From the Research
The maximum recommended dose of diazepam for adults is typically 40 mg per day, divided into multiple doses. When considering the treatment of moderate to severe alcohol withdrawal, diazepam has been shown to be effective and safe, with a gradual and self-tapering effect due to its long elimination half-life and that of its active metabolite, desmethyldiazepam 1. For anxiety, the usual dosage ranges from 2-10 mg taken 2-4 times daily, while for muscle spasms, 2-10 mg may be taken 3-4 times daily. Some key points to consider when prescribing diazepam include:
- Elderly patients or those with liver impairment should receive lower doses, often starting at half the standard adult dose
- Diazepam is a benzodiazepine that works by enhancing the effect of the neurotransmitter GABA in the brain, producing calming effects
- It should be used for the shortest duration possible due to risks of tolerance, dependence, and withdrawal symptoms
- Side effects include drowsiness, fatigue, muscle weakness, and impaired coordination
- Patients should avoid alcohol and other CNS depressants while taking diazepam, and should not stop taking it abruptly after prolonged use
- Always take diazepam exactly as prescribed by your healthcare provider. In comparison to other benzodiazepines like lorazepam and chlordiazepoxide, diazepam has been found to have a shorter time to peak effect and a longer elimination half-life, making it a preferred option for the treatment of moderate to severe alcohol withdrawal in most circumstances 1, although other studies have found similar effectiveness between lorazepam and chlordiazepoxide in preventing delirium tremens 2.