Skip to main content
. 2022 Aug 16;36(9):951–975. doi: 10.1007/s40263-022-00940-2

Table 3.

Summary of studies on the use of diazepam for status epilepticus

Delivery route Study design N Age (years) SE types Dosage (mg) Seizure control (%) TEAE rate (%) Frequent TEAE (%) References
Intravenous
DZP SC 15 16–73 RS, SE 5–40 82 – – [114]
DZP RCT, MC 21 0–2 RS – 87 – Respiratory arrest [111]
DZP infusion ReS, SC 62 1–12 RSE 0.017 mg/kg/min 86 Hypotension, respiratory depression [113]
DZP vs. i.v. VPA RCT, SC 20 0–12 RSE 10 85 – Respiratory depression [117]
DZP vs. i.v. VPA PS 66 41d SE 2 × 0.2b in 10 min 56 – – [116]
DZPvs. i.v. LZP RCT, DB, SC 78 – S 5 76 – Respiratory depression [46]
DZP vs. i.v. LZP RCT, DB, MC 140 3–18 SE 0.2b 72 – Respiratory depression [50]
DZP vs. i.v. LZP RCT, MC 273 0–17 SE – Not superior – Respiratory depression [139]
DZP vs. i.v. LZP vs. i.v. placebo RCT, DB, SC 205 ≥ 18 SE 5 Superior to placebo – Respiratory complications, circulatory complications [22]
DZP vs. i.v. LZP and rectal DZP vs. rectal LZP RCT, SC 53 3.3–6.6c SE 0.3–0.4b 85 (i.v.) 37 (rectal) 15 Respiratory depression [51]
DZP + PHT vs. i.v. LZP vs. i.v. PH RCT, DB, MC 570 58.6c SE 0.15b 56 – Hypoventilation, cardiac arrhythmia [47]
DZP + PHT vs. i.v. LZP RCT, SC 88 1–12 SE 0.2b (+ 18b PHT) 100 – Respiratory depression [121]
DZP vs. i.v. MDZ RCT, SC 19 2–12 RSE 0.5a 90 – Respiratory depression [118]
DZP vs. i.v. MDZ RCT 120 Children S 0.3–0.5b 100 – – [119]
DZP vs. i.v. MDZ vs. i.v. LZP RCT, SC 120 0–14 S 0.3b 73 – Somnolence, sedation [198]
DZP + PHT vs. PB + PHT RCT, SC 36 43.8c SE 2/min Inferior to PB – Respiratory failure [122]
DZP vs. i.n. MDZ RCT, SB, SC 35 0–15 S 0.2b Superior to MDZ – – [81]
DZP vs. i.n. MDZ RCT, SC 60 0–15 S 0.3b Inferior to MDZ – – [127]
DZP vs. i.n. MDZ RCT, SC 50 1–12 S 0.3b 65 – – [15]
DZP vs. i.n. MDZ RCT, SC 125 – S 0.3b Inferior to MDZ – – [130]
DZP vs. i.m. MDZ RCT, SC 115 0–12 S 0.2b – 11 Thrombophlebitis [123]
DZP vs. i.m. MDZ RCT, SC 32 0–14 S 0.5b 88 – Vomiting, hyperactivity [124]
DZP vs. i.m. MDZ RCT, SC 11 0–10 SE 0.3b 91 9 Respiratory depression [72]
DZP vs. buccal MDZ RCT, SC 120 0–12 S 0.3b 93.3 – – [128]
DZP vs. buccal MDZ RCT, SC 92 0–14 S 0.3b 70 42 Respiratory failure [129]
Intramuscular
DZP RCT, DB, MC 234 ≥ 2 RS 5, 10, 15, 20a Reduction of time to next seizure 42 Injection site pain (17), injection site hemorrhage (5) [103]
DZP RCT, MC 234 2–83 RS 5, 10, 15a 78 75 Injections site pain (11), injections site hemorrhage(6) [104]
DZP vs. i.m. rectal gel SC, OLS 24 18–55 HV 10 i.m. superior to rectal – Pain, discomfort, drowsiness [100]
