Respiratory Depression by Midazolam and Diazepam

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Abstract
Ventilatory and mouth occlusion pressure responses to CO2 were measured in 8 healthy human volunteers before and after the i.v. administration of 0.3 mg/kg of diazepam and 0.15 mg/kg of midazolam. The mean ventilatory response to CO2 (mean .+-. standard error of the mean) decreased after administration of diazepam or midazolam from 2.0 .+-. 0.2 to 1.3 .+-. 0.1 l/min torr or from 2.1 .+-. 0.2 to 1.4 .+-. 0.1 l/min torr, respectively. In the same volunteers, the mouth occlusion pressure responses decreased from 0.54 .+-. 0.05 to 0.30 .+-. 0.04 cm H2O/torr after midazolam and from 0.67 .+-. 0.12 to 0.28 .+-. 0.07 cm H2O/torr after diazepam. When compared with the control slopes of the ventilatory and mouth occlusion pressure responses, the drug slopes were significantly different. Respiration was similarly depressed after diazepam and after midazolam. That the ventilatory and mouth occlusion pressure responses to CO2 are equally depressed by i.v. injections of midazolam and of diazepam at equipotent doses suggests a direct depression of the central respiratory drive by these drugs.

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