THERAPEUTICS

Brands

• Valium, Diastat, Diastat AcuDial, Diazepam Intensol, Dialar, Diazemuls, Rimapam, Stesolid, Tensium, Valclair, Alupram, Solis, Atensine, Evacalm, Valrelease

Generic?

• Yes

Class

• Benzodiazepine, antiepileptic drug (AED)

Commonly Prescribed for

(FDA approved in bold)

• Seizure disorders. Adjunctively and to control bouts of increased seizure activity

• Anxiety disorders

• Acute alcohol withdrawal

• Muscle relaxant

• Preoperative medication

• Status epilepticus

• Tetanus

• Insomnia

• Agitation

• Stiff person syndrome

• Spasticity due to upper motor neuron disorders

• Irritable bowel syndrome

• Panic attacks

• Nausea and vomiting (from chemotherapy)

• Emergency treatment of preeclampsia

• Dystonia

• Vertigo

• Opioid or other drug withdrawal

• Acute mania in bipolar disorder

How the Drug Works

• Benzodiazepines bind to and potentiate the effect of GABAA receptors, which are ligandgated chloride channels activated by GABA. It boosts chloride conductance across the cell membrane, hyperpolarizes the membrane potential, and increases the threshold potential. Specific GABA receptor subunits have been associated with diazepam's function (e.g., α1: sedation, anterograde amnesia; α2: anxiolytic effect; α1,2,3: AED effect). Benzodiazepines act at spinal cord, brainstem, cerebellum, and limbic and cortical areas

How Long Until It Works

• Works quickly (minutes to hours depending on formulation) in the treatment of seizures, acute anxiety, drug withdrawal, and muscle relaxation. In patients with chronic disorders such as spasticity, dystonia, or generalized anxiety it may take weeks to determine optimal dose for maximal therapeutic benefit

If It Works

• Seizures: rectal diazepam is used intermittently as an adjunctive for patients with known epilepsy with increased seizure frequency. IV diazepam is used for status epilepticus in conjunction with IV maintenance AEDs. In patients with epilepsy who benefit from oral diazepam as an adjunctive medication, consider tapering the medication after 2 years without seizures, depending on the type of epilepsy