What is the first-line medication used to treat status epilepticus?

In the management of status epilepticus, the first-line medication is typically an intravenous benzodiazepine. This approach is supported by the goal of rapidly halting ongoing seizures, which is crucial in this emergency setting. Benzodiazepines, such as lorazepam or diazepam, provide immediate anticonvulsant effects and are well-established in protocols for managing acute seizures. They enhance the effect of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), leading to a quick cessation of seizure activity.

The reason for prioritizing intravenous benzodiazepines is their rapid onset of action and effectiveness in aborting active seizures, which can prevent potential complications from prolonged seizure activity, such as brain damage or respiratory failure.

Other medications mentioned, like phenytoin, lacosamide, and levetiracetam, may play important roles in the broader treatment strategy for epilepsy or as adjuncts after initial seizure control has been established, but they are not considered first-line treatments for acute status epilepticus due to their slower onset or specific indications.