Description
Diazepam is a medication primarily used to address various conditions, including anxiety, insomnia, and symptoms of acute alcohol withdrawal. It is also administered as a premedication to induce sedation, anxiolysis, or amnesia before certain medical procedures, such as endoscopy.
Intravenous diazepam or lorazepam are the preferred initial treatments for status epilepticus, with lorazepam having advantages such as higher seizure termination rates and a more prolonged anticonvulsant effect. Diazepam is rarely used for long-term treatment of epilepsy due to the development of tolerance within 6 to 12 months, rendering it ineffective. In emergency situations, diazepam can be used to treat eclampsia when other measures have failed. Additionally, diazepam’s muscle relaxant properties can alleviate pain caused by muscle spasms in certain dystonias, although tolerance may develop. Baclofen or tizanidine may be used as alternatives. Diazepam does not possess intrinsic pain-relieving properties and is generally not recommended for individuals with pain.
Diazepam can aid in the treatment of seizures resulting from drug overdose or exposure to certain toxins. It is also intermittently used for the prophylaxis of febrile seizures in young children. Long-term use of diazepam for epilepsy management is generally discouraged, but a subgroup of individuals with treatment-resistant epilepsy may benefit, with clorazepate recommended for its slower onset of tolerance.
Diazepam has a wide range of indications, many of which are off-label, including the treatment of anxiety, panic attacks, agitation, neurovegetative symptoms associated with vertigo, and withdrawal symptoms from alcohol, opiates, or benzodiazepines. It is also used for short-term insomnia treatment, as an adjunctive treatment for spastic muscular paresis, palliative treatment of stiff person syndrome, and pre-/postoperative sedation and anxiolysis. Additionally, diazepam can be used in the management of complications from hallucinogens or overdose of CNS stimulants, prophylactic treatment of oxygen toxicity during hyperbaric oxygen therapy, and various veterinary applications for sedation, anxiolysis, seizure treatment, and appetite stimulation.
Dosages of diazepam should be tailored to each individual, taking into account the specific condition being treated, symptom severity, body weight, and any comorbidities. Typical dosages for healthy adults range from 2 mg to 10 mg per dose, taken 2 to 4 times daily, while adjustments may be necessary for the elderly or individuals with liver disorders, starting at lower doses and gradually increasing as needed.
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