For overdoses of benzodiazepines, which medication is the antidote?

Flumazenil is the specific antidote used for benzodiazepine overdoses. It works as a competitive antagonist at the benzodiazepine binding site of the GABA-A receptor, effectively reversing the central nervous system effects of benzodiazepines, such as sedation and respiratory depression. By binding to the same receptor without activating it, flumazenil can rapidly restore consciousness and improve respiratory function in patients who have overdosed on benzodiazepines.

Using flumazenil is particularly beneficial in cases where the patient is experiencing significant sedation or respiratory compromise due to benzodiazepine toxicity. However, it must be used cautiously, especially in patients who are dependent on benzodiazepines or those who have mixed overdoses, as it can precipitate seizures or withdrawal symptoms.

Other options listed do not specifically reverse the effects of benzodiazepines. For instance, N-acetylcysteine is the antidote for acetaminophen overdose, naloxone is used to reverse opioid overdose, and hydroxocobalamin is a treatment for cyanide poisoning. Hence, flumazenil stands out as the appropriate antidote for benzodiazepine overdoses.