Ativan versus Valium in Treatment of Children with Seizures

Status Epilepticus is a serious medical condition consisting of a prolonged seizure, or several seizure events in rapid succession that do not allow for complete recovery. Immediate treatment of the condition with an effective and powerful pharmaceutical agent is essential. When seizure continues for half an hour or more, there is a risk of brain damage and death. General anesthesia may be required to terminate seizures in the most severe of cases. Currently, children who arrive in emergency rooms in Status Epilepticus are treated with Ativan (lorazepam), an anti-anxiety drug that also has anticonvulsant properties. Some medical professionals have suggested that Valium (diazepam) represents a compelling alternative to Ativan, with lower risk of respiratory depression and more sustained action. In the pediatric population, Ativan is the only FDA approved treatment in this drug category. A nationwide study conducted at children’s hospitals will potentially underscore the relative safety and effectiveness of both of these medications.

The National Institute of Child Health and Human Development is sponsoring the study. Study authors will obtain informed consent from the guardians of epileptic children prior to potential admission to emergency departments. Children aged three months to 18 years will be eligible for the study. When deemed safe and appropriate, children presenting with ongoing Status Epilepticus will be randomized to either the standard Ativan treatment or a proportional dose of Valium. The primary outcome is the termination of convulsions within 10 minutes and continuation of normal status for at least 30 minutes. The authors of the study hope to ultimately enroll 262 children in the study. As of this writing, the study is set for a primary completion date of September 2012.

The results of the pediatric Status Epilepticus study will be helpful on several fronts. On the one hand, doctors will have more treatment options available for children experiencing prolonged seizure events. Valium is believed to hold several key advantages over Ativan, including fewer depressive effects, especially on the respiratory system, and a longer duration of beneficial action. In addition, Valium is generally a less expensive drug than Ativan. It has a longer shelf life and doesn’t require refrigeration. If the study results indicate that Valium is both safe and reliable for children in treating Status Epilepticus, then potentially dangerous complications will in many cases be avoided.

References:

  1. Epilepsy: Complications. (n.d.). Mayo Clinic. Retrieved June 15, 2012, from http://www.mayoclinic.com/health/epilepsy/ds00342/dsection=complications
  2. Heafield, M. (2000). Managing Status Epilepticus. BMJ, 320(7240). Retrieved June 15, 2012, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117894/

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