Toxicity in a case of acute and massive overdose of chlordiazepoxide and its correlation to blood concentration.

In previous studies no correlation between blood concentration and toxicity was found in acute chlordiazepoxide overdose. We describe a case of acute overdosage with 5.2 g chlordiazepoxide, in which toxicity correlated to blood concentration of the second metabolite of chlordiazepoxide, to demoxepam. Therefore, it is recommended to determine not only chlordiazepoxide, but also its active metabolites in cases of overdose. This can easily been achieved using the described method, HPLC with photodiode array detection.