Abstracts

Diazepam rectal gel (Diastat, Xcel Pharmaceuticals) is chiefly regarded as a useful out-of-hospital rescue medication for prolonged or repetitive seizures, due to its ease of use by nonprofessional caregivers. However, it is also useful in an inpatient setting. The data presented here reflect our experience with diazepam rectal gel in a residential facility for mentally retarded adults.
Patient charts were reviewed to identify patients who had received diazepam rectal gel. Demographic and background seizure data, duration of intermittent diazepam rectal gel use, clinical impression of efficacy, and adverse events were collected.
Sixteen patients received at least 1 dose of diazepam rectal gel. The study group included 5 female and 11 male patients aged 14 to 72 years, with median age 33.5 years. Doses, for the 13 patients who had dose information available, ranged from 10 mg to 20 mg. Five patients have been using diazepam rectal gel intermittently for 5 or more years. Efficacy impressions were available for 15 patients. In all cases diazepam rectal gel was effective for stopping seizures, with a mean efficacy impression of 81%. In 5 patients (33.3%) it was 100% effective over the period of use. Seizures were terminated within 10 minutes, with some patients responding in as little as 2 to 3 minutes. Only one patient experienced respiratory compromise and was not intubated. Another was sometimes lethargic after diazepam rectal gel administration.
Diazepam rectal gel was safe and effective over a period of 2 to 6 years in a residential facility for mentally retarded adults. Its rapid efficacy and ease of administration make diazepam rectal gel useful for medically supervised patients as well as independently living people with epilepsy.
[Supported by: Xcel Pharmaceuticals]