The following protocol has been taken from the “FAMILIAL DYSAUTONOMIA” A manual of Comprehensive Care Fith Edition 2009
Prepared by The Dysautonomia Center
In conjunction with The Dysautonomia Foundation
In our experiance, the most effective druig to treat a dysautonomic crisis is diazepam (Vallium®, a benzodiazepine). The reason why diazipam stops a crisis is not completely known, but is likely to be due to its sedative effects. The effects of diazipam allow a child to sufficiently relax and sleep if necessary. Sleep can play a crucial role in resolving a crisis for some patients. Many antiemetic drugs (drugs which conteract vomiting) have been tried as a possible crisis therapies, including trimethobenzmide(Tigan®), ondansetron (Zofran®), promethazine (Phenergan®) prochlorperazine (Compazine®) and chlorpromazine (Thorazine®) Unfortunatly, in many cases none of the drugs have been found to be effective.
Diazipam can be given in a number of ways
If the child can swallow diazipam can be given as a pill.
- Via Gastrostomy
If the child cannot swallow and has a gastrostomy, diazepam tablets can be crussed and washed through the gastrostomy tube ot diazipam can be administered in liquid form (a suspension).
If the child cannot swallow and does not have a gastrostomy, diazipam can be administered rectally. Diastat® is and enema containing diazipam for this purpose. If rectal diazipam is not effective the child may have a stool in the rectum and administering a water enema may be necessary before resuming rectal diazipam.
Diazipam can ba administered intracenously (in a vein so that it goes directly into the blood stream) in hospital.
This administrator od diazipam is contraindicated because absorption is unreliable and it often irritates the muscle.