Obtundation in the elderly patient: presentation of a drug overdose

The case of an obtunded elderly woman is presented. The patient initially was thought to have suffered a cardiovascular accident but was discovered to have taken an overdose of flurazepam hydrochloride. Depression is a common and under-recognized problem in the geriatric population. As a consequence, suicide rates are highest in the elderly. Over- and underdosing of both prescription and nonprescription drugs are common means available to the suicidal elderly patient. These overdoses are often attributed to unintentional patient errors and overlooked for what they are, attempted suicides, or they are missed entirely as a cause of the patient's presentation. This case illustrates the need to consider drug overdose in the obtunded elderly patient.