Effectiveness Of Diazepam Research Articles

Oral Diazepam versus Midazolam in controlling children's negative behaviour during dental treatment: a critical review of clinical trials

The present study aims to Critically review and summarise about the literature on the effectiveness of Diazepam compared to Midazolam in controlling children's negative behaviour during dental care. This is a critical review of the literature. The PICO strategy was adopted for this review: Population (children with negative behaviour during dental care), Intervention (Diazepam), Comparator (Midazolam), Outcome (Effectiveness in controlling anxiety associated with negative behaviour). Randomised Clinical Trials (RCTs) were included using the descriptors "Diazepam", "Midazolam" and "Dental Care" combined or not, in the Medline (via PubMed), Scopus, Web of Science, Cochrane and Embase databases. 270 articles were found, of which 6 were selected for full reading. Of these, 5 were excluded because they assessed populations that fell outside the eligibility criteria of this review. Therefore, only 1 RCT was assessed in terms of level of evidence and risk of bias. According to its study design, it was a triple-blind RCT, with a sample size of 40 children aged between 2 and 10 years, which assessed the effectiveness of oral Midazolam, oral Diazepam, intravenous Midazolam and an oral placebo. Of the four groups, intravenous Midazolam produced greater sedation and was more acceptable to patients. However, the study was classified as level III evidence, with a high risk of bias. Midazolam seems to produce greater control of children's negative behaviour during dental procedures when compared to diazepam.

Effectiveness of Atropine Sulfate and Diazepam in Organophosphate Poisoning in Remote Area: A Case Report

Effectiveness of Atropine Sulfate and Diazepam in Organophosphate Poisoning in Remote Area: A Case Report

Therapy of Catatonia in Schizophrenia and Schizophrenia Spectrum Disorders

Background: the study of catatonia’s treatment methods is one of the most important researchers’ tasks, nevertheless the common therapeutic strategies of cupping the catatonic phenomena haven’t been created yet. The aim: review to therapeutic interventions for catatonic disorders in schizophrenia.Materials and methods: according to the keywords “catatonia treatment”, “catatonia therapy”, publications found in the Scopus, PubMed, Cochrane Library, eLibrary databases were selected and analyzed.Results: historical background, illustrating the development of catatonia treatment methods, is given; the results of the last decades scientific studies of catatonia’s treatment and preliminary results of own study, devoted to the effectiveness of diazepam and cariprazine in relieving catatonia manifestations are presented. Based on the studies’ results, presented in the review, it can be concluded that the most common modern method of treating catatonic disorders is the use of benzodiazepines, however, in some cases, the use of antipsychotics is also advisable. Electroconvulsive therapy (ECT) remains an important treatment for catatonic phenomena. There are also isolated clinical cases of successful testing of both: other pharmacological groups (antidepressants, dopaminergic and anticholinergic drugs, normothymic drugs, etc.) and non-drug interventions (transcranial magnetic stimulation — TMS) presented in modern research data.Conclusion: the effectiveness of benzodiazepines in catatonia, associated with schizophrenia and schizophrenia spectrum disorders (SSD), remains controversial according to modern authors’ opinion. In turn, among antipsychotics, antipsychotics of the second and third generation seem to be safe for the treatment of psychomotor symptoms. In accordance with the results of our own study, catatonia in the structure of schizophrenia and SSD is heterogeneous and, depending on the psychopathological structure of catatonic disorders, a different reaction of psychomotor symptoms to therapeutic intervention was observed.

Intravenous promethazine vs. diazepam to reduce symptoms of peripheral vertigo in emergency section: a double blind clinical trial

