Diazepam
Benzodiazepine
Indications
Short-term severe anxiety (≤4 weeks)Alcohol withdrawalStatus epilepticusMuscle spasm
Adult dose
Anxiety: 2 mg TDS, up to 30 mg/day. Alcohol withdrawal: per CIWA regimen.
Common side effects
SedationAtaxiaCognitive impairmentMuscle weakness
Serious side effects
Respiratory depression (esp. with opioids/alcohol)DependenceParadoxical disinhibitionFalls in elderly
Contraindications
Severe respiratory insufficiencySleep apnoea syndromeSevere hepatic impairmentMyasthenia gravis
Monitoring
- Limit duration; document indication; review weekly
Notable interactions
- Opioids (MHRA black box — respiratory depression)
- Alcohol
- Other CNS depressants
- Strong CYP3A4 inhibitors raise levels
Notes
Long-acting; useful for benzodiazepine cross-titration to taper.
Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.