Diazepam

Diazepam was first marketed as Valium by Hoffmann-La Roche, is a benzodiazepine derivative drug. It is commonly used for treating anxiety, Short-term treatment of insomnia, panic attacks, and states of agitation, seizures, muscle spasms, restless legs syndrome, obsessive compulsive disorder , alcohol withdrawal, opiate and benzodiazepine withdrawal, and Ménière's disease.
Also used in the treatment for irritable bowel syndrome. It may also be used before certain medical procedures such as endoscopies to reduce tension and anxiety, and in some surgical procedures to induce amnesia. It possesses anxiolytic, anticonvulsant, hypnotic, sedative, skeletal muscle relaxant, and amnestic properties.
It is also commonly referred to as diazapam, diazpam, diazipam, diazipan.

Diazepam Dosage

Dosages should be determined on an individual basis, depending upon the condition to be treated, the severity of symptoms, the body weight of the patient, and any comorbid conditions the patient may have.
Typical dosages for healthy adults range from 2 mg per dose to 10 mg per dose taken 2 to 4 times per day, depending on such factors as body weight and condition being treated. For the elderly or people with liver disorders, initial dose is at the low end of the range, with the dose being increased as required.

Availability And Packaging

Diazepam is marketed in over 500 brands throughout the world. It is supplied in the following forms:
* For oral administration:
o Tablets – 2 mg, 5 mg, 10 mg. Generic versions available.
o Capsules, time-release – 15 mg (marketed by Roche as Valrelease)
o Liquid solution – 1 mg/ml in 500 ml containers and unit-dose (5 mg & 10 mg);
5 mg/ml in 30 ml dropper bottle (marketed by Roxane as Diazepam Intensol)

Side-effects Of Diazepam

Diazepam has a range of side-effects that are common to most benzodiazepines. Most common side-effects include:

  • Somnolence
  • Suppression of REM sleep
  • Impaired motor function
    • Impaired coordination
    • Impaired balance
    • Dizziness and nausea
  • Depression
  • Impaired learning
  • Anterograde amnesia (especially pronounced in higher doses)
  • Cognitive deficits
  • Reflex tachycardia

Less common paradoxical side-effects can include nervousness, irritability, insomnia, muscle cramps, changes in libido (increased or decreased libido) and in some cases, rage, and violence.
Diazepam may increase, in some people, the propensity toward self-harming behaviours and, in extreme cases, may provoke suicidal tendencies or acts.If these side-effects are present, diazepam treatment should be immediately terminated.

Precautions To Be Taken

Use of diazepam should be avoided, when possible, in individuals with the following conditions:
* Ataxia
* Severe hypoventilation
* Acute narrow-angle glaucoma
* Severe hepatic deficiencies (hepatitis and liver cirrhosis decrease elimination by a factor of 2)
* Severe renal deficiencies (e.g. patients on dialysis)
* Liver disorders
* Severe respiratory disorders
* Severe sleep apnea
* Severe depression, particularly when accompanied by suicidal tendencies
* Psychosis
* Pregnancy or breast feeding
* Caution required in elderly or debilitated patients
* Coma or shock
* Abrupt discontinuation of therapy
* Acute intoxication with alcohol, narcotics, or other psychoactive substances (with the exception of some hallucinogens, where it is occasionally used as a treatment for overdose)
* History of alcohol or drug dependence
* Myasthenia gravis, or MG, an autoimmune disorder causing marked fatiguability.
* Hypersensitivity or allergy to any drug in the benzodiazepine class
Special caution needed
* Benzodiazepines require special precaution if used in the alcohol- or drug-dependent individuals and individuals with comorbid psychiatric disorders.

Diazepam And Pregnancy

Diazepam when taken late in pregnancy, during the third trimester, causes a definite risk of a severe benzodiazepine withdrawal syndrome in the neonate with symptoms including hypotonia, and reluctance to suck, to apnoeic spells, cyanosis, and impaired metabolic responses to cold stress.
Floppy infant syndrome and sedation in the newborn may also occur. Symptoms of floppy infant syndrome and the neonatal benzodiazepine withdrawal syndrome have been reported to persist from hours to months after birth

Overdose Of Diazepam - Symptoms And Treatment

An individual that has consumed too much diazepam will typically display one or more of the following symptoms in the period up around four hours immediately following a suspected overdose.:

  • Drowsiness
  • Mental confusion
  • Hypotension
  • Impaired motor functions
    • Impaired reflexes
    • Impaired coordination
    • Impaired balance
    • Dizziness
  • Coma

Although not usually fatal when taken alone, a diazepam overdose is considered a medical emergency and generally requires the immediate attention of medical personnel. The antidote for an overdose of diazepam (or any other benzodiazepine) is flumazenil (Anexate).
This drug is only used in cases with severe respiratory depression or cardiovascular complications. Because flumazenil is a short-acting drug, and the effects of diazepam can last for days, several doses of flumazenil may be necessary. Artificial respiration and stabilization of cardiovascular functions may also be necessary.

Toxicity

Laboratory tests assessing the toxicity of diazepam, nitrazepam and chlordiazepoxide on mice spermatozoa found that diazepam produced toxicities in sperm including abnormalities involving both the shape and size of the sperm head. Nitrazepam, however, caused more profound abnormalities than diazepam.



Considerable portions of the text here is from http://en.wikipedia.org/wiki/Diazepam and is reproduced here under the Creative Commons Attribution-ShareAlike License