The present research aimed to compare the effectiveness of promethazine and diazepam in patients suffering from acute peripheral vertigo. This is a double blind clinical trial with a sample of 154 patients visiting the emergency section of Shahid Mohammadi Hospital in Bandar Abbas in 2017-18. The participants were randomly divided into two groups of 77, one treated with intravenous promethazine (50 mg) and the other with intravenous Diazepam (10 mg). The severity of vertigo was measured qualitatively and quantitatively 20 minutes later in both groups. Participants were 46 (29.9%) male and 108 (70.1%) female visiting the emergency section of hospital. The mean score of vertigo severity in Promethazine group was 44.44±17.94 and that of Diazepam group was 2.49±+3.87. The severity scores before and after the treatment in promethazine group were respectively 7.75±1.59 and 2.72±1.93. The mean scores of vertigo severity before and after the treatment in promethazine group was -5.04+2.10 and in the diazepam group it was -3.83+3.09. The intergroup difference was statistically significant (p=.013). The results revealed that intravenous promethazine and diazepam applied 20 minutes after prescription are both effective in controlling the severity of vertigo. Considering the probability of occurrence of extrapyramidal side-effects it can be suggested that the infusion of this medication be done slowly and take longer time. Meanwhile, vital signs should be precisely controlled.

Comparison of Effectiveness and Side Effects of Diazepam versus Midazolam Administration for Conscious Sedation in Patients Who Underwent Cataract Surgery

Background: The purpose of this study was to compare the effectiveness and side effects of diazepam and midazolam administration for conscious sedation in subjects who undergoing cataract surgery. Methods: A total of 79 patients undergoing cataract surgery under topical anesthesia with conscious sedation were prospectively reviewed. Our subjects were randomly divided to two groups. The first group comprised of 38 cases receiving 0.05 mg/kg diazepam slow intravenously (diazepam group) and the second group comprised of 41 cases receiving 0.01 mg/kg midazolam intravenously (midazolam group). Intraoperative variables such as systolic and diastolic arterial pressure, heart rate, respiratory rate and blood oxygen saturation were recorded immediately before sedation, 5, 10 and 15 minutes after diazepam or midazolam administration. All patients were contacted 24 hours after the operation for any early postoperative complications. Results: The variability of systolic and diastolic blood pressure at 5, 10 and 15 minutes after sedation were statistically significantly higher in midazolam group compared to diazepam group. Six patients developed episodes of apnea during operation, two patients in diazepam and four patients in midazolam group. The surgeons’ satisfaction was more in diazepam group but not statistically significant. Need for additional dose of benzodiazepine was more in the midazolam group. Drowsiness and functional impairment during 24 hours after surgery were not significantly different between the two groups. Conclusion: Diazepam produces better perioperative hemodynamic profile, level of sedation and surgeon’s satisfaction and less occurrence of apnea compared to midazolam group in patients who underwent cataract surgery.

Vaginal diazepam plus transcutaneous electrical nerve stimulation to treat vestibulodynia: A randomized controlled trial

ObjectiveTo assess the effectiveness of vaginal diazepam in addition to transcutaneous electrical nerve stimulation (TENS) in the treatment of vestibulodynia (VBD). Study DesignThis study was a randomized, double-blind, placebo-controlled trial. Forty-two patients with VBD were randomized, 21 underwent diazepam and TENS (diazepam group) and 21 received placebo and TENS (placebo group). Vulvar pain was assessed on a on a 10-cm visual analogue scale (VAS) and dyspareunia according to the Marinoff dyspareunia scale. Vaginal surface electromyography (EMG) and vestibular current perception threshold (CPT) testing were performed at baseline and 60 days after treatment. The primary endpoints included the change in pain and dyspareunia from baseline to 60 days of pain and dyspareunia. The secondary endpoints was the variation in objectivity of pelvic floor muscle (PFM) function and vestibular nerve fiber current perception threshold (CPT). ResultsThe VAS scores for pain from basal values of 7.5 and 7.2 for the diazepam and placebo, respectively, showed significant (p 0.01) decreases from 4.7 to 4.3, but this difference was not statistically significant. The Marinoff dyspareunia scores in the diazepam group showed a significant difference (p 0.05) from values measured in the placebo group. The ability to relax the PFM after contraction (difference between maximal contraction and rest tone) was significantly greater for the diazepam group versus the placebo group (3.8 μv and 2.4 μv, respectively, p 0.01). The CPT values for all of the nerve fibers increased after the treatment, but this increase was significant in the diazepam group only for the values at a 5-Hz stimulation (C fibers) with a change of 47.8% vs 26.9% (p < 0.05). Only two patients reported a mild drowsiness in the diazepam group. ConclusionsThe present study provided indications that vaginal diazepam plus TENS is useful to improve pain and PFM instability in women with VBD.

