Diazepam (Diazepam) - Summary

DIAZEPAM SUMMARY

Diazepam
Tablets USP C-IV
Rx only

Diazepam is a benzodiazepine derivative.

Diazepam tablets are indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic.

In acute alcohol withdrawal, diazepam may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis.

Diazepam is a useful adjunct for the relief of skeletal muscle spasm due to reflex spasm to local pathology (such as inflammation of the muscles or joints, or secondary to trauma); spasticity caused by upper motor neuron disorders (such as cerebral palsy and paraplegia); athetosis; and stiff-man syndrome.

Oral diazepam may be used adjunctively in convulsive disorders, although it has not proved useful as the sole therapy. The effectiveness of diazepam in long-term use, that is, more than 4 months, has not been assessed by systematic clinical studies. The physician should periodically reassess the usefulness of the drug for the individual patient.

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NEWS HIGHLIGHTS

Published Studies Related to Diazepam

High-dose diazepam facilitates core cooling during cold saline infusion in healthy volunteers. [2009.08]
Studies have suggested that inducing mild hypothermia improves neurologic outcomes after traumatic brain injury, major stroke, cardiac arrest, or exertional heat illness.Administration of high-dose diazepam resulted in decreased oxygen consumption during cold saline infusion, suggesting that 20 mg of intravenous diazepam may reduce the shivering threshold without compromising respiratory or cardiovascular function.

Bioavailability and tolerability of intranasal diazepam in healthy adult volunteers. [2009.04]
Intranasal therapy has been proposed as an alternative for the management of seizure emergencies. The bioavailability, dose proportionality and tolerability of a supersaturated intranasal formulation of diazepam (DZP) solubilized in a glycofurol-water cosolvent system was investigated... Our formulation provided reasonable bioavailability, but was not well tolerated.

Lorazepam versus diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children: A randomized controlled trial. [2009.03.16]
BACKGROUND: Convulsive status epilepticus demands urgent and appropriate management with anticonvulsants. Intravenous diazepam is an established drug in the management of convulsive status epilepticus in adults as well as in children. The efficacy of intravenous lorazepam has not been well established in children. OBJECTIVE: To determine whether intravenous lorazepam is as efficacious as diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children. STUDY DESIGN: Randomized controlled trial... CONCLUSION: Lorazepam is as efficacious and safe as diazepam-phenytoin combination. We recommend use of lorazepam as a single drug to replace the two drug combination of diazepam-phenytoin combination to control the initial seizure in pediatric convulsive status epilepticus.

The cardiopulmonary effects of anesthetic induction with isoflurane, ketamine-diazepam or propofol-diazepam in the hypovolemic dog. [2009.03]
OBJECTIVE: To evaluate and compare the cardiopulmonary effects of induction of anesthesia with isoflurane (Iso), ketamine-diazepam (KD), or propofol-diazepam (PD) in hypovolemic dogs.

Efficacy of buccal midazolam compared to intravenous diazepam in controlling convulsions in children: A randomized controlled trial. [2008.12.27]
A study was done to examine the efficacy of buccal midazolam in controlling convulsion in children by comparing it with intravenous diazepam, a standard mode of treating convulsions. One hundred and twenty cases presenting with convulsions to emergency were treated randomly with either buccal midazolam (in a dose of 0.2mg/kg) or intravenous diazepam (in a dose of 0.3mg/kg)...

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Clinical Trials Related to Diazepam

A Comparison of Lorazepam and Diazepam in the Treatment of Alcohol Withdrawal [Completed]
The purpose of this study is to compare the efficacy of two commonly used medications in the treatment of alcohol withdrawal, diazepam and lorazepam.

Exploring the Effects of Diazepam and Lorazepam [Recruiting]
Aims :

- exploring lorazepam (0. 038 mg/kg)effects, after a single oral intake, in healthy

volunteers, on the neural correlates of encoding and retrieval of information during a word-stem completion task (implicit memory), using fMRI

- comparing lorazepam effects to diazepam (0. 3 mg/kg)effects

- exploring benzodiazepines effects, after a single oral intake, on the neural correlates

of successful encoding of information within explicit memory using fMRI

Hypothesis :

- both diazepam and lorazepam will impair explicit memory performance, but lorazepam only

will impair perceptual priming

- lorazepam and diazepam will modify the normal correlates of information encoding wthin

explicit memory

- lorazepam only will alter the neural corraltes of perceptual priming

Intranasal Midazolam Versus Rectal Diazepam for Treatment of Seizures [Recruiting]
The investigators will conduct a randomized controlled trial comparing the use of nasal midazolam, using a Mucosal Atomization Devise, to rectal diazepam for the treatment of acute seizure activity in children under the age of 18 years with epilepsy in the community setting. The primary hypothesis is that nasal midazolam will be more effective and have shorter seizure time compared to rectal diazepam in the community. The secondary hypotheses are that patients treated with nasal midazolam will have fewer respiratory complications, emergency department visits, and admissions.

