Diazepam is regulated in most countries as a prescription drug.
Diazepam is a type of medicine called a benzodiazepine. Benzodiazepines are used for their sedative, anxiety-relieving and muscle-relaxing effects.
Diazepam works by acting on receptors in the brain called GABA receptors. This causes the release of a neurotransmitter called GABA in the brain. Neurotransmitters are chemicals that are stored in nerve cells in the brain and nervous system. They are involved in transmitting messages between the nerve cells. GABA is a neurotransmitter that acts as a natural 'nerve-calming' agent. It helps keep the nerve activity in the brain in balance, and is involved in inducing sleepiness, reducing anxiety and relaxing muscles. As diazepam increases the activity of GABA in the brain, it increases its calming effect and results in sleepiness, a decrease in anxiety and relaxation of muscles.
It is commonly used for treating anxiety, insomnia, seizures including status epilepticus, muscle spasms (such as in cases of tetanus), restless legs syndrome, alcohol withdrawal, benzodiazepine withdrawal and Ménière's disease. 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, sedative, skeletal muscle relaxant, and amnestic properties. The pharmacological action of diazepam enhances the effect of the neurotransmitter GABA by binding to the benzodiazepine site on the GABAA receptor leading to central nervous system depression.
Diazepam has several uses. Firstly, it can be used to calm severe anxiety and agitation. For example, benzodiazepines such as diazepam are effective at quickly reducing the symptoms of anxiety and agitation that occur in a manic episode of the psychiatric illness, bipolar affective disorder. A benzodiazepine may be given as part of the initial treatment of a manic episode, though they are not licensed specifically for this purpose. Benzodiazepines help calm the individual while the main medicines for this condition (mood stabilisers) begin to take effect.
Oral forms of diazepam are also used for short-term treatment of severe anxiety associated with insomnia, as well as for night terrors and sleep-walking in children. Diazepam decreases the time taken to fall asleep and nocturnal awakenings, as well as increasing the total amount of time spent sleeping. However, it is only suitable for short-term treatment of insomnia and anxiety as it has a high potential for dependence and addiction. As diazepam remains active in the body for many hours, drowsiness may also last into the next day.
Diazepam is also given for its sedating and anxiety-relieving effects as a pre-med before surgery or medical investigations or procedures, and to alcoholics during acute alcohol withdrawal.
The second main use of diazepam is in controlling convulsions, for example associated with poisoning, or seizures associated with fever in children (febrile convulsions). It is particularly useful for controlling repeated epileptic fits when a patient does not recover conciousness between fits (status epilepticus). Diazepam helps control convulsions because the increased activity of GABA that it causes in the brain helps to calm excessive electrical nerve activity that is responsible for causing seizures.
A further use of diazepam is in controlling muscle spasms due to tetanus or poisoning.
Diazepam may be given as tablets, syrup, injection or rectal solution (enema), depending on what condition is being treated and how fast a response is needed.
Advantages of diazepam are a rapid onset of action and high efficacy rates which is important for managing acute seizures, anxiety attacks and panic attacks; benzodiazepines also have a relatively low toxicity in overdose. Diazepam is a core medicine in the World Health Organization's “Essential Drugs List”, which is a list of minimum medical needs for a basic health care system. Diazepam is used to treat a wide range of conditions and has been one of the most frequently prescribed medications in the world for the past forty years.
This medication is classified as a benzodiazepine and works in the brain by enhancing the effects of gamma-aminobutyric acid (GABA), a chemical that is naturally calming. GABA can slow down or stop certain nerve signals in the brain. This is why diazepam and other benzodiazepines are known as mild tranquilizers, sedatives, or central nervous system depressants (CNS depressants).
As a benzodiazepine, diazepam can have several effects on the body. Some of these diazepam benefits include:
Reducing anxiety
Causing sleepiness
Relaxing muscles
Stopping seizures
Impairing short-term memory.
A healthcare provider may prescribe diazepam for the treatment of alcohol withdrawal, anxiety, muscle spasms, or seizures. When used for treating seizures, diazepam can be helpful in stopping a seizure that is particularly hard to control. From time to time, diazepam may be used for the treatment of something other than the conditions mentioned above. Among these other, “off-label” diazepam uses are the treatment of insomnia, agitation, and benzodiazepine withdrawal.
Diazepam (Valium®) is a prescription medication that is used for the treatment of the following conditions:
Alcohol withdrawal
Anxiety
Muscle spasms
Seizures (when used along with other seizure medications).
Stopping alcohol immediately is not always a good idea. In fact, it can be very dangerous. People who drink heavily or frequently may experience alcohol withdrawal symptoms if they stop drinking alcohol too quickly. Mild alcohol withdrawal symptoms can include slight shakiness, alcohol cravings, nervousness, depression, or clammy skin. More severe symptoms may include:
Seizures
Delirium tremens (“DTs”), a group of symptoms including confusion, agitation, and hallucinations
Severe nausea and vomiting
A very rapid heart rate (tachycardia).
