There are no controlled human studies to determine the efficacy of
benzodiazepines or
antipsychotic medications for prevention or treatment of acute
cocaine toxicity. The only available controlled data are from animal models and these studies have reported inconsistent benefits. The objective of this study was to quantify the reported efficacy of
benzodiazepines and
antipsychotic medication for the prevention of mortality due to
cocaine poisoning. We conducted a systematic review to identify English language articles describing experiments that compared a
benzodiazepine or
antipsychotic medication to placebo for the prevention of acute
cocaine toxicity in an animal model. We then used these articles in a meta-analysis with a random-effects model to quantify the absolute risk reduction observed in these experiments. We found 10 articles evaluating
antipsychotic medications and 15 articles evaluating
benzodiazepines.
Antipsychotic medications reduced the risk of death by 27% (95% CI, 15.2%-38.7%) compared to placebo and
benzodiazepines reduced the risk of death by 52% (42.8%-60.7%) compared to placebo. Both treatments showed evidence of a dose-response effect, and no experiment found a statistically significant increase in risk of death. We conclude that both
benzodiazepines and
antipsychotic medications are effective for the prevention of lethality from
cocaine toxicity in animal models.