How Are Diazepam And Midazolam Different?

I am studying diazepam and midazolam [among other drugs]. I noticed a couple of differences between the two drugs’ classifications and mechanism of actions. I figured that since they are both benzodiazepines, they would have the same exact action on the brain, and thus, produce the same exact effects on the body. My question is, shouldn’t the classes and mechanism of actions be identical for both drugs? I did a little research and I could not get a straight answer..

4 thoughts to “How Are Diazepam And Midazolam Different?”

  1. I was involved in research with both compounds in terms of prevent seizures to prevent secondary effects of chemical warfare agents.
    Both compounds have been studied in detail by the US Army because of these effects. Currently diazepam has been adminstered for prophylaxis of these secondary effects, but it has been proven that midazolam has had better effects in these regards.
    The question comes up (either for the warfighter or lay person), how well can someone operate their lives under its effects. Unfortunately it has been found that midazolam has been highly effected by many foods and other physiological issues. For example, ingesting grapefruit has been shown to enhance the effects (in some cases double) and can be unpredictable. Historically, these effects have not been seen with diazepam. Without consideration of outside effects (skip the OJ in the morning), soliders have been able to function normally after adminstration of mild doses of both drugs.
    Fundamentally, I guess the half-life of midazolam is longer, although the binding is less apparent to appropriate receptors in comparison to diazepam.
    To my understanding on the mechanism between each, midazolam has a milder effect, but more long lasting – which is the ideal case to overcome seizure issues during a chemical warfare agent event. Both diazepam and midazolam have been proven to be more effective than ativan which has a much shorter half-life.
    The reference I have included is a compilation of about 10-12 years of animal studies and clinical work done with the warfighter. I would direct you to the 4th page about these comparisons immediately – your question may be directly answered there.

  2. They are both from the same class, yes. They can both be used for sedation (though Versed is more potent). They can also both be used for anti-convulsant purposes. The difference I’ve found is that Versed seems to have a shorter half life than the Valium. In my EMS system, Diazepam is now the preferred anti-seizure drug because the sedative effects are not as severe. Interestingly enough, it is also preferred over Versed for things such as assisted intubation and cardioversion. I believe Midazolam will be on its way out of our ambulances soon. It seems better suited to an in-hospital environment.

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