Comparison of Effectiveness of Topiramate and Diazepam in Preventing Risk of Recurrent Febrile Seizure in Children under Age of 2 Years.

Febrile seizures are the most common type of convulsions. Medicinal prophylaxis is sometimes used for children at high risk of recurrent febrile seizure. In certain circumstances, conventional drugs such as diazepam and phenobarbital cannot be used and the need for alternative medicines is felt. This study compared the effectiveness of topiramate and diazepam in preventing the risk of recurrent febrile seizure in children under 2 yr old. This randomized controlled trial, in Besat Hospital in Hamedan, Iran from 22 Nov 2013 to 22 Nov 2015 (Registered code: IRCT Number: IRCT2015010120527N1), included 54 patients, at risk of recurrent febrile seizure, inhibited from taking phenobarbital. Samples were randomly divided into two groups. The first group received diazepam treatment during fever episodes and the second group received daily dose of topiramate. A one-year follow-up of recurrent febrile seizure and its complications was also conducted. Thirty-four patients (17 patients in each group) completed the one-year course of the trial. Recurrent febrile seizure was not observed in the course of preventive treatment. The prevalence of minor complications was 29.4% in the diazepam group and 48.5% in the topiramate group. No major complication was observed in among the subjects. Topiramate can be recommended for preventing recurrent febrile seizure when the use of frontline medicines is not possible.

Comparison of the Effectiveness of Intravenous Promethazine and Intravenous Diazepam in the Treatment of Benign Paroxysmal Positional Vertigo in the Emergency Department

Comparison of the Effectiveness of Intravenous Promethazine and Intravenous Diazepam in the Treatment of Benign Paroxysmal Positional Vertigo in the Emergency Department

Binge drinking and anxiety at the end of the nocturnal period in alcohol-preferring sP rats.

Previous studies suggested that exposure of Sardinian alcohol-preferring (sP) rats to daily drinking sessions of 1h, during the dark phase of the light/dark cycle, with multiple alcohol concentrations, and unpredictable access to alcohol, resulted in exceptionally high intakes of alcohol when the drinking session occurred over the last hours of the dark phase. Additionally, higher levels of anxiety-related behaviors were observed at the 12th, rather than 1st, hour of the dark phase, suggesting that uncertainty of time of alcohol access and expectation of alcohol availability produced an emotional "distress". The present study was designed to provide pharmacological support to the hypothesis that high alcohol intake under this drinking procedure is secondary to exacerbation of the anxiety-like state of sP rats. To this end, sP rats were initially exposed to daily 1-h drinking sessions during the dark phase and with multiple alcohol concentrations (0%, 10%, 20%, and 30%; v/v); time of alcohol exposure was changed each day and was unpredictable to rats. Rats were then treated acutely with non-sedative doses of diazepam (0, 1, 2, and 3mg/kg; intraperitoneally [i.p.]) before two drinking sessions occurring at the 1st and 12th hour of the dark phase, respectively. Treatment with diazepam was ineffective at the 1st hour; conversely, it selectively reduced alcohol intake (up to 50% at the dose of 3mg/kg) at the 12th hour. The preferential effectiveness of diazepam in reducing alcohol intake when the drinking session occurred at the 12th hour of the dark phase is consistent with the hypothesis that uncertainty of time of alcohol access and expectation of alcohol availability generated an emotional "distress" that rats counterbalanced with high alcohol drinking; the results of the present study are interpreted as the anxiolytic effects of diazepam substituting for those of alcohol, resulting in the observed reduction in alcohol intake.

Intermittent Diazepam versus Continuous Phenobarbital to Prevent Recurrence of Febrile Seizures: A Randomized Controlled Trial.

