How Effective Is Diazepam for Epilepsy?

Diazepam is a medication in the benzodiazepine family, which is used to prevent seizures and convulsions occurring from epilepsy, among other medical purposes. Most benzodiazepines could be used to treat this condition, but diazepam for epilepsy is often the first choice of many medical professionals. It remains one of the most effective epilepsy treatments for many individuals, although some circumstances may necessitate the use of other medications.

Clinically, most doctors use diazepam for epilepsy as a first-line treatment after diagnosis. Various studies have estimated its efficacy in preventing seizures among these individuals as ranging from 38 to 83 percent. It may be prescribed orally as a preventative measure, but some doctors only recommend using it intravenously (IV) during a seizure. Most seizures can be controlled with a dose of 10 milligrams (mg) via IV over a few minutes, and repeating the process if the convulsions do not stop.

The condition known as status epilepticus involves lengthy seizures that may last for 30 minutes or more. Taking diazepam for epilepsy of this type has been shown to be effective, with IV or rectal diazepam being used to control these seizures. Diazepam has a short half-life, being metabolized and cleared from the body in a matter of hours after use, so often, it is not the only medication given for episodes of this type of epilepsy.

Smaller doses of diazepam to control the immediate seizure are often given alongside a longer-acting benzodiazepine, or other anticonvulsant, to prevent the individual from slipping back into a seizure during status epilepticus. Other limits to diazepam for epilepsy include the fact that repeated doses of this drug can create a risk of coma, because this medication breaks down into other compounds with longer half-lives. A continuous IV preparation of diazepam could also potentially be used, but is often avoided because continuous use could lead to tolerance that forms rapidly, making the drug less effective.

Using diazepam for epilepsy is not generally done for long periods of time. After about six months, tolerance develops to this drug, so it is often only prescribed for a period of a few weeks until a long-term management medication can be found that is effective for the patient. Some doctors have begun avoiding diazepam for first-line epilepsy management in favor of a similar drug, lorazepam. Lorazepam has been shown to be slightly more effective at preventing and treating seizures, and remains effecctive for longer periods of time.