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Midazolam -  marketed in English-speaking countries under brand names Dormicum, Hypnovel, and Versed ,  is a short-acting benzodiazepine drug with an equally fast recovery time, that is used for treatment of acute seizures, moderate to severe insomnia, and for inducing sedation and amnesia before medical procedures.

 It possesses profoundly potent anxiolytic, amnesic, hypnotic, anticonvulsant, skeletal muscle relaxant, and sedative properties and as a consequence,  Midazolam is the most commonly used benzodiazepine as a premedication for sedation; less commonly it is used for induction and maintenance of anaesthesia.  Midazolam is also used for endoscopy procedural sedation and sedation in intensive care.  The anterograde amnesia property of midazolam is useful for premedication before surgery to inhibit unpleasant memories.

 It apparently -  if one simply takes the figures from the eHealthme web site - has far fewer hallucinatory effects than the other benzodiazepines, but these figures are misleading.  Intravenous midazolam is more often used  for procedural sedation (often in combination with an opioid, such as fentanyl), for preoperative sedation, for the induction of general anesthesia, and for sedation of ventilated patients in critical care units than it is as a general sedative or anti-anxiety drug.  This is principally because  Midazolam is far more effective at impairing memory than many of the other benzodiazepines – a property which would render the drug highly dangerous in a non clinical setting.  Since the eHealthme web site tends to record effects from general practise, the figures shown will be artificially low.

 As of 2010,  Midazolam was the most commonly used benzodiazepine in anaesthetic medicine, because it is shorter lasting, is more potent, and causes less pain at the injection site.  It is the most popular benzodiazepine in the intensive care unit (ICU) because of its short elimination half-life, combined with its water solubility and its suitability for continuous infusion. However, for long-term sedation, lorazepam is preferred due to its long duration of action.   In the final stages of ‘end-of-life’ care, midazolam is routinely used at low doses via subcutaneous injection to “alleviate agitation, myoclonus, restlessness or anxiety in the last hours or days of life”.   At higher doses during the last weeks of life, midazolam is considered a first line agent in palliative continuous deep sedation therapy when it is necessary to alleviate intolerable suffering unresponsive to other treatments.

Having said this, however, it too is [amazingly]  ‘abused’.  Not much though.  There are a number of experiences on EROWID, though it may be pushing it a bit to say they are experiences, since few people can really remember what happened, although of the very few experiences there are, many are genuine medical patients, who want to record the effects….

Midazolam is a Schedule IV drug under the Convention on Psychotropic Substances.