Diazepam, first marketed as the brand Valium, is a benzodiazepine. This is a class of psychoactive therapeutics which influence the brain activity through an interaction with gamma-aminobutyric acid (GABA).
Many patients using this medication often ask the question, how does diazepam work? And even though there is much known about this class of therapeutics, the exact mechanism of action of benzodiazepines is not well elucidated. It is known though that the GABA receptors are essentially ion channels that are activated by the main neurotransmitter of the central nervous system (CNS), GABA.
The therapeutic action of this class of medicines binds to these receptors so as to promote the binding of GABA as well. This subsequently increases the flow of chloride ions across the cell membrane and in turn, activates the receptors.
The overall effect is an enhanced functioning of GABA, in which the chemical messages, transmitted through nerve cells, are blocked or inhibited and hence, certain brain signals are also inhibited. There is a depression of the CNS which ultimately occurs through the above mentioned process, resulting in calm and relaxing thoughts, relaxed muscles and an overall state of conditions conducive to sleep.
By making one feel relaxed and calm, mental health conditions, such as anxiety and panic disorders, can be effectively managed; and sleep difficulties can be treated as well.
Does Diazepam Work Only For Sleep Issues?
Although the main function of these tablets are for the treatment of insomnia. There are other FDA-approved and non-FDA approved uses as well, and these include:
- Seizures: Intravenous formulations of this medicine are first-line treatments of status epilepticus, which is a condition characterised by a single seizure lasting more than five minutes, or multiple seizures which occur for longer than five minutes without a break in duration. This therapeutic is also used for the prevention of febrile seizures (seizures occurring in children due to high fevers), in children under the age of five years. Evidence shows that the gel form of this medicament was able to reduce the risk of non-cessation of seizures.
- Eclampsia: This is a severe condition of pre-clampsia, which is high blood pressure during pregnancy. Eclampsia is the onset of seizures as a result of high blood pressure. This medication is used as an emergency treatment of eclampsia, especially in cases where blood pressure control measures and intravenous magnesium sulphate have failed.
- Alcohol withdrawal: Alcohol withdrawal symptoms occur when one stops drinking alcohol after using it for a long time. Benzodiazepines are normally used for the management of these symptoms, but Valium is the most preferred medication for this purpose because of its relatively long duration of action, as well as its safety and efficacy in treating alcohol withdrawal symptoms.
Does Diazepam Work For Everyone?
The standard uses of this medication are intended for those over the age of 18 years, but diazepam may also be used for children for the management of epileptic seizures. The management of febrile seizures is one of the medical uses of this therapeutic and these are geared toward children over the age of five years. For children of this age, the syrup form of the medicine is most appropriate.
For those who wonder does diazepam work for minors, the answer is, yes. This medication may be used for children over the age of one month, for the relaxation of muscle spasms. When used as a muscle relaxant for children as young as one month, the rectal tubes can be administered.
Older individuals are cautioned against the use of this medication, especially in high dosages. The risk of accidental falls and other injuries are greater for seniors when using these tablets, than for younger adults.
This therapeutic should also be used with caution in patients with severe hepatic or renal dysfunction. Impairments to the liver or kidneys can prolong the elimination of the medicine from the body, resulting in untoward effects.
How to Take Diazepam
There are different formulations of this medication and the route of administration depends on the form you are using:
- Tablets: These are taken by mouth. Swallow the pills with a glass of water and without altering the form of the tablet. That means that the medication should be swallowed intact and without breaking or crushing the pill.
- Nasal spray: This is to be spray directly into the nose, one nostril at a time. When spraying into one nostril, you should press down on the other nostril. You should not prime or push the nasal pump until you are ready to spray. The prescribed dosages of this form depend on the weight of the patient.
- Intravenous injections: These are administered directly into a vein or muscle by way of injecting the liquid medicament. This is the fastest acting formulation and should be used in situations where rapid relief is required, for example the treatment of epileptic seizures. Intravenous injections are also typically used as pre-medication.
- Rectal tubes or gels: This formulation is generally used for children as they work quickly for the relief of symptoms. These are inserted directly into the rectum.
How Long Does Diazepam Take To Work?
The onset of therapeutic action of diazepam depends on the formulation you are using. The fastest acting form of this medication is an intravenous injection. This is because the active ingredient is injected directly into a muscle or vein and does not have to go through the digestive system to be released into the bloodstream.
The rectal tubes are also a rapidly acting formulation, unlike the conventional tablet form which has to enter the stomach and be passed through the digestive system to be metabolised and broken down, to release the active ingredient for absorption into the bloodstream.
The time it takes a medication to work can depend on many factors, from the body weight of the patient to their age and medical history. Generally, the therapeutic action will be observed much quicker in those with lower body weights, like children, than those who are typically heavier.
Age is another factor affecting the onset of action. Younger children normally do not have much experience with using medications and hence, the therapeutic action may occur more rapidly in these patients.
The dosage, and onset and duration of therapeutic action are factors which are individualised for each patient.