DESCRIPTION
Diazepam, which is a benzodiazepine-type drug, induces a calming effect of the central nervous system (CNS). It possesses anti-anxiety, anticonvulsant, sedative, and skeletal muscle relaxant properties. It is closely related to clonazepam. Valium is prescribed for anxiety-related disorders and alcohol withdrawal. Common side effects of diazepam include drowsiness and fatigue; dependence and withdrawal upon abrupt discontinuation are possible. Any unusual side effects such as behavior problems, convulsions, hallucinations, anger, confusion, mental depression, and difficulty concentrating should be discussed with a doctor. Diazepam has the potential to magnify effects of alcohol and other CNS depressants (antihistamines, sleep aids, pain drugs, muscle relaxants, and anticonvulsants).

ORIGINAL USES (ON-LABEL)
Anxiety disorders, ethanol withdrawal symptoms, skeletal muscle relaxant, treatment of convulsive disorders, management of selected therapy-resistant epilepsy patients on stable regimens of antiepileptic drugs requiring intermittent use of diazepam to control episodes.

NEWLY DISCOVERED USES (OFF-LABEL)
Acute schizophrenia, labyrinthitis, Meniere's disease, multiple sclerosis, oculogyric crisis, tetanus

POTENTIAL SIDE EFFECTS
Drowsiness, amnesia, slurred speech, rash, changes in libido, changes in salivation, constipation, nausea, incontinence, urinary retention, pain with injection, tremor, blurred vision, changes in vision, double vision, decrease in respiratory rate.

CAUTIONS
  • Notify your doctor if you have narrow angle glaucoma, liver or kidney impairment, lung disease, depression, a history of drug dependence, or if you are over 65 years old or are pregnant.
  • May increase the frequency of grand mal seizures.
  • Associated with anterograde amnesia and paradoxical reactions.
DRUG INTERACTIONS
Diazepam potentiates the central nervous depressant effects of narcotic analgesics, barbiturates, phenothiazines, ethanol, antihistamines, MAO inhibitors, sedative-hypnotics, and cyclic antidepressants. Clarithromycin, carbamazepine, cimetidine, ciprofloxacin, clozapine, delavirdine, disulfiram, erythromycin, ethanol, fluconazole, fluoxetine, fluvoxamine, isoniazid, itraconazole, ketoconazole, levodopa, metoprolol, omeprazole, phenytoin, quinolones, rifampin, troleandomycin.

FOOD INTERACTIONS
Grapefruit juice. May be taken with food if stomach upset occurs.

HERBAL INTERACTIONS
St. John's wort, valerian, kava kava, gotu kola

PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category D. Excreted into the breast milk. Refrain from breast-feeding while taking this drug.

SPECIAL INFORMATION
May cause drowsiness; avoid driving or other tasks that require being alert. Avoid alcohol.

In Multiple Sclerosis (MS), diazepam is used primarily for the relief of muscle spasm, stiffness, difficulty walking, and muscle spasticity. Along with other drugs, it can contribute to sexual dysfunctions including decreased libido, erectile problems, and abnormal ejaculation. Although scientific data are limited on the use of benzodiazepines in Multiple Sclerosis, diazepam is also used for tremors. Patients with MS may experience spasticity (uncontrolled contraction or squeezing) of the bladder, which involves discomfort and pain. Valium also has been used to treat these contractions due to its sedating properties. It may be difficult to distinguish between symptoms associated with Multiple Sclerosis and some side effects of diazepam; therefore, patients have regular appointments with their doctor to communicate any concerns.

If you tend to have low blood pressure, diazepam can aggravate it, and Valium should not be given if you have glaucoma. In oculogyric crisis, diazepam can be given as an intravenous infusion or an intramuscular injection, according to the Canadian Movement Disorder Group. It is also available in oral form for maintenance treatment.

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