Alcohol withdrawal can be life-threatening. It should always be done under a healthcare provider's supervision, and hospitalization is often necessary. Diazepam can help with agitation, shakiness, and delirium tremens associated with alcohol withdrawal.
Most people experience feelings of anxiety before an important event. Anxiety disorders, however, are illnesses that load people's lives with overwhelming anxiety and fear that are chronic and unremitting, and that can grow progressively worse.
Depending on the type of anxiety, a person can experience several possible anxiety symptoms, including:
Feeling shaky, jittery, or nervous
Feeling tense, fearful, or apprehensive
Avoiding certain places or activities because of fear
A pounding or racing heart or trouble catching your breath
Unexplained sweating or trembling
Fear of losing control, going crazy, or dying.
Diazepam is approved for anxiety treatment. However, diazepam is not for “everyday anxiety” and is recommended only for short-term use. Other anxiety medications (such as SSRIs, a certain type of antidepressants) are more appropriate for long-term use.
Muscle spasms are involuntary contractions of a muscle or group of muscles. While not usually dangerous, muscle spasms can be uncomfortable and painful. Diazepam is useful for treating muscle spasms due to the following causes:
Joint or muscle inflammation
Injury
Cerebral palsy
Paraplegia
Athetosis (a movement disorder of the hands and feet)
Stiff-man syndrome (a rare neurological disorder).
Diazepam is approved to treat seizures. However, it is not approved to be used alone. Instead, it is used along with other seizure medications. It can be useful for stopping a seizure that is particularly difficult to control.
On occasion, your healthcare provider may recommend diazepam for something other than the condition listed in this article. This is known as using the medication “off-label.” Currently, off-label diazepam uses can include treating the following conditions:
Agitation
Insomnia
Benzodiazepine withdrawal (due to stopping a benzodiazepine medication too quickly).
Sometimes, diazepam is used as a sedative before certain medical or surgical procedures.
Get emergency medical help if you have any of these signs of an allergic reaction to diazepam: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using diazepam and call your doctor at once if you have a serious side effect such as:
confusion, hallucinations, unusual thoughts or behavior;
unusual risk-taking behavior, decreased inhibitions, no fear of danger;
depressed mood, thoughts of suicide or hurting yourself;
hyperactivity, agitation, aggression, hostility;
new or worsening seizures;
weak or shallow breathing;
feeling like you might pass out;
muscle twitching, tremor;
loss of bladder control; or
urinating less than usual or not at all.
Less serious diazepam side effects may include:
drowsiness, tired feeling;
memory problems;
dizziness, spinning sensation;
feeling restless or irritable;
muscle weakness;
nausea, constipation;
drooling or dry mouth, slurred speech;
blurred vision, double vision;
mild skin rash, itching.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Diazepam should be used with caution in:
Children.
Elderly people.
Weak or debilitated people.
Decreased kidney function.
Decreased liver function.
Disease affecting the airways or lungs (respiratory disease).
Abnormal muscle weakness (myasthenia gravis).
Hereditary blood disorders called porphyrias.
History of alcoholism or drug abuse.
Personality disorders.
Depression.
It is important to tell your doctor if you have recently suffered a loss or bereavement, for example the death of a close friend or relative, before taking this medicine. Benzodiazepines such as this one can affect the way you adjust psychologically to events like this.
Not to be used in:
A sudden worsening of any underlying lung disease (acute pulmonary insufficiency).
Slow, shallow breathing (respiratory depression).
Syndrome involving short spells when breathing stops during sleep (sleep apnoea syndrome).
Long-term psychotic illness.
Phobias or obsessional states.
Severely decreased liver function.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Do not use diazepam if you are pregnant or want to become pregnant. It could harm the unborn baby.
Neither use this medication while breast-feeding due to diazepam is excreted into human milk. Sedation, lethargy and weight loss have been reported in nursing infants.
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.
There may be an increased risk of drowsiness and sedation if diazepam is taken with any of the following (which can also cause drowsiness):
alcohol
antipsychotics, eg chlorpromazine, clozapine
barbiturates, eg phenobarbital
other benzodiazepines, eg temazepam
MAOI antidepressants, eg phenelzine
sedating antihistamines, eg chlorphenamine
sleeping tablets, eg zopiclone
strong opioid painkillers, eg morphine, codeine, dihydrocodeine
tricyclic antidepressants, eg amitriptyline.
The following medicines may prevent the breakdown of diazepam in the body. As this could increase the blood level of diazepam and its sedative effects, as well as the risk of its side effects, your doctor may need to prescribe you a lower than normal dose of diazepam if you are taking any of these medicines:
cimetidine
disulfiram
esomeprazole
fluoxetine
fluvoxamine
fosamprenavir
isoniazid
modafinil
omeprazole
ritonavir.