DZP vs. DZP rectal gel RCT, DB, SC, CO 48 18–40 RS 5, 10, 15a – 22 Injection site discomfort [101]
Rectal (gel or solution)
DZP ReS, SC 50 34.7c RS 0.2b 90 Somnolence [107]
DZP SC 39 16–65 RS 20, 30 29–72 Drowsiness [108]
DZP SC 17 – RS 0.5b 66 Respiratory difficulties, dizziness [115]
DZP OLS 149 2–76 RS 0.2–0.5b 77 – Sedation [109]
DZP vs. placebo RCT, DB, MC 96 ≥ 18 RS 0.2b – – – [105]
DZP vs. placebo RCT, DB 125 2–60 RS 0.2–0.5b Superior to placebo – – [28]
DZP (rectal or p.o.) vs. placebo RCT, DB, SC 40 18–60 RS 20 Superior to placebo – – [110]
DZP vs. placebo RCT, DB, MC 158 > 2 RS 0.2–0.5b 55 – Somnolence [29]
DZP vs. placebo PS, DB 133 2–17 RS 5 Superior to placebo – Somnolence [112]
DZP vs. i.m. MDZ RCT, SC 100 0–16 SE 0.5b 94 – – [74]
DZP vs. buccal MDZ RCT, MC 110 0–15 S 2.5–10 45 6 Respiratory depression [12]
DZP vs. buccal MDZ RCT, SB, SC 165 0–12 S 2.5–10 57 – Respiratory depression [131]
DZP vs. buccal MDZ RCT, SC 39 5–22 S 10 59 – – [75]
DZP vs. buccal MDZ RCT, MC 98 0–12 S 0.5b 82 – – [132]
DZP vs. buccal MDZ RCT, SC 43 0–12 S 0.3–0.5b 85 – – [133]
DZP vs. buccal MDZ RCT, SC 22 25–82 S 5 83 – Tiredness, ataxia [77]
DZP vs. buccal MDZ RCT, SC 34 0–18 S 0.5b 100 – – [136]
DZP vs. sublingual LZP RCT, MC 436 0–10 S 0.5b 79 – – [137]
DZP vs. i.n. MDZ RCT, SC 45 0–13 S 0.3b 60 – – [134]
DZP vs. i.n. MDZ RCT, SC 46 0–12 S 0.3b 89 – Vomiting, drowsiness, hypoxia [135]
DZP vs. i.n. MDZ PS, SC 21 25–69 S 10 89 – Drowsiness [83]
DZP vs. i.n. MDZ RCT, SB, MC 358 3–11 S 0.3–0.5b Not superior – Respiratory failure (1) [14]
DZP vs. i.n. MDZ RCT, MC 358 – RS 0.3–0.5b – – – [138]
Intranasal
DZP Pilot study 24 18–45 HV 10 – – – [96]
DZP Pilot study 8 28.3c HV 5, 10 – – – [98]
DZP MC 78 18–65 S 0.2b – Nasopharyngeal signs [92]
DZP vs. i.v. MZD Pilot study 4 20–24 HV 5 – – – [99]
DZP vs. rectal gel DZP OLS, CO 24 18–50 RS 5, 20 a – 32–48 Nasal redness, nasal discomfort [102]
DZP vs. i.v. DZP Pilot study 9 20–30 HV 20 (i.n.) 2 (i.v.) – – – [97]

RCT randomized controlled trial, OLS open-label study, SC single-centre, MC multicentre, DB double-blind, PS prospective study, ReS retrospective study, CO cross-over, HV healthy volunteer, S seizure, RS repetitive seizure, SE status epilepticus, RSE refractory status epilepticus, TEAE treatment-emergent adverse event, i.v. intravenous, i.n. intranasal, i.m. intramuscular, p.o. oral, MDZ midazolam, LZP lorazepam, DZP diazepam, VPA valproate, PHT phenytoin, PB phenobarbital

a Absolute

b Milligram per kilogram body weight (mg/kg BW)

c Average