Diazepam: Effects, Uses & Risks

Diazepam is a psychotropic drug belonging to the group of tranquillizers. It is primarily used to treat anxiety and epilepsy. Diazepam is a benzodiazepine that has become known by the trade name Valium.

What is diazepam?

Diazepam is a psychotropic drug in the tranquilizer group. It is primarily used to treat anxiety and epilepsy. As a psychotropic drug, diazepam belongs to the group of drugs that affect the human psyche. Psychopharmaceuticals can be subdivided into various substance groups. These include neuroleptics, antidepressants, psychostimulants and tranquillizers. Tranquillants (from the Latin tranquillare = to calm, also known as tranquilizers) are substances that – unlike neuroleptics – have a calming effect without having an antipsychotic effect. They have an anxiety-relieving effect and provide mental balance without affecting mental performance too much. Tranquilizers make you tired and relax the muscles. Tranquillizers can also be further divided into groups: The largest and most important of these groups are the so-called benzodiazepines. However, benzodiazepines, which include diazepam, are used not only as tranquillizers but also as antiepileptic drugs, i.e., drugs to treat epilepsy.

Pharmacologic action

Diazepam exerts its effects in the human nervous system. The part of the brain responsible for generating emotions (such as fear) and our drive behavior is called the limbic system. Every form of stimulus within the nervous system – and therefore also in the brain – is transmitted by nerve impulses. In order for these stimuli to be transmitted from one nerve cell to the next, messenger substances – known as neurotransmitters – are required. They are released from the excited nerve cell, thus crossing cell boundaries and transmitting the information to the next cell. One such messenger is gamma-aminobutyric acid (GABA). Benzodiazepines reduce the number of transmitted impulses in the limbic system by inhibiting the release of GABA. The suppression of the conduction of arousal states results in the anticonvulsant and antianxiety effects of diazepam and other benzodiazepines.

Medical use and application

Diazepam is available under various trade names: Valium, Faustan, Lamra, Tranquase, Valiquid, Diazepam Stada, Diazepam-ratiopharm, and many others. There are different forms of administration for treatment with diazepam: The drug can be administered intravenously or rectally. When administered intravenously, the effect occurs rapidly, i.e. within one to two minutes. When administered into the rectum, the onset of action may be delayed; in both cases, significant effects are perceptible after ten minutes at the latest. Both the duration and intensity of the effect are dose-dependent. In clinical medicine, diazepam is mainly used for a limited time to treat states of tension and anxiety and in epilepsy. In emergency medicine, diazepam is used primarily for severe states of agitation, anxiety and panic attacks, seizures, severely increased muscle tone, and analgesia (simultaneous administration of sedatives and analgesics) of ventilated patients. The administration of diazepam for seizures is not without controversy and is now rarely practiced because of the high risk of injury to the patient when administering the medication. Diazepam may be administered preventively as a sedative before stressful situations. Because repeated administration rapidly increases the risk of dependence and the body quickly develops a tolerance to the drug, many physicians consider the administration of diazepam to be contraindicated in such cases.

Risks and side effects

Diazepam has a variety of side effects: In addition to drowsiness and dizziness, the muscle-relaxing effect can cause slowing of breathing. Nausea to vomiting may also occur. Occasionally, a slight drop in blood pressure can be observed. During pregnancy, in case of kidney and liver damage and after having already taken alcohol, painkillers and sleeping pills, diazepam should urgently not be administered!Benzodiazepines – like all other tranquilizers – can intensify the effects of painkillers, alcohol and other psychostimulants. Occasionally – especially in elderly patients – a so-called paradoxical mode of action is observed, i.e. the symptoms are not attenuated but intensified. In extreme cases, the effect of diazepam can be antidosed by administration of flumazenil.