From the FDA Drug Label
The primary outcome measure was a comparison of the proportion of responders in each treatment group, where a responder was defined as a patient whose seizures stopped within 10 minutes after treatment and who continued seizure-free for at least an additional 30 minutes Twenty-four of the 30 (80%) patients were deemed responders to lorazepam and 16/28 (57%) patients were deemed responders to diazepam (p=0. 04). After this additional dose administration, 28/30 (93%) of patients randomized to lorazepam and 24/28 (86%) of patients randomized to diazepam were deemed responders, a difference that was not statistically significant
The answer to which provides longer seizure cessation, Lorazepam or Diazepam, in status epilepticus is:
- Lorazepam initially provided longer seizure cessation, with 80% of patients seizure-free for at least 30 minutes after treatment, compared to 57% for Diazepam. However, after additional dose administration, the difference was not statistically significant, with 93% of Lorazepam patients and 86% of Diazepam patients deemed responders 1.
From the Research
Comparison of Diazepam and Lorazepam in Status Epilepticus
- The study 2 compared the efficacy, safety, and cost of lorazepam and diazepam in adults with convulsive status epilepticus (CSE) and found that both drugs were equally effective at terminating seizures, but lorazepam had significantly fewer seizure recurrences and required fewer repeat doses.
- Another study 3 discussed the pharmacokinetics of benzodiazepines, including diazepam and lorazepam, and noted that lorazepam has a longer duration of action (up to 72 hours) compared to diazepam (< 2 hours).
- A review of benzodiazepines in the management of status epilepticus 4 found that lorazepam is preferable for the initial management of status epilepticus due to its longer duration of action and smaller volume of distribution of unbound drug.
Efficacy of Lorazepam and Diazepam in Children
- A randomized controlled trial 5 compared the efficacy of lorazepam and diazepam-phenytoin combination in children with convulsive status epilepticus and found that lorazepam was as efficacious and safe as the diazepam-phenytoin combination.
- A review of status epilepticus management 6 recommended intravenous benzodiazepines, including diazepam, midazolam, or lorazepam, as first-line drugs for terminating seizures, but did not specifically compare the efficacy of lorazepam and diazepam.