Abstracts

The safety and efficacy of diazepam rectal gel (Diastat) has been established in both adults and children. However, most of the reported experience with treatment has focused on the pediatric age group. This study examines the use of diazepam rectal gel among adult patients and its role in adult seizure management.
We reviewed the charts of adult epilepsy patients to identify those who had used diazepam rectal gel for breakthrough seizures. We collected information on diagnosis, diazepam rectal gel dose, frequency of treatment, and reasons for use, as well as efficacy and safety.
Twenty patients received at least 1 treatment of diazepam rectal gel. There were 7 males and 13 females, and the age range was 20 to 56 years with a mean age of 37 years. Thirteen patients had partial epilepsy and 7 had generalized epilepsy, including 4 with Lennox-Gastaut syndrome. The dose of diazepam rectal gel used ranged from 10 to 20 mg. The medication was administered for treatment of clusters of seizures in 10 patients, prolonged seizures in 7 patients, and for both types in 3 patients. The frequency of use ranged from once every 4 months, for patients with well-controlled epilepsy, to weekly. Diazepam rectal gel was effective for 19 patients (95%). All patients experienced somnolence but no serious adverse event was reported.
Diazepam rectal gel is effective and well tolerated in adult patients. As a rescue medication for breakthrough seizures, diazepam rectal gel is a valuable component of seizure management for a diverse group of adults with well-controlled or refractory epilepsy syndromes.
[Supported by: Xcel Pharmaceuticals]