Febrile seizure is the most common neurologic problem in children between 3 months to 5 years old. Two to five percent of children aged less than five yr old will experience it at least one time. This type of seizure is age dependent and its recurrence rate is about 33% overalls and 50% in children less than one yr old. The prophylactic treatment is still controversial, so we conducted a randomized controlled clinical trial to find out the effectiveness of continuous phenobarbital versus intermittent diazepam for febrile seizure. This clinical trial was conducted in the Department of Pediatric Neurology, Babol University of Medical Sciences, Babol, Iran between March 2008 and October 2010. All children from 6 month to 5 yr old referred to Amirkola Children's Hospital, Babol, Iran were enrolled in the study. Children with febrile seizure that had indication for prophylaxis but did not receive any prophylaxis previously were enrolled in the study. For prophylactic anti convulsion therapy, patients were divided randomly in two groups. One group received continuous phenobarbital and another treated with intermittent diazepam whenever the children experienced an episode of febrile illness for up to one year after their last convulsion. Of all 145 studied cases, the recurrent rate in children under prophylaxis with diazepam was 11/71 and in phenobarbital group was 17/74. There was no significant difference in the recurrence rate in both groups. There was no significant difference in the effectiveness of phenobarbital and diazepam in prevention of recurrent in febrile seizure and we think that in respect of lower complication rate in diazepam administration, it cloud be better choice than phenobarbital.

Comparison of the Safety and Effectiveness of Oral Diazepam and Oral Midazolam for the Conscious Sedation of Pediatric Patients During Dental Treatment

Comparison of the Safety and Effectiveness of Oral Diazepam and Oral Midazolam for the Conscious Sedation of Pediatric Patients During Dental Treatment

Diazepam or midazolam for orotracheal intubation in the ICU?

to compare clinical and cost effectiveness of midazolam and diazepam for urgent intubation. patients admitted to the Central ICU of the Santa Casa Hospital Complex in Porto Alegre, over the age of 18 years, undergoing urgent intubation during 6 months were eligible. Patients were randomized in a single-blinded manner to either intravenous diazepam or midazolam. Diazepam was given as a 5 mg intravenous bolus followed by aliquots of 5 mg each minute. Midazolam was given as an intravenous bolus of 5 mg with further aliquots of 2.5 mg each minute. Ramsay sedation scale 5-6 was considered adequate sedation. We recorded time and required doses to reach adequate sedation and duration of sedation. thirty four patients were randomized, but one patient in the diazepam group was excluded because data were lost. Both groups were similar in terms of illness severity and demographics. Time for adequate sedation was shorter (132 ± 87 sec vs. 224 ± 117 sec, p = 0.016) but duration of sedation was similar (86 ± 67 min vs. 88 ± 50 min, p = 0.936) for diazepam in comparison to midazolam. Total drug dose to reach adequate sedation after either drugs was similar (10.0 [10.0-12.5] mg vs. 15.0 [10.0-17.5] mg, p = 0.248). Arterial pressure and sedation intensity reduced similarly overtime with both drugs. Cost of sedation was lower for diazepam than for midazolam (1.4[1.4-1.8] vs. 13.9[9.4-16.2] reais, p <0.001). intubation using intravenous diazepam and midazolam is effective and well tolerated. Sedation with diazepam is associated to a quicker sedation time and to lower costs.

Primary afterdischarge in organotypic hippocampal slice cultures: Effects of standard antiepileptic drugs

