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is a medicine of the benzodiazepine family that acts as an anxiolytic.
It is commonly used to treat a range of conditions, including anxiety,
seizures, alcohol withdrawal syndrome, benzodiazepine
withdrawal syndrome, muscle spasms, insomnia, and restless legs syndrome.
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When given into a vein, effects begin in one to five minutes and last up to an hour.
By mouth, effects begin after 15 to 60 minutes.
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Common side effects include sleepiness and trouble with coordination.
Serious side effects are rare. They include suicide, decreased breathing,
and an increased risk of seizures if used too frequently in those with epilepsy.
Occasionally, excitement or agitation may occur.
Long term use can result in tolerance, dependence,
and withdrawal symptoms on dose reduction.
Abrupt stopping after long-term use can be potentially dangerous.
After stopping, cognitive problems may persist for six months or longer.
It is not recommended during pregnancy or breastfeeding.
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Its mechanism of action is by increasing the effect of the
neurotransmitter gamma-aminobutyric acid (GABA).
In the United States it was the highest selling medication between
1968 and 1982, selling more than 2 billion tablets in 1978 alone.
In 2018, it was the 115th most commonly prescribed
medication in the United States, with more than 6 million prescriptions.
In 1985 the patent ended, and there are more than 500 brands available on the market.
It is on the World Health Organization’s List of Essential Medicines.
Diazepam is the drug of choice for treating benzodiazepine
dependence with its long half-life allowing easier dose reduction.
Benzodiazepines have a relatively low toxicity in overdose.
Diazepam has a number of uses including:
- Treatment of anxiety, panic attacks, and states of agitation
- Treatment of neurovegetative symptoms associated with vertigo
- Treatment of the symptoms of alcohol, opiate, and benzodiazepine withdrawal
- Short-term treatment of insomnia
- Treatment of muscle spasms
- Treatment of tetanus, together with other measures of intensive treatment
- Adjunctive treatment of spastic muscular paresis
- (paraplegia/tetraplegia) caused by cerebral or spinal
- cord conditions such as stroke, multiple sclerosis, or spinal cord injury
- (long-term treatment is coupled with other rehabilitative measures)
- Palliative treatment of stiff person syndrome
- Pre- or postoperative sedation, anxiolysis or amnesia
- (e.g., before endoscopic or surgical procedures)
- Treatment of complications with a hallucinogen crisis and
- stimulant overdoses and psychosis, such as LSD, cocaine, or methamphetamine
Used in treatment of organophosphate poisoning and
reduces the risk of seizure induced brain and cardiac damage.
- Preventive treatment of oxygen toxicity during hyperbaric oxygen therapy
diazepam for anxiety
Intravenous diazepam or lorazepam are first-line treatments for status epilepticus.
However, intravenous lorazepam has advantages over intravenous diazepam,
including a higher rate of terminating seizures and a more prolonged anticonvulsant effect.
Diazepam gel was better than placebo gel in reducing the risk of non-cessation of seizures.
Diazepam is rarely used for the long-term treatment of epilepsy
because tolerance to its anticonvulsant effects usually develops
within six to 12 months of treatment, effectively rendering it useless for that purpose.