Physostigmine-atropine solution fails to reverse diazepam sedation

Patients undergoing dental extraction under intravenous diazepam sedation were studied to determine whether physostigmine, a cholinesterase inhibitor, reverses diazepam-induced sedation. A modified Bender-Gestalt Dot Test was used to measure psychomotor function. Patient self-assessment of recovery and a surgeon's independent assessment of recovery were scored on a 0 to 10 measured scale before and after administration of either a physostigmine-atropine mixture (nine patients) or saline (12 patients). The physostigmine-atropine mixture did not significantly speed recovery or improve psychomotor function when compared with normal saline. The results indicate that, in contradiction to previous case report, the analeptic effect of physostigmine may be specific for anticholinergic drugs.