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  • Valium

    Chemical structure of diazepam.

    Diazepam
    7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one
    Empiric formula C16H13ClN2O
    Molecular weight 284.7
    Bioavailability ?
    Metabolism Liver
    Elimination half life biphasic 1-2d/2-5d
    Excretion Urine
    ATC code N05BA01
    Pregnancy category D (USA)
    C (Aus)

    Diazepam, brand names: Valium, Seduxen, in Europe Apozepam, is a 1,4-benzodiazepine derivative, which possesses anxiolytic, anticonvulsant, sedative and skeletal muscle relaxant properties. Diazepam is used to treat anxiety and tension, and is the most effective benzodiazepine for treating muscle spasms. It is also used as a sedative premedication for various medical procedures, and to treat alcohol and opiate withdrawal symptoms. Diazepam is a Schedule IV drug under the Convention on Psychotropic Substances[1].

    Contents

    Mode of action

    Diazepam affects mainly the central nervous system. It binds in to specific benzodiazepine-receptors, which are part of the GABA-receptors. When diazepam binds to this receptor, it causes an increase in the inhibitory effects on GABA. The effect of diazepam does not last long, partly because it is fairly quickly redistributed into tissues and fat deposits, and partly because of the adaptation of benzodiazepine receptors. link title

    Pharmacokinetics

    Diazepam can be administered orally, as an injection (intravenous or intramuscular), or as a suppository. When taken orally, diazepam is rapidly absorbed. Absorption is much slower and more erratic when diazepam is given as an intramuscular injection. Diazepam is highly lipid-soluble and therefore crosses the blood-brain barrier easily. Diazepam is metabolised in the liver, and it has a biphasic half-life. The first phase half-life (t1/2α) is 24-48 hours, and its main active metabolite, desmethyldiazepam, has a half-life of 2-5 days. Diazepam's other active metabolites include, among others, temazepam and oxazepam. Diazepam and its metabolites are excreted into the urine.

    Side effects

    Diazepam has few side effects. It increases the sedating effects of alcohol and hypnotics. It can paradoxically cause agitation. As with all benzodiazepines, diazepam can cause physiological tolerance and occasionally psychological addiction when used for a long time, especially when the doses are large. Withdrawal symptoms can be minimized by tapering off the drug slowly.

    Inventor

    Chemist Leo Sternbach created diazepam in the 1950s. When introduced in 1963, it was the best of the new alternatives to barbiturates, drugs that could be deadly when overused. Because it caused few side effects, diazepam gave doctors a safe way to treat chronic anxiety. Diazepam was America's top-selling drug from 1969 to 1982 and is the subject of a Rolling Stones song, "Mother's Little Helper." In the autumn of 1973, a report aired on the television show 60 Minutes attesting to the drug's addictiveness, which had not been widely believed prior. Sternbach was inducted into the National Inventors Hall of Fame in 2005.

    References

    http://newsobserver.com/news/story/2405403p-8783241c.html






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