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The physician’s psychoactive medication resource guide
25% of your patients taking an antidepressant will have
weight gain and the weight gain is directly caused by the antidepressant.
Valium side effects, warnings, precautions, adverse effects, overdose, withdrawal symptoms
and Valium natural alternatives. Before you begin the spiral down with this drug, try giving
your body what it really wants.
Taking Valium or other benzodiazepines for a prolonged period depletes certain nutrients from
the body that can cause depression or a numbness or tingling of the extremities. An inability to
sleep soundly and daytime anxiety will also be part of the symptoms. There is an answer for
these symptoms found in How to Get Off Psychiatric Drugs Safely 2010 Edition by James Harper
N.C. Click here, get the book for you and your patients. They do not need to keep suffering.
Valium Side Effects
Anxiolytic - Sedative - Muscle Relaxant
Diazepam is a benzodiazepine with CNS depressant properties and a somewhat flatter dose-
response slope than the sedative-hypnotic drugs. In laboratory animals, it produces, in varying
doses, taming, disinhibitory, sedative, anticonvulsant, muscle relaxant, ataxic and hypnotic
Diazepam is relatively devoid of autonomic effects and does not significantly reduce locomotor
activity at low doses, or depress amphetamine-induced excitation. In high doses, it activates the
drug metabolizing enzymes in the liver. Diazepam also possesses dependence liability and may
produce withdrawal symptoms, but has a wide margin of safety against poisoning.
Metabolism studies in animals and man have indicated that oral diazepam is rapidly absorbed
from the gastrointestinal tract. Peak blood levels are reached within 1-2 hours after
administration. The acute half-life is 6-8 hours with a slower decline thereafter, possibly due to
In humans, comparable blood levels of diazepam were obtained in maternal and cord blood
indicating placental transfer of the drug. Diazepam may appear in human breast milk.
With the parenteral form, peak blood levels are reached within 15 minutes after i.v.
administration and are of the same magnitude as after oral administration. The respective half-
life is approximately 2-3 hours.
The distribution and fate of tritium-labeled diazepam in man has indicated that the drug has a
rapid and extensive uptake by tissues. Although the radioactivity in the blood appears to
represent mainly the intact drug, diazepam was shown to be excreted exclusively in the form of
its metabolites. The two major metabolites are oxazepam glucuronide and N-desmethylated
The short-term symptomatic management of mild to moderate degrees of anxiety in conditions
dominated by tension, excitation, agitation, fear or aggressiveness, such as may occur in
psychoneurosis, anxiety reactions due to stress conditions and anxiety states with somatic
In acute alcoholic withdrawal, diazepam may be useful in the symptomatic relief of acute
agitation, tremor and impending acute delirium tremens.
As an adjunct for the relief of skeletal muscle spasm due to reflex spasm to local pathology, such
as inflammation of the muscle and joints or secondary to trauma; spasticity caused by upper
motor neuron disorders, such as cerebral palsy and paraplegia; athetosis and the rare stiff man
Myasthenia gravis, known hypersensitivity to benzodiazepines. Not recommended for children
under 6 months of age.
Several studies have suggested an increased risk of congenital malformations associated with the use of diazepam, chlordiazepoxide
and meprobamate during the first trimester of pregnancy. Therefore, the administration of diazepam is rarely justified in women of
childbearing potential. If the drug is prescribed for a woman of childbearing potential, she should be warned to contact her physician
regarding discontinuation of the drug if she intends to become or suspects that she is pregnant.
Elderly and debilitated patients or those with organic brain disorders have been found to be prone to CNS depression following even
low doses. For these patients it is recommended that the dosage be limited to the smallest effective amount to preclude development
of ataxia, oversedation or other possible adverse effects.
Use in emotional disorders:
Diazepam is not recommended in the treatment of psychotic or severely depressed patients. Precautions are indicated for severely
depressed patients or those who show evidence of impending depression, particularly the recognition that suicidal tendencies may be
present and protective measures may be necessary. Since excitement and other paradoxical reactions may result from the use of the
drug in psychotic patients, it should not be used in ambulatory patients suspected of having psychotic tendencies.
