term treatment of severe insomnia, particularly where sleep disturbances or difficulty in falling asleep cause significant distress. It is also used as a premedication for inducing sedation and amnesia before surgical or diagnostic procedures.

Pharmacology

As a benzodiazepine, flunitrazepam acts on the GABA_A receptor in the brain, enhancing the effect of the neurotransmitter GABA (gamma-aminobutyric acid). This action results in the sedative, hypnotic, anxiolytic, and muscle relaxant properties of the drug. Flunitrazepam is known for its rapid onset and relatively long half-life compared to other benzodiazepines.

Side Effects

The side effects of flunitrazepam include drowsiness, decreased motor coordination, dizziness, and confusion. It can also cause anterograde amnesia, particularly at higher doses, which has contributed to its involvement in cases of sexual assault. Long-term use can lead to dependence and withdrawal symptoms upon cessation.

Legal Status and Abuse

Flunitrazepam is a Schedule III drug under the Convention on Psychotropic Substances and is tightly controlled in countries where it is legal. Its potential for abuse and involvement in drug-facilitated crimes has led to increased regulatory measures, including the requirement for manufacturers to include dye in the tablets to make them more noticeable in liquids.

Detection in Biological Fluids

Flunitrazepam and its metabolites can be detected in blood and urine, which is crucial for the investigation of suspected drug-facilitated sexual assault cases. However, the drug has a relatively short detection window, making timely testing important.

Treatment of Overdose

Overdose of flunitrazepam is treated with supportive care and, if necessary, the administration of flumazenil, a benzodiazepine receptor antagonist. However, flumazenil should be used with caution due to the risk of precipitating withdrawal or seizures in individuals dependent on benzodiazepines.

See Also

• Benzodiazepine
• GABA_A receptor
• Drug-facilitated sexual assault
• Flumazenil