What medication is the first-line therapy for status epilepticus?

Lorazepam is recognized as the first-line therapy for status epilepticus due to its pharmacokinetic properties and efficacy in quickly terminating active seizures. It is a benzodiazepine that acts rapidly by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor. This action is crucial in treating status epilepticus, a medical emergency characterized by prolonged seizures or recurrent seizures without recovery between them.

One primary advantage of lorazepam is its longer duration of action compared to other benzodiazepines like diazepam, making it particularly suitable for use in an emergency setting. Moreover, lorazepam is less lipophilic, leading to a reduced risk of redistribution and maintaining its therapeutic effect for a longer time, which is critical in managing an ongoing seizure episode.

While medications such as diazepam and phenobarbital are used in the context of seizures, they are not preferred as first-line treatments for status epilepticus. Diazepam, for instance, has a shorter duration and may necessitate repeated dosing, which is less ideal in emergency situations. Phenobarbital, although effective, has a slower onset of action and is generally considered when initial treatments fail or in specific