What can be used to reverse the effects of an overdose of alprazolam?

Flumazenil is a specific benzodiazepine antagonist that works by competing for the same binding sites on the GABA-A receptor where benzodiazepines, such as alprazolam, act. In cases of benzodiazepine overdose, flumazenil can rapidly reverse the sedative effects of the drug, restoring normal respiratory function and level of consciousness. Its action is particularly important in emergency medicine, as it can help mitigate the potentially life-threatening effects of an overdose.

While other medications may have some relevance in pharmacology, they do not have the same direct effect on benzodiazepines. Diazepam, for example, is another benzodiazepine and would not be used to reverse an overdose; rather, it would reinforce the effects of alprazolam. Ramelteon works as a melatonin receptor agonist and is not indicated for benzodiazepine reversal. Naloxone is an opioid antagonist and is used specifically for reversing opioid overdoses, not benzodiazepines. Therefore, flumazenil is the most appropriate choice for reversing an overdose of alprazolam.