The differential diagnosis should include intoxication by other substances with sedative effects, such as benzodiazepines, anticonvulsants (carbamazepine), alcohols (ethanol, ethylene glycol, methanol), opioids, carbon monoxide, sleep aids, and gamma-Hydroxybutyric acid (GHB – a known date rape drug). Natural disease that can result in disorientation may be in the differential, including hypoglycemia and myxedema coma. In the right setting, hypothermia should be ruled out.
Barbiturate overdose
Salicylate poisoning
Carbamate poisoning
Chlorine gas poisoning
Ethylene glycol poisoning
Nicotine poisoning
Cyanide poisoning
Organophosphate poisoning