In the hippocampus intense high frequency electrical stimulation induces a long-lasting rhythmic synchronization (primary afterdischarge). In order to examine the suitability of primary afterdischarges (PADs) in organotypic hippocampal slice cultures (OHSCs) as an in vitro model of evoked seizures, we have worked out in detail the sensitivity of PADs to standard antiepileptic drugs (AEDs) and compared the necessary concentrations to those that were effective in animal models of partial and generalized tonic-clonic seizures. OHSCs were prepared according to the interface culture method from 8 to 11-day-old Wistar rats. A PAD in CA1 was elicited by stimulating the stratum radiatum with an intensity of two times that required to elicit a maximal population spike. The effects of carbamazepine, phenytoin, valproic acid, phenobarbital, diazepam, and ethosuximide on the duration and on frequency properties of PADs and the tonic-like and clonic-like subdivisions of PADs were determined, and as a measure of the AEDs potency half maximal effective concentration (EC(50) ) values were calculated from concentration-response curves. Carbamazepine, phenytoin, valproic acid, phenobarbital, and diazepam reduced the durations of PADs and tonic-like and clonic-like subdivisions of PADs. The effects were concentration dependent and reversible. Ethosuximide was ineffective. The effects on subdivisions of PADs differed between AEDs. Carbamazepine and phenytoin shortened the tonic-like and clonic-like subdivisions at similar proportions, whereas phenobarbital, diazepam, and valproic acid preferentially shortened the clonic-like subdivision. Diazepam at low concentrations increased the duration of tonic-like subdivisions, an effect not seen with the other AEDs. The suppressive effects of AEDs on frequency properties of tonic-like and clonic-like subdivisions were variable and observed only at higher concentrations. Carbamazepine and phenytoin were more effective in the PAD test in OHSCs than in the maximal electroshock and kindled seizures tests. The effectiveness of phenobarbital, diazepam, and valproic acid in the PAD test matched their effectiveness in the MES test and-with the exception of valproic acid and diazepam-in kindled seizures tests. Valproic acid was less effective in OHSCs than in the kindled seizure tests, and diazepam was more (generalized seizures) or less (focal seizures and afterdischarge durations) effective in this animal model than in OHSCs. We conclude that the PAD test in OHSCs is a suitable in vitro model of evoked seizures. The model could serve as an initial screen to identify the most promising leads for further evaluation and characterization in in vivo models of efficacy and toxicity.

Time-dependent reduction in the anticonvulsant effectiveness of diazepam against soman-induced seizures in guinea pigs

Near-lethal exposure to nerve agents produces prolonged epileptiform seizures requiring the administration of benzodiazepine anticonvulsant drugs, such as diazepam. Clinically, benzodiazepines are reported to lose anticonvulsant effectiveness the greater the delay between seizure onset and benzodiazepine treatment. This time-dependent diminished effectiveness of diazepam was tested in the present study. Seizures elicited by the nerve agent, soman, were produced in guinea pigs instrumented to record brain electrocorticographic (ECoG) activity. Different groups of animals were administered 10 mg/kg, intramuscularly, of diazepam at 5, 40, 60, 80, or 160 minutes after the onset of seizure activity. There was a progressive loss in the anticonvulsant efficacy of diazepam as the treatment was delayed after seizure onset, but no differences in the time for diazepam to stop seizures. The results show a diminished ability of diazepam to stop nerve-agent–induced seizures the longer treatment is delayed.

Effectiveness of diazepam rectal gel in adults with acute repetitive seizures and prolonged seizures: A single-center experience

Many adults with epilepsy have breakthrough seizures despite treatment with antiepileptic drugs (AEDs), requiring them to have a rescue medication as part of a comprehensive treatment plan. We evaluated the effectiveness and tolerability of rectal diazepam in the treatment of breakthrough seizures in adult patients with epilepsy. We identified 50 such patients who had used diazepam rectal gel for clusters of seizures defined as acute repetitive seizures, prolonged seizures, or both, in the previous 18 months. Information on diagnoses, dose, frequency of use, reasons for use, safety, and efficacy was collected. Diazepam rectal gel was effective in stopping seizures in 45 patients (90%). Somnolence was reported in most patients, but no other adverse events were reported. Diazepam rectal gel demonstrates efficacy and tolerability as a seizure rescue medication for adult patients with a variety of seizure types, and may help improve quality of life.

Effectiveness of intermittent diazepam in febrile convulsions: A long term prospective controlled study

Objectives: To assess the efficacy of intermittent rectal diazepam prophylaxis in the prevention of recurrent febrile seizures (FS).

Intermittent oral diazepam prophylaxis in febrile convulsions: its effectiveness for febrile seizure recurrence

In order to evaluate the effectiveness of diazepam for the reduction in the recurrence of febrile seizures we carried out a prospective study in two groups of children; Group A: 45 children (25 female, 20 male), receiving oral prophylaxis with diazepam, and Group B: 65 children (35 female, 30 male) who did not receive any oral prophylaxis. All subjects of both groups were followed for at least 4 years and finally re-evaluated at the mean age of 6.7±1.4 years. Among the patients of Group A, recurrent febrile seizures (FS) occurred in five of the 45 children (11.1%). Among the 65 children of Group B, 20 (30.7%) went on to have one or more additional episodes. In conclusion, our study demonstrates that oral diazepam, given only when fever is present, is an effective means of reducing the risk of recurrences of FS.

