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Midazolam is the most commonly prescribed for this use because of its strong sedative actions and fast recovery time, as well as its water solubility, which reduces pain upon injection. Diazepam and lorazepam are sometimes used. Lorazepam has particularly marked amnesic properties that may make it more effective when amnesia is the desired effect.
Drug Name Common Trade Names [a] Year Approved Typical Oral Dosage Formulations (mg) Approx. Equivalent Oral Dose to 10 mg Diazepam [b] (mg) Peak Onset of Action (hours) Elimination Half-life of Active Metabolite (hours) Primary Therapeutic Use Adinazolam: Deracyn: Research chemical: 1–2: 3: anxiolytic, antidepressant: Alprazolam
Keppra (levetiracetam) – an anticonvulsant drug which is sometimes used as a mood stabilizer and has potential benefits for other psychiatric and neurologic conditions such as Tourette syndrome, anxiety disorder, and Alzheimer's disease; Klonopin – anti-anxiety and anti-epileptic medication of the benzodiazepine class
In acute medicine, midazolam has become more popular than other benzodiazepines, such as lorazepam and diazepam, because it is shorter lasting, is more potent, and causes less pain at the injection site. [69] Midazolam is also becoming increasingly popular in veterinary medicine due to its water solubility. [75]
Diazepam, sold under the brand name Valium among others, is a medicine of the benzodiazepine family that acts as an anxiolytic. [15] It is used to treat a range of conditions, including anxiety , seizures , alcohol withdrawal syndrome , muscle spasms , insomnia , and restless legs syndrome . [ 15 ]
The consensus is to reduce dosage gradually over several weeks, e.g. 4 or more weeks for diazepam doses over 30 mg/day, [1] with the rate determined by the person's ability to tolerate symptoms. [120] The recommended reduction rates range from 50% of the initial dose every week or so, [121] to 10–25% of the daily dose every 2 weeks. [120]
An Australian study (2004) of overdose admissions between 1987 and 2002 found alprazolam, which happens to be the most prescribed benzodiazepine in Australia and the United States, to be more toxic than diazepam and the other three benzodiazepines which it was compared to (alprazolam, diazepam, oxazepam, chlordiazepoxide, and clonazepam).
The most significant difference in side effects of loprazolam and diazepam is it is less prone to day time sedation as the half-life of loprazolam is considered to be intermediate whereas diazepam has a very long half-life. The side effects of loprazolam are the following: drowsiness; paradoxical increase in aggression; lightheadedness; confusion
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