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Diazepam

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

By mouth

Diazepam is used to relieve symptoms of anxiety and alcohol withdrawal. This medicine may also be used to treat certain seizure disorders and help relax… Read more

Brand names include: Diazepam Intensol, Valium

By injection

Diazepam injection is used to relieve symptoms of anxiety and alcohol withdrawal. It may also be used to treat certain seizure disorders and help relax… Read more

Brand names include: Novaplus Diazepam, Valium

Into the rectum

Diazepam rectal gel is used to control certain seizure disorders such as epilepsy. Diazepam is a benzodiazepine. Benzodiazepines belong to the group of… Read more

Brand names include: Diastat, Diastat AcuDial

Drug classes About this
Antianxiety, Anticonvulsant, Skeletal Muscle Relaxant

What works? Research summarized

Evidence reviews

Magnesium sulphate versus diazepam for eclampsia

Magnesium sulphate leads to fewer maternal deaths and fewer further seizures than diazepam (Valium) when given for eclamptic seizures (fits).

Diazepam for treating tetanus

Tetanus is a disease caused by bacteria (Clostridium tetani) found in soil and faeces. It can be immunised against but continues to kill children and adults. Newborn infants are the most vulnerable, particularly in Bangladesh, India, Indonesia, Nigeria and Pakistan, mainly because of unhygienic umbilical cord practices. Puncture wounds, burns, multiple ear piercing, tattooing and circumcision (male and female) can also cause tetanus infection. The symptoms include a sudden onset of muscle stiffness and spasms (involuntary contractions) in the neck, jaw and back, sufficient to cause rigid arching of the back. Glottal and laryngeal spasms may result in fluid being sucked into the breathing passages (aspiration) or inability to breathe (asphyxiation). These spasms progress over two weeks and recovery then takes some four weeks. Complications of the disease or its treatment include depressed breathing, extrapyramidal signs that mimic the tetanus spasms and rigidity, body (autonomic) dysfunction and pneumonia. Supportive nursing, nutritional support and physiotherapy are important. Mechanical ventilation is rarely available in resource poor countries to treat total paralysis. Drugs are needed to reducing the muscle spasms and rigidity, antibiotics to kill the bacteria and tetanus immunoglobulin to remove the toxins in the body. Diazepam has anticonvulsant, muscle relaxant, sedative and anxiety reducing effects. Diazepam treatment was associated with fewer deaths than was treatment with a combination of phenobarbitone and chlorpromazine. Combination treatments with diazepam did not give any further benefit (and may cause harm). The review authors searched the medical literature and identified two randomised controlled trials with a total of 134 hospitalized neonates and older children who had tetanus from Nigeria (19 neonates, seven children aged between one month and 10 years of age) and Indonesia (74 neonates, 34 children aged between three days and 12 years). All drugs were given orally as medications and feeds are usually given via nasogastric tube in the settings where the disease burden is high. Neither study provided information on the safety of the interventions or followed up survivors beyond discharge from hospital.

Efficacy of diazepam as an anti-anxiety agent: meta-analysis of double-blind, randomized controlled trials carried out in Japan

Diazepam is one of the most widely used, broad-spectrum anti-anxiety agents. The aim of this study was to evaluate the efficacy of diazepam, and to establish whether it is more effective than a placebo in improving the various neurotic anxiety states seen in patients with neurosis or psychosomatic disease. Of the recently established comprehensive register of psychotropic drug trials carried out in Japan, a total of 17 double-blind, randomized controlled trials were identified on the treatment of neurosis using anti-anxiety compounds, in which both diazepam and placebos were used. Meta-analysis of these 17 studies demonstrated that diazepam is significantly more effective than a placebo (relative risk 1.35, 95% confidence interval 1.21-1.51, number needed to treat 9). The maximal effective dose of diazepam seems to be 12 or 18 mg/day with a treatment duration of 2 or more weeks. There was no significant difference between the effects of placebo and a diazepam dose of 6 mg/day. Caution should be exercised in assessing these results, however, since this is the first meta-analysis showing the significant effectiveness of diazepam in the treatment of neurosis or psychosomatic disease.

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Summaries for consumers

Magnesium sulphate versus diazepam for eclampsia

Magnesium sulphate leads to fewer maternal deaths and fewer further seizures than diazepam (Valium) when given for eclamptic seizures (fits).

Diazepam for treating tetanus

Tetanus is a disease caused by bacteria (Clostridium tetani) found in soil and faeces. It can be immunised against but continues to kill children and adults. Newborn infants are the most vulnerable, particularly in Bangladesh, India, Indonesia, Nigeria and Pakistan, mainly because of unhygienic umbilical cord practices. Puncture wounds, burns, multiple ear piercing, tattooing and circumcision (male and female) can also cause tetanus infection. The symptoms include a sudden onset of muscle stiffness and spasms (involuntary contractions) in the neck, jaw and back, sufficient to cause rigid arching of the back. Glottal and laryngeal spasms may result in fluid being sucked into the breathing passages (aspiration) or inability to breathe (asphyxiation). These spasms progress over two weeks and recovery then takes some four weeks. Complications of the disease or its treatment include depressed breathing, extrapyramidal signs that mimic the tetanus spasms and rigidity, body (autonomic) dysfunction and pneumonia. Supportive nursing, nutritional support and physiotherapy are important. Mechanical ventilation is rarely available in resource poor countries to treat total paralysis. Drugs are needed to reducing the muscle spasms and rigidity, antibiotics to kill the bacteria and tetanus immunoglobulin to remove the toxins in the body. Diazepam has anticonvulsant, muscle relaxant, sedative and anxiety reducing effects. Diazepam treatment was associated with fewer deaths than was treatment with a combination of phenobarbitone and chlorpromazine. Combination treatments with diazepam did not give any further benefit (and may cause harm). The review authors searched the medical literature and identified two randomised controlled trials with a total of 134 hospitalized neonates and older children who had tetanus from Nigeria (19 neonates, seven children aged between one month and 10 years of age) and Indonesia (74 neonates, 34 children aged between three days and 12 years). All drugs were given orally as medications and feeds are usually given via nasogastric tube in the settings where the disease burden is high. Neither study provided information on the safety of the interventions or followed up survivors beyond discharge from hospital.

Valerian for anxiety disorders

Anxiety disorders are a very common mental health problem in the community. Most of the medications used to treat anxiety have side effects. Valerian is a phytotherapeutic medication frequently used for insomnia. The aim of this study was to investigate the efficacy and safety of valerian for anxiety disorders. Only one study was identified, involving 36 patients and comparing valerian with placebo and diazepam. This study found no significant differences in effectiveness between valerian and placebo, or between valerian and diazepam, for clinician‐rated anxiety symptoms, and that both valerian and diazepam were equally well tolerated by patients. However, additional studies with larger numbers of patients are necessary before drawing conclusions about the effectiveness and safety of valerian as a treatment option for anxiety disorders.

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