Diazepam Adverse Reactions
- anxiety
- apnea
- asthenia
- ataxia
- cardiac arrest
- confusion
- depression
- dizziness
- drowsiness
- ejaculation dysfunction
- euphoria
- fatigue
- headache
- hypotension
- impotence (erectile dysfunction)
- insomnia
- interstitial nephritis
- libido decrease
- mania
- nightmares
- orgasm dysfunction
- respiratory depression
- restlessness
- syncope
- teratogenesis
- tolerance
- tremor
- vertigo
- withdrawal
Diazepam Adverse Reactions
Most of the adverse effects associated with diazepam therapy are dose-dependent and CNS-related including headache, drowsiness, ataxia, dizziness, confusion, depression, syncope, fatigue, tremor, and vertigo. Tolerance may develop to these effects.
CNS stimulation occurs in as many as 10% of patients and is of particular significance in psychiatric patients and hyperactive children. This paradoxical effect is possibly due to release of previously inhibited responses. Symptoms of CNS stimulation include nightmares, talkativeness, excitement, mania, tremor, insomnia, anxiety, restlessness, euphoria, acute rage reactions, and hyperactivity. Benzodiazepine therapy usually should be discontinued if signs of CNS stimulation occur.
Apnea, asthenia, hypotension, and cardiac arrest have been reported following parenteral administration of benzodiazepines to the elderly, severely ill patients, or patients with compromised respiratory function. Respiratory depression also has occurred in these patients during benzodiazepine therapy, occasionally resulting in death.
Abrupt discontinuation of diazepam after prolonged use can cause seizures in susceptible patients. Benzodiazepine withdrawal causes irritability, nervousness, and insomnia. Benzodiazepine withdrawal is more likely to occur following abrupt cessation after excessive or prolonged doses, but it can occur following the discontinuance of therapeutic doses administered for as few as 1 - 2 weeks. Benzodiazepine withdrawal is also more severe if the agent involved has a relative shorter duration of action. Abdominal cramps, confusion, depression, perceptual disturbances, sweating, nausea, vomiting, parasthesias, photophobia, hyperacusis, tachycardia, and trembling also occur during benzodiazepine withdrawal, but the incidence is less frequent. Convulsions, hallucinations, delirium, and paranoia can occur as well. Benzodiazepines should be withdrawn cautiously and gradually, using a very gradual dosage-tapering schedule. Diazepam is usually chosen as the agent for controlled tapering in all cases of benzodiazepine withdrawal.
Sexual dysfunction has been reported with diazepam. Libido decrease, impotence (erectile dysfunction), ejaculation dysfunction (delayed ejaculation), and orgasm dysfunction (retarded or no orgasm).
A number of reports have documented diazepam causing interstitial nephritis, although this is considered a rare adverse effect.
Diazepam is classified as FDA pregnancy risk category D. Many benzodiazepines have been associated with teratogenesis. Use of benzodiazepines during pregnancy, particularly in the first trimester, increases the risk of congenital malformations and decreases viability. Diazepam injection should generally not be given to a pregnant women except in serious or life-threatening situations (e.g., status epilepticus).
[ Last revised: 2/5/2003 3:53:00 PM ]
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