Value of serum diazepam and nordiazepam measurements in anxious patients.

The relationship between the dose and anxiolytic effects of diazepam and the serum concentrations of diazepam and nordiazepam were examined in groups of acutely and chronically anxious patients. The results showed a significant correlation between dose and serum nordiazepam concentrations after short-term (14-day) administration, but no significant association between clinical symptoms of anxiety and serum diazepam and nordiazepam. We conclude that the main value of serum benzodiazepine measurements in anxious patients in assessing compliance, particularly in patients suspected of taking more than the recommended dose. Serum nordiazepam is a more consistent index of dosage after chronic therapy than serum diazepam because it has a longer elimination half-time.