Diazepam Valproate

Case series Severe vomiting was reported following domperidone administration in 10 paediatric patients witix severe acquired brain injury. These patients shared spastic tetraparesis, minimal consciousness and the inability to take solids or liquids orally. They were receiving treatment with baclofen, diazepam, valproate, omeprazole and antibiotics when needed. To facilitate gastric emptying, therapeutic doses of domperidone were administered 15-20 min... 

Benzodiazepines are the evidence-based treatment of choice for uncomplicated alcohol withdrawal.17 Barbiturates are not recommended because of their low therapeutic index due to respiratory depression. Some of the anticonvulsants have also been used to treat uncomplicated withdrawal (particularly car-bamazepine and sodium valproate). Although anticonvulsants provide an alternative to benzodiazepines, they are not as well studied and are less commonly used. The most commonly employed benzodiazepines are chlordiazepoxide, diazepam, lorazepam, and oxazepam. They differ in three major ways (1) their pharmacokinetic properties, (2) the available routes for their administration, and (3) the rapidity of their onset of action due to the rate of gastrointestinal absorption and rate of crossing the blood-brain barrier. 

Mood stabilizers phenytoin, valproate, topiramate Sedative/anxiolytics diazepam, barbiturates Beta-blockers propranolol... 

It is a benzodiazepine useful in the treatment of petitmal epilepsy, myoclonic seizures and infantile spasms. It is used in the treatment of petitmal epilepsy not responding to ethosuximide and sodium valproate. Clonazepam and diazepam act by increasing the effectiveness of the inhibitory neurotransmitter GABA, within the central nervous system. 

Electrophysiological studies show that benzodiazepines, barbiturates and sodium valproate facilitate GABAergic transmission in the animal brain. Further evidence comes from studies on the GABA-benzodiazepine receptor complex, the order of potency of a series of benzodiazepines to displace [3H] diazepam from its receptor site being clearly correlated with the antagonism of pentylenetetrazol seizures, but not with electroconvulsive seizures. However, most classes of anticonvulsants appear to facilitate... 

In cell culture preparations, diphenylhydantoin, carbamazepine and valproate have been shown to reduce membrane excitability at therapeutically relevant concentrations. This membrane-stabilizing effect is probably due to a block in the sodium channels. High concentrations of diazepam also have similar effects, and the membrane-stabilizing action correlates with the action of these anticonvulsants in inhibiting maximal electroshock seizures. Intracellular studies have shown that, in synaptosomes, most anticonvulsants inhibit calcium-dependent calmodulin protein kinase, an effect which would contribute to a reduction in neurotransmitter release. This action of anticonvulsants would appear to correlate with the potency of the drugs in inhibiting electroshock seizures. The result of all these disparate actions of anticonvulsants would be to diminish synaptic efficacy and thereby reduce seizure spread from an epileptic focus. 

Phenobarbital Phenytoin Primidone Felbamate Lamotrigine Tiagabide Topiramate Valproate Zonisamide Clobazam Clonazepam Diazepam usually compensated by the effect of the added drug risk of toxicity when interfering drug is discontinued drug... 

Felbamate Clonazepam Diazepam Phenobarbital Phenytoin Valproate High risk of toxicity with phenytoin, phenobarbital, and valproate Inhibition of metabolism of the affected drug... 

Isonlazid Carbamazepine Diazepam Ethosuximide Phenobarbital Phenytoin Primidone Valproate High risk of toxicity, especially with carbamazepine and phenytoin Inhibition of metabolism of the object drugs... 

Koulu M, Lammintausta R, Kangas L, Dahlstrom S. The effect of methysergide, pimozide and sodium valproate on the diazepam-stimulated growth hormone secretion in man. J Clin Endocrinol Metab 1979 48 119-22. 

Noninterfering acetaminophen, acetazolamide, amphetamine, bilirubin, caffeine, diazepam, dimenhydrinate, meperidine, meprobamate, methamphetamine, methaqualone, methylphenidate, nicotine, propojcyphene, theophylline, valproate Interfering phensuximide... 

The most frequent side effect for diazepam is somnolence dizziness, ataxia, headache, nervousness, euphoria, and rash occur iess frequently. Excessive use of rectai diazepam may produce rebound seizures (63). Intravenous administration may produce infrequent respiratory depression and hypotension. Other sedative drugs, such as barbiturates, valproate, narcotics, phenothiazines, monoamine oxidase inhibitors, and antidepressants, can potentiate the effects of diazepam. 

Valproate appears to increase the serum levels of diazepam lo-razepam and possibly midazolam, while clobazam appears to raise valproate levels. Clonazepam clearance may increase and valproate clearance decrease during concurrent use, and increased adverse effects have been seen. An isolated case describes sleepwalking in a patient taking valproate and zolpidem. 

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