Diazepam is a sedative, hypnotic, and antianxiety drug. It is a muscle relaxant and has an anticonvulsant effect.
In most cases, Diazepam is used as a hypnotic, sedative and antianxiety drug.
In adult psychiatry and psychotherapy, this drug is prescribed in the following cases:
- Affective disorders (mood disorders): subdepression (dysthymia), depressive disorder.
- Neuroses: panic disorder, specific isolated phobias, agoraphobia, obsessive-compulsive disorder, acute reaction to stress and post-traumatic stress disorder.
- Somatoform disorders: conversion syndromes (psychogenic blindness, deafness, loss of sensitivity, etc.), psychogenic asthenia, anorexia nervosa, dysmorphophobia.
- Dissociative disorders.
- Psychopathy and psycho-like states.
- Psychopathy-like and neurosis-like states in schizophrenia.
- Organic brain damages, including those caused by cerebrovascular disease.
- Non-organic psychoses.
- Fear, anxiety, emotional stress, hypochondria, irritability, obsession and phobic disorders in somatic diseases.
- Disorders in habits and drives.
- Restless agitation and psychomotor agitation in patients suffering from the above-listed pathological conditions.
In children psychoneurology, Diazepam is prescribed for neuroses and neurotic states that are accompanied by fear, anxiety, nervousness and sleep disorders, as well as for enuresis, headaches, mood and behavior disorders.
In narcology, the drug is administered as part of a combination therapy in patients with alcohol dependence syndrome (including delirium), behavioral and mental disorders caused by the use of opioids.
In anaesthesiology, Diazepam is used in combination with other medications for preoperative preparation of patients and for combined anesthesia.
In gynecology, the drug is administered as part of a combination therapy for the relief of labor, for premature detachment of the placenta, premature birth, gestational toxicosis, menstrual and menopausal disorders.
In cardiology, Diazepam is used as part of a complex therapy for treatment of stenocardia and myocardial infarction.
Diazepam reduces the secretion of gastric juice in the night. Therefore, it is a drug of choice for insomnia and anxiety in patients suffering from gastric ulcer.
In dermatology, the drug is prescribed for itching dermatoses.
As an anticonvulsant, Diazepam is used for epilepsy to treat mental equivalents, convulsive paroxysms and status epilepticus, as well as for tetanus.
As a muscle relaxant, Diazepam is used in spastic conditions resulting from brain or spinal cord lesions (athetosis, cerebral palsy), and in skeletal muscle spasm caused by fresh injuries. It is also used in bursitis, myositis, arthritis, progressive chronic polyarthritis, rheumatoid pelvic spondyloarthritis and osteoarthritis accompanied by muscle tension.
Nervous system disorders in the initial period of treatment, especially in elderly patients: there rare cases of dizziness, drowsiness, weakness, fatigue, confusion, decreased concentration, ataxia (imbalance when standing or walking), deterioration of attention concentration, unsteady gait, lack of emotions, slowing down of motor and mental reactions, and anterograde amnesia. The patient may have hiccups after intravenous administration of the drug.
The patient may sometimes have a decrease in blood pressure after parenteral administration of the drug. There are possible local inflammatory processes (infiltration, phlebitis, thrombophlebitis) at the injection site.
Allergy to Diazepam may manifest in the form of itching and skin rashes.
Rare side effects
Some of the rare side effects on the nervous system include tremor, headache, depression or euphoria, dysarthria, muscle weakness during the day, confusion, catalepsy, uncontrolled movements of the body and eyes.
Gastro-intestinal tract: possible hiccups, heartburn, nausea, vomiting, loss of appetite, stomach pain, constipation, abnormal liver function.
Side effects on other organs and systems: bradycardia or tachycardia, urine retention or urinary incontinence, menstrual disorders, decreased or increased libido, weight loss, bulimia, double vision (visual impairment), impaired external respiration.
There are very rare paradoxical reactions: fear, muscle spasms, outbreaks of aggression, agitation, anxiety, irritability, nightmares, insomnia.
Serious side effects
Jaundice and severe hepatic impairment are rarely observed.
With parenteral administration, cardiovascular collapse and depression of the respiratory center are possible.
In few cases, there are paradoxical reactions with hallucinations and suicidal tendencies.
Using the drug to facilitate delivery may cause respiratory disorders in the newborn.
Changes in laboratory parameters
Anemia, neutropenia, leukopenia, agranulocytosis, thrombocytopenia occur rarely. There is possible elevation of liver transaminases and alkaline phosphatase.
Side effects during pregnancy and lactation
The drug is contraindicated in the first trimester of pregnancy since it increases the likelihood of birth defects. In the second and third trimester, the drug is used only in cases where the effect of the use of Diazepam exceeds the potential risk to the fetus. Please be aware that taking the drug during pregnancy can affect fetal heart rate.
Breast-feeding should be stopped at the time of treatment with Diazepam.
Side effects in children
Diazepam should not be given to children under 6 months old because their enzyme system, which is involved in the metabolism of the drug, is not fully formed. In exceptional cases, the drug can be used in emergencies to relieve convulsive attacks.
In the application of Diazepam in obstetric practice (to facilitate delivery), infants may experience low body temperature and decreased muscle tone.
Sharp reduction of the dose or discontinuation may cause after-effect syndrome (emergence or intensification of symptoms for which the drug was prescribed to eliminate).
Drug dependence emerges with prolonged use. Withdrawal syndrome may manifest in the form of headache, anxiety, irritability, agitation, nervousness, anxiety, sleep disturbances, dysphoria, depersonalization, depression, tremors, muscle spasms, nausea, vomiting, paresthesia, increased sensitivity to sound, photophobia, hallucinations, and convulsions. In some cases, acute psychosis is possible.
Based on what has been said above, Diazepam should be withdrawn gradually by slowly reducing the dose.