The following medicines may decrease the blood level of diazepam. As this could make it less effective, your doctor may need to prescribe you a larger than normal dose of diazepam if you are taking any of these medicines:
phenytoin
rifampicin.
Caffeine and theophylline may reduce the sedative and anxiety-reducing effects of diazepam.
Diazepam may reduce the effectiveness of levodopa in treating Parkinson's disease.
Diazepam may increase or decrease blood levels of the anticonvulsant medicine phenytoin.
Before taking diazepam,
tell your doctor and pharmacist if you are allergic to diazepam, alprazolam (Xanax), chlordiazepoxide (Librium, Librax), clonazepam (Klonopin), clorazepate (Tranxene), estazolam (ProSom), flurazepam (Dalmane), lorazepam (Ativan), oxazepam (Serax), prazepam (Centrax), temazepam (Restoril), triazolam (Halcion), or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antihistamines; cimetidine (Tagamet); digoxin (Lanoxin); disulfiram (Antabuse); fluoxetine (Prozac); isoniazid (INH, Laniazid, Nydrazid); ketoconazole (Nizoral); levodopa (Larodopa, Sinemet); medications for depression, seizures, pain, Parkinson's disease, asthma, colds, or allergies; metoprolol (Lopressor, Toprol XL); muscle relaxants; sedatives; sleeping pills; theophylline (Theo-Dur); tranquilizers; valproic acid (Depakene); and vitamins. These medications may add to the drowsiness caused by diazepam.
if you use antacids, take diazepam first, then wait 1 hour before taking the antacid.
tell your doctor if you have or have ever had glaucoma; seizures; or lung, heart, or liver disease.
talk to your doctor about the risks and benefits of taking diazepam if you are 65 years of age or older. Older adults should not usually take diazepam because it is not as safe as other medications that can be used to treat the same conditions.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking diazepam.
you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
remember that alcohol can add to the drowsiness caused by this drug.
tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.
These user reviews are from WebMD's homepage among other big internet sites:
Condition: Anxious, 9/14/2011 1:47:24 PM
Reviewer: 45-54 Female on Treatment for 10 years or more (Patient)
Comment: this medication was given to me for anxiety and muscle spasms it does reduce the effects and accurances of these thinngs
Review by GoldenOldies: User Rating: 10
Valium (diazepam) for Anxiety: I used to get severe panic attacks quite often. I started taking 10mg of Valium three times daily as prescribed by my psychiatrist, and after a year my dose has decreased to 5mg and I have never had another panic attack. Anxiety attack(or panic attacks) are very scary. I had made many trips to the emergency room thinking I was having a heart attack. I had symptoms like sweating, tingling in arms and legs, cold chills in face and a rapid heartbeat, feeling of hysteria, and wishing I would just die and get it over with. Valium saved my life. It is very effective, and I am greatful it works.
Condition: Anxious, 7/30/2011 1:23:55 PM
Reviewer: danidoinbetter, 45-54 Female on Treatment for less than 1 month (Patient)
Comment: After a neck fusion, shattered wrist, gallbladder removal and fractured pelvis and sacrum all in a year's period of time I was unable to work, I felt constant pain, anxious, and depression, not contributing to my family of finances. Was on myriads of meds. My family doc insisted I give diazepam a try. After just 3 day, lessened muscle pain, anxiety and depression, and sleep better than on Lunesta or Ambien. This has been a lifesaver for me! And I don't have to take so many pills. I'm delighted!! God bless ... and my savvy doctor!
Review by jk33: User Rating: 10
Valium (diazepam) for Muscle Spasm: This medicine has helped me very much. I get very bad spasms in my neck and shoulder. It helps 100% and I also have a much better time sleeping. It keeps my mind from wondering while I try to sleep. It also makes me feel more refreshed when I wake up. I have less mood swings. I used to pace back and fourth all day and it put a stop to that as well. It has improved my life very much.
Condition: Anxious, 7/29/2011 9:20:11 PM
Reviewer: j2ny, 45-54 Female on Treatment for 10 years or more (Patient)
Comment: I have used this medicine successfully for anixiety, panic attacks for the past 11 years. That said, it has been 11 years...I cannot get OFF it! I tried to STOP, I wound up in the HOSPITAL! I am back on diazepam! I would caution anyone to speak with their doc about an exit strategy prior to starting, unless they WANT a life-long committment. It does not appear to have negative impacts on my day-to-day functioning (I can drive, work, go to school, etc.). The only other thing is that at times undue stress causes increased dosage requirements (my prescribed dose is 5 mg 3 times/day).
