TY - JOUR T1 - Coma in a patient with Alzheimer's disease taking low dose trazodone and ginkgo biloba JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 679 LP - 680 DO - 10.1136/jnnp.68.5.679a VL - 68 IS - 5 AU - SAMANTHA GALLUZZI AU - ORAZIO ZANETTI AU - GIULIANO BINETTI AU - MARCO TRABUCCHI AU - GIOVANNI B FRISONI Y1 - 2000/05/01 UR - http://jnnp.bmj.com/content/68/5/679.2.abstract N2 - We describe a patient with Alzheimer's disease who developed coma a few days after starting low dose trazodone associated with ginkgo biloba. Coma was reversed by flumazenil, a specific antagonist of the benzodiazepine (BDZ) receptor. The finding is relevant in that, although the sedative effects of trazodone are well known, the drug is inactive on the BDZ receptor. On the other hand, ginkgo is active on the receptor, but sedation has so far never been reported. Pathway from trazodone to coma. In March 1999, an 80 year old woman was first evaluated in our facility and given a diagnosis of probable Alzheimer's disease (NINCDS-ADRDA criteria) of a moderate severity (mini mental state examination of 10/30). She had no physical comorbidity or vascular risk factors. At the time of observation she was taking 3.5 mg bromazepam for mild restlessness, anxiety, and irritability, with only partial benefit (neuropsychiatric inventory: anxiety 4/12, irritability/lability 3/12). … ER -