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Diazepam, first marketed as Valium, is a medicine of the benzodiazepine family that acts as an anxiolytic.[9] It is commonly used to treat a range of conditions, including anxiety, seizures, alcohol withdrawal syndrome, benzodiazepine withdrawal syndrome, muscle spasms, insomnia, and restless legs syndrome.[9] It may also be used to cause memory loss during certain medical procedures.[10][11] It can be taken by mouth, inserted into the rectum, injected into muscle, injected into a vein or used as a nasal spray.[5][11] When given into a vein, effects begin in one to five minutes and last up to an hour.[11] By mouth, effects begin after 15 to 60 minutes.[12]

Common side effects include sleepiness and trouble with coordination.[7][11] Serious side effects are rare.[9] They include suicide, decreased breathing, and an increased risk of seizures if used too frequently in those with epilepsy.[9][11][13] Occasionally, excitement or agitation may occur.[14][15] Long term use can result in tolerance, dependence, and withdrawal symptoms on dose reduction.[9] Abrupt stopping after long-term use can be potentially dangerous.[9] After stopping, cognitive problems may persist for six months or longer.[14] It is not recommended during pregnancy or breastfeeding.[11] Its mechanism of action is by increasing the effect of the neurotransmitter gamma-aminobutyric acid (GABA).[14]

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Diazepam is mainly used to treat anxiety, insomnia, panic attacks and symptoms of acute alcohol withdrawal. It is also used as a premedication for inducing sedation, anxiolysis, or amnesia before certain medical procedures (e.g., endoscopy).[21][22] In 2020, it was approved for use in the United States as a nasal spray to interrupt seizure activity in people with epilepsy.[5][23] Diazepam is the drug of choice for treating benzodiazepine dependence with its long half-life allowing easier dose reduction. Benzodiazepines have a relatively low toxicity in overdose.[14]

Diazepam has a number of uses including: