Diazepam used for anxiety, insomnia and muscle spasms.

Diazepam

Diazepam is a type of medicine called a benzodiazepine. Benzodiazepines are used for their sedative, anxiety-relieving and muscle-relaxing effects.

What is Diazepam used for?

  • Short-term (two to four weeks only) treatment of severeanxiety that is disabling or subjecting the individual to unacceptable distress.
  • Short-term (two to four weeks only) treatment of severeinsomnia that is disabling or subjecting the individual to extreme distress (oral forms of diazepam only).
  • Relieving anxiety and causing sedation before surgery or medical procedures (pre-med).
  • Managing symptoms of withdrawal from alcohol (used in combination with other treatment for alcoholism).
  • Controlling convulsions (fits) caused by poisoning (intravenous and rectal forms of diazepam only).
  • Controlling repeated fitting with no recovery of conciousness between seizures (status epilepticus)(intravenous and rectal forms of diazepam only).
  • Controlling fitting associated with fever (febrile convulsions).
  • Controlling muscle spasms, for example due to tetanus or poisoning.

How does Diazepam work?

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.

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. Diazepam decreases the time taken to fall asleep and wakings during the night, 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 and procedures, and to alcoholics during acute alcohol withdrawal (‘cold-turkey’).

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 the person doesn’t 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 the 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.

How do I take Diazepam?

  • Diazepam may be taken as tablets or syrup, or given by injection or rectal solution (enema), depending on what condition is being treated and how fast a response is needed.
  • Diazepam tablets and syrup can be taken either with or without food.
  • Always take the medicine as directed by your doctor. Do not exceed the dose prescribed by your doctor.

Things you should know before taking Diazepam?

  • This medicine causes drowsiness and muscle weakness and impairs concentration and alertness. These effects may continue into the following day and are made worse by drinking alcohol. If you are affected you should not drive or operate machinery.Do not drink alcohol while taking this medicine.
  • From March 2015 a new ‘drug driving’ law comes into force, which makes it an offence to drive with certain drugs or prescription medicines above specified limits in your body. The list includes diazepam, which means it may be an offence to drive while you are taking this medicine. The new law will allow police to use roadside drug tests to check for the presence of the prohibited drugs in a driver’s saliva. There are very low limits for illegal drugs, but higher limits for prescribed medicines. This should mean that most people taking diazepam as prescribed will not be breaking the law, provided they are not driving dangerously. If you are found to be above the limit for diazepam there is a medical defence if you are taking the medicine as prescribed, as long as your driving is not impaired. If you are taking a high dose of diazepam it may therefore be sensible to carry your prescription with you when driving, in case you are asked to take a test by the police. However, if you are driving dangerously while taking this medicine you will be breaking the law. You should not drive if you think this medicine affects your ability to drive safely, for example if it makes you feel sleepy, dizzy, unable to concentrate or make decisions, or if you have blurred or double vision.
  • This medicine is generally only suitable for short-term use. If it is used for long periods or in high doses, tolerance to and physical and psychological dependence upon the medicine may develop, and withdrawal symptoms may occur if treatment is stopped suddenly.
  • Treatment with this medicine should usually be stopped gradually, following the instructions given by your doctor, in order to avoid withdrawal symptoms such as rebound insomnia or anxiety, confusion, sweating, tremor, loss of appetite, irritability or convulsions.

Diazepam should be used with caution in

  • Children.
  • Elderly people.
  • Weak or debilitated people.
  • Decreased kidney function.
  • Decreased liver function.
  • People with disease affecting the airways or lungs (respiratory disease).
  • People with a history of alcoholism or drug abuse.
  • People with 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.
  • Who should not take Diazepam?

    • People who are allergic to other benzodiazepines.
    • People with a sudden worsening of any underlying lung disease (acute pulmonary insufficiency).
    • People with slow, shallow breathing (respiratory depression).
    • People who suffer from sleep apnoea syndrome, which is a problem involving short spells when breathing stops during sleep.
    • People with abnormal muscle weakness due to the conditionmyasthenia gravis.
    • Long-term psychotic illness.
    • Phobias or obsessional states.
    • People who are very restless or hyperactive.
    • Severely decreased liver function.
    • Breastfeeding.

    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.

    Can I take Diazepam while pregnant or breastfeeding?

    Certain medicines should not be used during pregnancy orbreastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

    • This medicine may be harmful to a developing baby and it should be avoided during pregnancy unless considered essential by your doctor. This is particularly important during the first and third trimesters of pregnancy and before or during labour. Regular use during pregnancy should especially be avoided, as the baby could become dependent on the medicine and then suffer withdrawal symptoms after the birth. If this medicine is used in late pregnancy or during labour it may cause floppiness, low body temperature and breathing or feeding difficulties in the baby after birth. Ask your doctor for further information.
    • Significant amounts of this medicine may pass into breast milk. It should not be used by breastfeeding mothers as it may be harmful to the nursing infant. Seek medical advice from your doctor.