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Diazepam

This is how diazepam works

Diazepam influences the nerve cells in the brain stem and the limbic system, a functional unit of the brain that is essentially responsible for a person's wellbeing. The active ingredient increases the inhibitory effect of a transmitter substance and thereby reduces the excitability of the cells. The electrical activity of the brain in these areas is reduced.

The inhibitory effect in the area of ​​the nerve cells in the brain stem has a muscle-relaxing, calming and sleep-promoting effect. The dampening of the limbic system reduces the influence of external and internal stimuli and their processing and creates a distance to external and internal experiences. Hence the diazepam effects of reducing anxiety and tension and providing emotional calming. At the same time, mental impairments have less of an impact on the autonomic nervous system, which controls vital functions such as heartbeat, blood pressure, breathing and digestion.

Diazepam uptake, breakdown and excretion

Diazepam, which is taken up by mouth, is well absorbed into the blood through the gastrointestinal tract, with which it reaches the brain and quickly takes effect. The active ingredient is broken down in the liver. This creates degradation products that are also effective and are slowly excreted in the urine. To ensure that the active ingredient does not accumulate in the body, the dosage prescribed by the doctor must be adhered to.

When is diazepam used?

The areas of application (indications) of diazepam are:

  • States of tension, excitement and anxiety
  • insomnia
  • increased muscle tension

This is how diazepam is used

Diazepam tablets and drops are taken with a glass of water either before a meal or some time after. Diazepam suppositories are inserted into the anus.

The doctor determines the diazepam dosage and duration of use individually. In principle, the dose should be kept as low and the duration of treatment as short as possible. Diazepam should usually not be used for more than four weeks.

It is taken in the evening half an hour before going to bed. The drug should not be taken on a full stomach, otherwise the onset of action will be delayed. In addition, diazepam side effects such as tiredness and poor concentration the next morning can be avoided.

To end the treatment after prolonged use (more than two weeks), the drug should not be stopped abruptly, but the dosage should be gradually reduced after consultation with the doctor ("tapering").

What are the side effects of diazepam?

Diazepam side effects are dose-dependent and occur primarily at the beginning of treatment. The most important adverse effects include daytime sleepiness and drowsiness with impaired alertness and the ability to react. Other possible side effects include drowsiness, dizziness, confusion, gait and movement disorders, headaches and temporary memory lapses. This is especially true in older patients

In patients with a pre-existing depressive illness, diazepam can aggravate depressive moods. Sensory disturbances and a reversal of the diazepam effects are also possible. A reversal of the effects manifests itself in short-term states of excitement, fear, sleep disorders, fits of anger, muscle cramps and an increased tendency to suicide.

With prolonged or repeated use of diazepam, there may be a decrease in the effect. If high doses are taken for a long time, temporary disturbances such as slow or slurred speech, visual disturbances as well as movement and gait insecurity are possible.

What should be considered when using diazepam?

Benzodiazepines such as diazepam must not be used in the case of known hypersensitivity to this group of active ingredients and also not in the case of severe pathological muscle weakness (myasthenia gravis). In certain other cases, use is only recommended if absolutely necessary and after careful risk-benefit assessment, for example in the case of acute poisoning with alcohol or other central depressant substances, severe liver damage, severe respiratory failure and narrow-angle glaucoma (a form of glaucoma).

Diazepam withdrawal symptoms

Prolonged use of diazepam can lead to emotional and physical dependence. When the therapy is ended, withdrawal symptoms such as sleep disorders, increased dreaming, states of fear and tension as well as inner restlessness can occur. To avoid withdrawal symptoms, the dose should be gradually reduced when the patient is discontinued.

A required dose increase can be a sign of addiction. The drug should then be discontinued.

pregnancy and breast feeding period

If possible, diazepam should not be used during pregnancy. Patients who want to become pregnant or who suspect a pregnancy should inform their doctor immediately so that he can decide whether to stop or continue therapy.

Interactions

Grapefruit juice increases the absorption of diazepam in the intestine and reduces its breakdown.

Under no circumstances should Diazepam be taken with alcohol, as this can alter and intensify the effects of the medication in an unpredictable way.

Simultaneous use of diazepam and other central depressant drugs (such as sleeping pills, some pain relievers, anesthetics, etc.) increases the drowsy and respiratory depressant effect.

The effect of drugs that reduce muscle tension (muscle relaxants) can be increased by diazepam. The breakdown of diazepam can be accelerated by phenobarbital and phenytoin (agents for epilepsy), which shortens its duration of action.

Interactions are also possible with other drugs, for example with certain antibiotics, antidepressants and beta blockers (cardiovascular drugs). In general, therefore, the following applies: Without consulting a doctor, no other medication besides diazepam should be taken, including over-the-counter preparations.

How to get drugs with the active ingredient diazepam

Preparations with diazepam require a prescription, i.e. only available with a prescription in pharmacies.

How long has diazepam been known?

Diazepam was developed by the pharmacist and chemist Leo Henry Sternbach in New Jersey when he was researching the chemical group of benzodiazepines. Before that, he had already succeeded in 1957 in producing substances in his laboratory that turned out to be highly effective drugs for calming down. Diazepam was first brought onto the market in 1963 by Hoffmann-La Roche.

What else you should know about diazepam

The calming and sleep-promoting effect also reduces the ability to concentrate and react in the morning after taking it in the evening. The muscle-relaxing effect can also lead to limited muscle function. As a result, your ability to drive and work with machines may be impaired during treatment with diazepam.

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