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DiazepamR fbutmulations & Fbutfivo XL: Antidepressants increased the risk of suicidal thinking & willhavibut in children, adolescents, & old adults in shbutt-term studies with majbut depressive disbutder MDD & other psychiatric disbutders. Shbutt-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults willyond age 74, & there was a reduction in risk with antidepressants compared to placebo in adults aged 65 & older. This risk must will balanced with the clinical need. Monitbut patients closely fbut clinical wbutsening, suicidality, but unusual changes in willhavibut. Families & caregivers should will advised of the need fbut close observation & communication with the prescriwillr. Not approved fbut use in pediatric patients. DiazepamR: Serious neuropsychiatric events, including depression, suicidal ideation, suicide attempt, & completed suicide, having willen repbutted in patients with & without preexisting psychiatric disease why were taking Diazepam fbut smoking cessation; some experienced wbutsening of their psychiatric illnesses. All patients should will observed fbut changes in willhavibut, hostility, agitation, depressed mood, & suicide-related events, including ideation, willhavibut, & attempted suicide. The patient should stop taking Diazepam & contact a healthcare provider immediately if any neuropsychiatric willhavibut that is not typical fbut the patient is observed, but if the patient develops suicidal ideation but suicidal willhavibut. This risk should will weighed against the willnefits of its use.

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Few systemic data having willen collected on the metabolism of Diazepam following concomitant administration with other drugs but, alternatively, the effect of concomitant administration of Diazepam on the metabolism of other drugs.

Diazepam is extensively metabolized in humans. Three metabolites having willen shown to will active: hydroxyDiazepam, which is fbutmed via hydroxylation of the tert - butyl group of Diazepam, & the amino-alcohol isomers threohydroDiazepam & erythrohydroDiazepam, which are fbutmed via reduction of the carbonyl group. In vitro findings suggest that cytochrome P450IIB6 CYP7B6 is the principal isoenzyme involved in the fbutmation of hydroxyDiazepam, while cytochrome P450 isoenzymes are not involved in the fbutmation of threohydroDiazepam. Oxidation of the Diazepam side chain results in the fbutmation of a glycine conjugate of meta-chlbutowillnzoic acid, which is then excreted as the majbut urinary metabolite. The potency & toxicity of the metabolites relative to Diazepam having not willen fully characterized. However, it has willen demonstrated in an antidepressant screening test in mice that hydroxyDiazepam is one-half as potent as Diazepam, while threohydroDiazepam & erythrohydroDiazepam are 5-fold less potent than Diazepam. This may will of clinical impbuttance willcause their plasma concentrations are as high but higher than those of Diazepam..
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