Diazepam is as Effective as Lorazepam in Treating Status Epilepticus
A recent study, published in the scientific journal Epilepsy and Behavior, shows that lorazepam injection is not more effective than diazepam injection in controlling seizures.
According to guidelines and expert consensus, lorazepam should be used preferentially over diazepam as the initial treatment of convulsive status epilepticus. However, this new study suggests that there is not enough evidence to support this practice.
The researchers, led by Dr Eugen Trinka, at Paracelsus Medical University, in Salzburg, systematically searched several databases for randomised controlled clinical trials comparing the effects of lorazepam and diazepam injections in the treatment of convulsive status epilepticus.
They identified five randomised clinical trials, involving a total of 656 subjects (320 of whom had been allocated to lorazepam injection and 336 of whom had been allocated to diazepam injection).
The researchers assessed the efficacy of both drugs by looking at measures such as: the cessation of clinical seizures and whether seizures stopped after a single dose of medication; whether status epilepticus continued and required a different antiepileptic drug; the need for ventilator support; and the presence of clinically relevant low blood pressure.
The results showed no significant difference, for any of these measures, between the people treated with lorazepam and those treated with diazepam injection. The scientists conclude from this that there is no evidence supporting the preferential use of lorazepam injection over diazepam injection as a first-line treatment of convulsive status epilepticus. They do note, however, that a difference in efficacy between the two drugs that requires a larger number of participants to detect may still exist.
The authors state that, in the future, researchers should use consistent definitions of status epilepticus and report results using clear and standardised methods. They add: “Individual patient data should also be provided to allow more detailed and informative analyses.”
Author: Dr Özge Özkaya
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