The effectiveness and safety of a single-dose Diastat (diazepam rectal gel) for treating clusters of acute repetitive seizures in a nonmedical setting by caregivers was evaluated by a multicenter, double-blind study at Oregon Health Sciences University and 28 other centers. Median seizure frequency in children aged 2 years or older was significantly reduced by Diastat compared to placebo, and a greater number of Diastat patients were seizure free post-treatment (55% cf 34%). Somnolence was the most common adverse effect. Only 3 of 56 receiving Diastat required additional emergency treatment compared to 7 of 58 in the placebo group. 
COMMENT. A single rectal dose of Diastat administered by a non-professional caregiver in a home environment is an effective and safe method of reducing seizure recurrence in children with clusters of acute repetitive seizures. The need for emergency medical treatment is often avoided, and family life is less disruptive. Respiratory depression, a safety concern after IV diazepam, was not observed after rectal Diastat.