From the Guidelines
Valium (diazepam) works by activating γ-aminobutyric acid A (GABA) neuronal receptors in the brain, resulting in anxiolytic, amnestic, sedating, hypnotic, and anticonvulsant effects. This mechanism of action is supported by the clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit 1. The activation of GABA receptors leads to an increase in chloride ion channel opening, causing hyperpolarization of the neuronal membrane and making neurons less excitable.
Some key points to consider about Valium's mechanism of action include:
- It has no analgesic activity, but it can produce amnestic effects that extend beyond its sedative effects 1
- Its effects can be influenced by factors such as age, hepatic dysfunction, and renal insufficiency, which can affect the drug's clearance and duration of action 1
- The use of Valium can lead to tolerance and dependence with long-term administration, as well as respiratory depression and systemic hypotension, especially when combined with other cardiopulmonary depressants 1
The clinical implications of Valium's mechanism of action are significant, and its use should be carefully considered in patients with certain medical conditions or those taking other medications that may interact with it. Overall, Valium's mechanism of action explains its effectiveness for various clinical indications, but also highlights the need for cautious use and monitoring to minimize potential risks.
From the FDA Drug Label
Diazepam is a benzodiazepine that exerts anxiolytic, sedative, muscle-relaxant, anticonvulsant and amnestic effects. Most of these effects are thought to result from a facilitation of the action of gamma aminobutyric acid (GABA), an inhibitory neurotransmitter in the central nervous system The mechanism of action of Valium (diazepam) is through the facilitation of GABA, an inhibitory neurotransmitter in the central nervous system, resulting in anxiolytic, sedative, muscle-relaxant, anticonvulsant, and amnestic effects 2.
- The key points of the mechanism of action are:
- Facilitation of GABA: Diazepam enhances the effect of GABA, leading to an increase in inhibitory neurotransmission.
- Central nervous system effects: The facilitation of GABA results in various effects, including anxiolytic, sedative, muscle-relaxant, anticonvulsant, and amnestic effects.
From the Research
Valium Mechanism of Action
- Valium, a benzodiazepine, mediates its clinical effects by enhancing the effect of gamma-aminobutyric acid (GABA) at the GABA-A receptor 3, 4.
- The drug acts through allosteric modulation of the GABAA receptor to enhance the activity of GABA, an inhibitory neurotransmitter, resulting in a slowing of neurotransmission and sedative and anxiolytic effects 4.
- Research suggests that the sedative but not anxiolytic properties of benzodiazepines are mediated by the GABA(A) receptor alpha1 subtype 5.
- Valium and other benzodiazepines have anticonvulsant, hypnotic-sedative, and muscle-relaxant properties, and interact with neurotransmitters, especially GABA, and have specific receptors in the brain and central nervous system 6.
- The discovery of a large number of subtypes of GABAA receptors has raised hopes for a clear separation of the spectrum of actions of benzodiazepines, including valium 7.
Key Findings
- Benzodiazepines, including valium, have been shown to be effective anxiolytics, but carry unwanted side effects including sedation, dependence, and abuse liability 3, 4.
- The GABA-A receptor is a viable target for novel anxiolytics, and receptor subtype-selective benzodiazepine site ligands have been developed 3.
- Valium and other benzodiazepines have been found to have little adverse effect on well-established higher mental functions, and may affect the speed with which simple repetitive motor actions are performed 6.