Drug

Diazepam

introduction

Diazepam is a drug that is sold in pharmacies, for example, under the trade name Valium®. The drug belongs to the group of long-acting benzodiazepines (it has a comparatively long half-life) and is used in many different ways as a psychotropic drug.

Diazepam is used to treat anxiety, as a sleep aid and / or in epilepsy therapy. The greatest danger of using diazepam is developing addiction. For this reason, it is prescribed primarily for acute therapy and less for long-term treatment.

Mechanism of action

The drug Diazepam mediates its effect via the modulation of GABA- (gamma-aminobutyric acid) Receptors in the Spinal cord. After binding to a so-called Benzodiazepine binding site of the GABA receptor, Diazepam causes a structural change in the receptor and thus ensures it increased sensitivity compared to gamma-aminobutyric acid.

In this way, the opening probability of the receptor-associated chloride channel increases, it follows increased influx of chloride ions. The increase in the intracellular (in the cell) chloride concentration in turn leads to hyperpolarization of the cell. Simply put, this means that the cell is responsible for external stimuli less sensitive is.

Effect of diazepam

The effect of diazepam is contained in the drug known as Valium®, among other things. Diazepam belongs to the group of long-acting benzodiazepines, which have a comparatively long half-life, and is used in many ways as a psychotropic drug.

application areas

Diazepam is used to treat Anxiety, as Sleeping pills and / or in the Epilepsy therapy applied.One of the most serious side effects that can occur while using diazepam is Developing a dependency (height Addictive). Therefore will Valium® and / or other drugs containing diazepam are usually only prescribed for acute therapy and less for long-term treatment.

As a sleep aid: The effect of diazepam from a non-pharmacological point of view can be divided into different categories. The active ingredient primarily conveys one sedative (sleep-inducing, calming) Effect that is achieved by inhibiting specific regions within the Brain (more precisely: des Brain stem) is conveyed (Limbic system and Formatio reticularis). However, the sedative effect of diazepam is relatively small, as it has no narcotic effects.

As a sedative: In addition, the effects of the diazepam include a relieving effect on anxiety and Panic attacks (Anxiolysis). This effect is also via the inhibition of various specific structures in the Brain stem conveyed.
Furthermore, the effects of diazepam include one on the Relaxing muscles effective part. This effect is achieved by intervening in the natural processes of the brain stem and its interaction with the Spinal cord conveyed. In view of this effect of Valium® and other drugs containing diazepam, one recommends one to patients Take just before bed. The medication should only be taken when the patient no longer has to get up because of the relaxation of the muscles especially with older people a great danger to Bone bsmells consists.

Against epilepsy: Also on the development of Convulsions and / or spread of seizures in the brain, does diazepam have an influence (Anticonvulsion). The effect of diazepam in this area is based on one Stimulation of inhibitory nerve cells.

Indications / contraindications

Diazepam is mainly used for Treatment of mental tension and Anxiety applied. In addition, diazepam is considered Standard drug in preoperative medication. This means that this drug is given orally to patients a short time before surgery and one strong calming influence exercises.

In emergency therapy, Diazepam is often used to supply patients with acute epileptic seizures administered. Due to its reliable effect, diazepam has become an indispensable part of the pharmaceutical market, but certain counter-signs must be ruled out before taking it.

severe breathing difficulties (for example Sleep apnea syndrome)
Liver disease and / or Muscle weakness
Allergies to the active ingredient diazepam
Drug, drug and / or alcohol addiction

This fact is due to the fact that Diazepam in prolonged use for addiction can lead. This danger does not only exist in the case of improper use, but also in the case of regular use of the preparation. Diazepam should never stopped suddenly otherwise there is a risk that the treated patient will undergo Withdrawal symptoms Suffer.

Dosage of diazepam

The dosage of diazepam depends on the indications. For anxiety disorders treated on an outpatient basis, the administration is usually 2.5 to 10 mg. For inpatient treatment of anxiety, up to 60 mg per day can be given orally.
In anxious states of excitement, 10 mg orally, intravenously or intramuscularly is recommended, repeated once or twice at intervals of 30 minutes. A dose of more than 40 mg within the first 24 hours is only advisable in exceptional cases. In older patients, treatment with diazepam is gradual.
For alcohol withdrawal syndrome, 10 mg 3-4 times per day and then 5 mg 3-4 times per day are recommended on the 1st day. In some cases the daily dose can be significantly higher. If you have trouble falling asleep, 5 to 20 mg are usually given in the evening.
For acute seizures called epileptic seizures, 10 mg is given intravenously. If this does not work, other drugs are used in these acute situations, such as phenytoin, rhenobarbital or valproate.

Side effects

The most common side effect of diazepam is manifested after the too rapid withdrawal of the drug.

Strength Withdrawal symptomsthat take the form of Anxiety, Hallucinations, Seizures and express irritation.
Fatigue, drowsiness and sleepiness (because of the strong sedative effect)
partly strong a headache
extended response time up to temporary Memory loss
Speech disorders, unsteady gait, muscle cramps and sleep disorders

Also the appearance of so-called paradoxical side effects, i.e. abnormalities that should actually be suppressed by taking diazepam, are not uncommon. Some patients report of sudden onset of anxiety and outbursts of anger.

In addition, diazepam can irritate the gastrointestinal tract, it can too Dry mouth, stomach pain and or Diarrhea come. An overdose of the active ingredient usually occurs Dizziness and temporary memory loss on. With some sufferers can Speech disorders (for example lisp) and enormous incoordination observe.

Since diazepam has an inhibitory effect on muscle tone, it can lead to excessive overdose Decreased breathing and in the worst case, stop breathing.

Diazepam and alcohol - are they compatible?

If diazepam and alcohol are consumed together, it can have fatal consequences. Alcohol increases the side effects of diazepam in unpredictable ways. Therefore, alcohol consumption should be avoided when taking diazepam.

Withdrawal from diazepam

Diazepam addiction is fundamentally different from other addictions. Withdrawal is accordingly characterized by a few special features.
Usually the dose of diazepam is in the therapeutic range. This means that the patients mostly did not increase the dose themselves. Therefore, it is often a so-called low-dose dependency. This usually does not exceed 20 mg per day.
In order to achieve a successful withdrawal treatment, it is essential to sensitize the persons concerned to the dangers of taking diazepam continuously. A lot of sensitivity on the part of the doctor is required here.
Withdrawal should be done with a trusted doctor. Diazepam should never be stopped suddenly. The dosage is usually done in 2.5 - 5 mg steps. Because it is easy to divide, the dose can be administered throughout the day. This gives a constant effective level and can thus minimize withdrawal symptoms. A withdrawal period of 3 to 5 weeks is recommended for inpatient treatment. If the withdrawal is carried out on an outpatient basis, a period of 2 - 4 months can be beneficial. Withdrawal should not take place too slowly, however, as the patient's patience and perseverance may be demanded too much.
Common withdrawal symptoms are sleep disorders, anxiety, mood swings, mood swings, muscle aches, muscle twitching, tremors, headaches, nausea and loss of appetite.