Intermittent diazepam and continuous phenobarbital to treat recurrence of febrile seizures: a systematic review with meta-analysis.

Convulsions triggered by fever are the most common type of seizures in childhood, and 20% to 30% of them have recurrence. The prophylactic treatment is still controversial, so we performed a systematic review to find out the effectiveness of continuous phenobarbital and intermittent diazepam compared to placebo for febrile seizure recurrence. Only randomized, double-blind, placebo-controlled trials were analyzed. The recurrence of febrile seizure was assessed for each drug. Ten eligible clinical trials were included. Febrile seizure recurrence was smaller in children treated with diazepam or phenobarbital than in placebo group. Prophylaxis with either phenobarbital or diazepam reduces recurrences of febrile seizures. The studies were clinical, methodological, and statistically heterogeneous. The effectiveness of phenobarbital and diazepam could not be demonstrated because clinical trials were heterogeneous, and the recommendation for treatment recurrence should rely upon the experience of the assistant physician yet.

Efficacy of diazepam as an anti-anxiety agent: meta-analysis of double-blind, randomized controlled trials carried out in Japan.

Diazepam is one of the most widely used, broad-spectrum anti-anxiety agents. The aim of this study was to evaluate the efficacy of diazepam, and to establish whether it is more effective than a placebo in improving the various neurotic anxiety states seen in patients with neurosis or psychosomatic disease. Of the recently established comprehensive register of psychotropic drug trials carried out in Japan, a total of 17 double-blind, randomized controlled trials were identified on the treatment of neurosis using anti-anxiety compounds, in which both diazepam and placebos were used. Meta-analysis of these 17 studies demonstrated that diazepam is significantly more effective than a placebo (relative risk 1.35, 95% confidence interval 1.21-1.51, number needed to treat 9). The maximal effective dose of diazepam seems to be 12 or 18 mg/day with a treatment duration of 2 or more weeks. There was no significant difference between the effects of placebo and a diazepam dose of 6 mg/day. Caution should be exercised in assessing these results, however, since this is the first meta-analysis showing the significant effectiveness of diazepam in the treatment of neurosis or psychosomatic disease.

Different actions of general anesthetics on the firing patterns of neocortical neurons mediated by the GABA(A) receptor.

In cultured slice preparations of rat neocortical tissue, clinically relevant concentrations of volatile anesthetics mainly decreased action potential firing of neurons by enhancing gamma-aminobutyric acid (GABA(A)) receptor-mediated synaptic inhibition. The author's aim was to determine if other anesthetic agents are similarly effective in this model system and act via the same molecular mechanism. The actions of various general anesthetics on the firing patterns of neocortical neurons were investigated by extracellular single-unit recordings. Pentobarbital, propofol, ketamine, and ethanol inhibited spontaneous action potential firing in a concentration-dependent manner. The estimated median effective concentration (EC50) values were close to or below the EC50 values for general anesthesia. Bath application of the GABA(A) antagonist bicuculline (100 microM) decreased the effectiveness of propofol, ethanol, halothane, isoflurane, enflurane, and diazepam by more than 90%, indicating that these agents acted predominantly via the GABA(A) receptor. The depressant effects of pentobarbital and ketamine were not significantly reduced by bicuculline treatment. Drugs acting mainly via the GABA(A) receptor altered the firing patterns of neocortical cells in different manners. Diazepam reduced the discharge rates by decreasing the number of action potentials per burst, leaving the burst rate unaffected. In contrast, muscimol, GABA, propofol, and volatile anesthetics decreased the burst rate. Although several anesthetic agents acted nearly exclusively via the GABA(A) receptor, they changed the discharge patterns of cortical neurons in different ways. This finding is explained by GABA-mimetic or benzodiazepine-like molecular interactions.