Diazepam: Effects, Dosage, Side Effects

Anxiety, restlessness, and sleep disturbances can occur in many mental illnesses and in acute situations of stress. The active ingredient diazepam is used as a sedative for short-term relief of these symptoms. Side effects of diazepam are usually rare and depend on the dosage.

Diazepam not available without a prescription

The active ingredient diazepam belongs to the benzodiazepine group. Benzodiazepines are a class of anxiety-relieving (anxiolytics) and sleep-inducing (hypnotics) medications that have been on the market since about the mid-1950s. Diazepam has antianxiety, sedative, and anticonvulsant effects. Diazepam is known to laypersons primarily as Valium. Other drugs containing the active ingredient diazepam are, for example, Faustan, Valocordin diazepam, Stesolid or Valiquid. Diazepam is available in the form of tablets, suppositories or drops. In acute emergency situations, diazepam is also injected. It is an active ingredient that is available in pharmacies and on prescription in Germany. Obtaining diazepam without a prescription is therefore not legal.

Diazepam: effect and use

Diazepam enhances the effect of an inhibitory neurotransmitter in the brain (gamma-amino-butyric acid; GABA for short), which reduces the activity of nerve cells in the central nervous system. As a result, diazepam achieves an antianxiety, anticonvulsant, sedative, and sleep-inducing effect that occurs relatively quickly after ingestion. Doctors prescribe diazepam to treat acute states of anxiety and tension and as a sleep aid. In psychiatry, diazepam is prescribed primarily for anxiety and panic disorders. However, it is also used in the treatment of heightened states of agitation. These states can occur in some other psychiatric disorders, such as schizophrenia or bipolar disorder. In neurology, diazepam is a valuable drug for treating epileptic seizures because of its anticonvulsant effects. Because of its sedative and relaxing properties, diazepam is also administered before surgery or extensive examinations.

Dosage of diazepam

Diazepam should always be dosed as directed by your doctor. Determination of the correct dose depends on age, weight, individual response status, and type and severity of illness. In general, dosage and duration of use should always be kept as low as possible. Usually, the dosage is 3 to 5 milligrams per day initially and can be gradually increased by the physician up to 10 milligrams. In certain cases, the doctor may prescribe a larger amount. Discontinuation should always be gradual (known as tapering).

Side effects of diazepam

Overall, diazepam has rather minor side effects and is usually well tolerated. However, because of these rather minor side effects, it also carries an increased potential for dependence. Side effects of diazepam, especially at higher doses, may include marked drowsiness and daytime sleepiness, impaired attention, and poor concentration. These side effects may reduce the ability to actively participate in road traffic. In the elderly and at high doses, muscle flaccidity and movement disorders (ataxias) may also occur, which significantly increases the risk of falls in the elderly. Occasionally, a paradoxical effect may also occur in the elderly: Instead of a sedative effect, diazepam then leads to increased drive and increased restlessness.

Drug interactions and contraindications

The combination of diazepam and alcohol increases the side effects mentioned above. Therefore, it is essential to avoid consumption of alcohol when taking diazepam. Diazepam should also not be taken during pregnancy. In addition, it may interact with other medications: The effect of other drugs that act on the central nervous system (CNS) (for example, neuroleptics, antidepressants) is enhanced by diazepam. Other examples of drugs that can cause interactions with diazepam are omeprazole or sedating antihistamines. Diazepam is also not suitable in cases of previous medication, alcohol or drug abuse, severe liver failure, myasthenia gravis (a nerve disease resulting in severe muscle weakness) or sleep apnea syndrome, among others. For more information on drug interactions and contraindications, please consult your attending physician or ask at the pharmacy.

Instructions for taking diazepam

When taking diazepam, it is important to keep the following points in mind:

  • Diazepam does not treat the causes of anxiety, only the symptoms. It does not replace treatment for possible underlying mental health conditions.
  • Diazepam should not be taken for longer than four to six weeks. Taking it beyond this period should only be done in consultation with the attending physician.
  • With prolonged use, there is a risk of tolerance development, that is, to achieve a consistent effect over time, a steadily increasing dosage is needed.
  • When discontinuing diazepam, psychological and physical withdrawal symptoms may occur, such as tremors, sweating, nausea, restlessness, increased anxiety and insomnia.
  • In addition, rebound effects may occur when diazepam is discontinued, meaning that the original symptoms occur more strongly than before.