Review by Anonymous: User Rating: 9.0
Valium (diazepam) for Seizure Prevention: I have had seizures from a kick to the head. For 6 years, they started out giving me Valium and it worked great for the prevention of the seizures for about 4 1/2 years. Then it was no longer effective. They had to switch me to Klonopin, another benzodiazepine, but that is working for me now.
Review by ...: User Rating: 10
Valium (diazepam) for Muscle Spasm: I find this drug to be great for muscle spasm. It helps me greatly for tension headaches.
Condition: Anxious, 12/7/2010 11:39:21 PM
Reviewer: noshoremana, 45-54 Female on Treatment for 1 to less than 2 years (Patient)
Comment: I've been diagnosed for depression, panic attacks, agoraphobia,and anxiety for the last 15 yrs ...recently, PTSD. I've taken Clonopin and Xanax along with an antidepressant (you name it, I've taken it). Diazepam works much better than Clonopin or Xanax...it doesn't keep me loopy or as sleepy as the other two do for a much longer time.
Review by leopardeyes: User Rating: 5.0
Valium (diazepam) for Light Anesthesia: I was given Valium intravenously for light sedation during a quick medical procedure. It worked very well, but about 30 minutes after the i.v. was removed I became very irritable and depressed and craved more. It also caused a slight temporary personality change in me that lasted the rest of the day.
Review by Anonymous: User Rating: 10
Valium (diazepam) for Temporomandibular Joint Disorder: I had no idea I had TMJ but actually thought I was getting wisdom teeth because of the pain. I went to a dentist and he gave me Valium and Percocet. He told me to go to my doctor and have them prescribe more as he could not. My doctor thought I was crazy and drug seeking so I could not get anything and still suffering from TMJ. The Valium was very helpful for TMJ, more than anything else I have tried or the doctor has given me instead of Valium.
Review by pearl123: User Rating: 4.0
diazepam for Light Sedation: Made me yawn a little. Not much help with my sleeping.
Condition: Anxious, 4/27/2010 10:20:31 AM
Reviewer: pmdstables, 25-34 Female on Treatment for 10 years or more (Patient)
Comment: VERY SATISFIED, like a [good] pill for me during an anxiety attack or if I feel one coming on. It does not make me drowsy if I take the correct dosage and I actually feel more productive as I can focus better on it than when feeling anxious.
Review by pompey:
Valium (diazepam) for Alcohol Withdrawal: So far it has stopped the normal vomiting and shaking when I try to stop. I have also had an increased appetite.
Condition: Anxious, 3/30/2010 2:01:04 PM
Reviewer: 13-18 Male on Treatment for less than 1 month (Patient)
Comment: This medication did make me a bit uncoordinated and drowsy the first time I took it, but afterwards it made me feel so much better. I was also taking this for muscle pain and now it's like it was never there!
Review by Elciddad: User Rating: 10
Valium (diazepam) for Meniere's Disease: I have been inflicted with an inner ear problem for 40 years. I have been to so many specialist who could not find the cause. The flare ups are devastating and cause me to have dizzy spells that last for a few minutes each time. It occurs when I change head positions in a hurry. When the episodes occur, a combination of Valium and a vertigo medicine works fine. After a few days, I'm back to normal. It has been a blessing and allowed me to keep my job in law enforcement for many years until I retired. The only other alternative was to surgically serve my nerves in my ears so that I would not experience the symptoms. The doctors all agreed this was too drastic and if the medicine works, to stay with it.
Review by Matt d: User Rating: 10
Valium (diazepam) for Night Terrors: I take Valium for night terrors in relation to PTSD and anxiety disorder. I have tried many medications but nothing works as well as Valium does. This includes Klonopin, Xanax, and SSRI's used for this condition that do not work at all.
Review by Anonymous: User Rating: 7.0
diazepam for Endoscopy or Radiology Premedication: I was given the generic equivalent of Valium prior to a closed MRI as I am claustrophobic. It did not completely relax me during the protracted procedure, however, it did help to some degree. I only took a 5mg dose; if I were to have to undergo this procedure in the future, I would take a 10mg dose. One 5mg pill, however, does help me greatly when I experience bouts of insomnia.
Review by bizzo: User Rating: 10
I was prescribed valium for tension headaches. I have severe migraines and tension headaches. They could not find out exactly why I was having them, so we have to treat the symptom. Valium actually makes me able to function through some of the worst tension headaches. Before, I was spending so much time locked in a dark room between the migraines and tension headaches. I was missing my life and the lives of my children. It is really nice to be able to have a part in their lives and my own. I am thankful daily ...
Review by Anonymous: User Rating: 10
Valium (diazepam) for Anxiety: Use of this medicine is to very effective in treating the illnesses for which it is prescribed. They will also admit that it is an extremely safe medicine to use. Valium when used by me, sporadically, as needed, effectively treats my anxiety episodes, which untreated would probably lead to ulcers.