Diazepam

Lore & Background

Diazepam is a medication of the benzodiazepine family that acts as an anxiolytic. It is used to treat anxiety, seizures, alcohol withdrawal syndrome, muscle spasms, insomnia, and restless legs syndrome. It may also be used to cause memory loss during certain medical procedures. It can be taken orally, as a suppository, intramuscularly, intravenously, or as a nasal spray. When injected intravenously, effects begin in one to five minutes and last up to an hour. When taken by mouth, effects begin after 15 to 60 minutes. Common side effects include sleepiness and trouble with coordination. Serious side effects are rare and include increased risk of suicide, decreased breathing, and a paradoxical increased risk of seizures if used too frequently in those with epilepsy. Long-term use can result in tolerance, dependence, and withdrawal symptoms on dose reduction. Its mechanism of action works by increasing the effect of the neurotransmitter gamma-aminobutyric acid (GABA).

Reader's Guide

It is on the World Health Organization's List of Essential Medicines. Diazepam is mainly used to treat anxiety, insomnia, panic attacks, and symptoms of acute alcohol withdrawal. It is also used as a premedication for inducing sedation, anxiolysis, or amnesia before certain medical procedures. Intravenous diazepam and lorazepam are first-line treatments for status epilepticus. Diazepam is rarely used for the long-term treatment of epilepsy because tolerance to its anticonvulsant effects usually develops within six to twelve months of treatment. The United States military employs a specialized diazepam preparation known as Convulsive Antidote, Nerve Agent (CANA), which contains diazepam.

Did You Know?

• Diazepam is the most commonly used benzodiazepine for tapering benzodiazepine dependence due to its comparatively long half-life.
• The United States military issues a specialized diazepam preparation known as Convulsive Antidote, Nerve Agent (CANA).