Use in epileptic patients:
Since diazepam may exacerbate grand mal seizures in some patients, caution is required when it is used in epileptic patients. An
adjustment may be necessary in their anticonvulsive medication. Abrupt withdrawal of diazepam in these patients should also be
Potentiation of drug effects:
Patients should be advised to abstain from alcohol and other CNS depressant drugs during treatment with diazepam. Phenothiazines,
barbiturates, MAO inhibitors and other psychoactive drugs may potentiate the action of the drug and should not usually be given
Abrupt cessation of large doses of diazepam after prolonged periods may precipitate acute withdrawal symptoms and, in these cases,
the drug should be discontinued gradually. Caution should be exercised when it is considered necessary to administer diazepam to
addiction prone individuals.
Patients receiving diazepam should be advised to proceed cautiously whenever mental alertness and physical coordination are
The usual precautions in treating patients with impaired renal and hepatic functions should be observed. If diazepam is administered
for protracted periods, periodic blood counts and liver function tests would be highly advisable.
The most common adverse effects reported are drowsiness and ataxia. Other reactions noted less frequently are fatigue, dizziness,
nausea, blurred vision, diplopia, vertigo, headache, slurred speech, tremors, hypoactivity, dysarthria, euphoria, impairment of memory,
confusion, depression, incontinence or urinary retention, constipation, skin rash, generalized exfoliative dermatitis, hypotension,
changes in libido.
The more serious adverse reactions occasionally reported are leukopenia, jaundice, hypersensitivity and paradoxical reactions.
Paradoxical reactions such as hyperexcited states, anxiety, excitement, hallucinations, increased muscle spasticity, insomnia, rage, as
well as sleep disturbances and stimulation, have been reported; should these occur, the drug should be discontinued.
Minor changes in EEG patterns have been observed in patients on diazepam therapy. These changes consist of low to moderate
voltage fast activity, 20 to 30 cycles/second and are of no known significance.
Drowsiness, oversedation and ataxia. When the effects of drug overdosage begin to wear off, the patient exhibits some jitteriness and
overstimulation. The cardinal manifestations of overdosage are drowsiness and confusion, reduced reflexes and coma. There are
minimum effects on respiration, pulse and blood pressure unless the overdosage is extreme.
Gastric lavage may be beneficial if performed soon after oral ingestion of diazepam. If necessary, a CNS stimulant such as caffeine or
methylphenidate may be administered with caution. Supportive measures should be instituted as indicated, such as, maintenance of an
adequate airway, levarterenol for hypotension. Dialysis appears to be of little value.
Must be individualized according to diagnosis, severity of symptoms and degree of response. While the usual daily dosages given
below will meet the needs of most patients, there will be some who may require higher doses. In the first few days of administration a
cumulative effect of the drug may occur, and therefore the dosage should be increased only after stabilization is evident.
Symptomatic relief of anxiety and tension in psychoneurosis and anxiety reactions: 2 to 10 mg, 2 to 4 times daily depending upon
severity of symptoms.
Symptomatic relief in acute alcohol withdrawal: 10 mg, 3 or 4 times during the first 24 hours, reducing to 5 mg, 3 or 4 times daily as
Adjunctively for relief of skeletal muscle spasms: 2 to 10 mg, 3 to 4 times daily.
Elderly and debilitated patients, or in the presence of debilitating disease:
2 mg, 1 or 2 times daily initially; increase gradually as needed and tolerated.
Children (Because of varied responses, initiate therapy with lowest dose and increase as required. Not for use in children under 6
1 to 2.5 mg, 3 or 4 times daily initially; increase gradually as needed and tolerated.
Do not prescribe or administer diazepam for periods in excess of 6 weeks, unless a definite need for utilizing this medication has been
established by a follow-up medical examination.