Comparison Between Nurse-Administered Propofol Sedation and Diazemuls / Pethidine in Outpatient Colonoscopy [Completed]
Colonoscopy is a common endoscopic procedure as an investigation of colorectal pathology. Different modalities of pain control have been described in the past. Propofol is a perfect drug for endoscopic procedure since it has the characteristic of fast onset, short half-life and early recovery. Its unfamiliarity and its potential cardiovascular and respiratory side effect make it unpopular to endoscopists. Recent reports showed propofol is safe in bolus titration by nurse in Caucasian in all endoscopic procedures. Our previous pilot study showed nurse administered propofol sedation (NAPS) is effective and safe and highly acceptable by Chinese patients. Here we conduct a randomized controlled study to compare the effectiveness of NAPS versus traditional sedation.

Efficacy and Safety Study Comparing Lorazepam and Diazepam for Children in the Emergency Department With Seizures [Recruiting]
Children with seizures are frequently seen in the emergency department. The drug lorazepam, which is commonly used, is not labeled by the US Food and Drug Administration for children for this use. The FDA, under the Best Pharmaceuticals for Children Act, has requested that a study comparing diazepam, a drug that is labeled by the FDA for this indication, with lorazepam be performed. The study will show whether one drug is more effective and safe than the other.

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PATIENT REVIEWS / RATINGS / COMMENTS

Diazepam review by 54 year old female patient
		Rating
Overall rating:
Effectiveness:		Moderately Effective
Side effects:		Severe Side Effects
		Treatment Info
Condition / reason:		to relax muscles
Dosage & duration:		2mg taken two tablets three times daily for the period of two weeks
Other conditions:		severe pain right side upper going around to the back
Other drugs taken:		Warfrin & Zydol
		Reported Results
Benefits:		The Zydol was effective in reducing my pain after the dose was increased from 50 mg to 100 mg. The Diazepam made me sleep all the time which was a good thing as I believe the body heals while sleeping
Side effects:		I will never take Diazepam again as it gave me a headache, I had unpleasant dreams and I felt that I was not always here, so trying to focus or remember things was dificult.
Comments:		The pain in my side was found to be viral hepatitis. I continued with Diazepam for two weeks. Treatment then consisted of reducing fat in the diet and not drinking alcohol for 3 months. I lost a considerable amount of weight as a result.

Diazepam review by 40 year old female patient
		Rating
Overall rating:
Effectiveness:		Ineffective
Side effects:		Extremely Severe Side Effects
		Treatment Info
Condition / reason:		Anxiety
Dosage & duration:		10 mg qid taken one day for the period of one day
Other conditions:		PTSD
Other drugs taken:		None
		Reported Results
Benefits:		None
Side effects:		Drug-induced psychosis, resulting in 10 day commitment to a mental institution.
Comments:		Many people I know - I now work as a health care professional - erroneously believe that Valium, Xanax, Ativan, and other benzodiazepines must be used "as directed" and have enhanced benefit if "built up in the brain"- ie: in ways similar to SSRI's effect on the brain over time. I was entirely aware that diazepam is a "prn" medication, and chose to use the prescribed dosage on one particular day hoping it would carry me through a difficult situation. Unfortunately, I suffered a "paradoxical reaction" which cost me dearly in many tragic ways. I was in a state of severe psychosis for days- because my "benzo" level was low when admitted to the hospital, I was given diazepam for an additional two days, whereupon I apparently refused to take any medication at all, and recovered as I "detoxed". I have absolutely no memory of five days of my life. I have done research into this phenomenon, and must warn all that this seems to occur most often in indiviguals with dopamine/GABA reuptake variants- such as those with ADHD, Parkinsons, and also PTSD. Diazepam is a "bandaid" and offers no long-term therapeutic benefit whatsoever. In fact, "rebound" anxiety and profound depression are common. What is most ironic is that in the medical setting, this occurs often after administration of "Versed", is recognized quickly, and fluzanimine is given as an antidote. Outside of this scenario, the patient is blamed, treated as a suspected drug addict, and stigmatized.