Diazepam is an interesting drug.
The question of just how long diazepam works is clouded somewhat
by the fact that the main metabolite of diazepam, nordiazepam
(the desmethyl metabolite) is both pharmacologically active and
has a long half life, of several days. Thus, the recommendation
for using diazepam for alcohol withdrawl is sound, as the
combination of the drug plus its active metabolites are indeed
long-acting. As noted, diazepam — like other benzodiazepines —
acts by binding to a unique allosteric site on the GABA receptor.
The efficacy of binding, however, isn’t equivalent — lorazepam is
more potent than midazolam, which in turn is more potent that
diazaepam. Thus, there are pharmacodynamic differences, at least
at the level of drug binding, which favour lorazepam’s efficacy.
It should also be noted that a Cochrane review by Appleton
et al (Evidence-Based Child Health 2009;4(4):1806-9)
notes that lorazepam is associated with equivalent efficacy for
the therapy of seizures as diazepam, while having fewer adverse
effects.