Lorazepam: Uses, Side effects & Precautions

Introduction

Lorazepam

Lorazepam, a benzodiazepine with a history in psychopharmacology, has emerged as a corner stone in managing various neurological and psychiatric conditions. As a medication renowned for its anxiolytic, soothing, and anti-convulsant properties, lorazepam has traversed decades of clinical use, leaving an indelible mark on the landscape of mental health therapeutics.

This article endeavors to comprehensively explore lorazepam, delving into its pharmacological underpinnings, diverse medical applications, nuanced dosage considerations, and the intricate web of potential side effects and risks. We will navigate the complexities of lorazepam withdrawal and dependence issues and shed light on special considerations for specific patient populations.

Uses

Lorazepam Uses

• Anxiety
• Insomnia
• Seizure disorders
• Preoperative sedation
• Alcohol withdrawal
• Muscle spasms
• Chemotherapy-induced nausea and vomiting

It is employed for various medical purposes, including:

Anxiety disorders

• It is frequently given to treat the signs and symptoms of anxiety disorders, including generalized anxiety disorder.
• It works by signaling the central nervous system-calming effects of the neurotransmitter gamma-aminobutyric acid (GABA).

Insomnia

• In cases of acute insomnia or sleep disturbances associated with anxiety, it may be used as a short-term solution.
• It helps induce sleep by promoting relaxation.

Seizure disorders

• Certain forms of seizures are efficiently controlled by it, especially those connected to status epilepticus, a severe and protracted seizure activity.

Sedation before surgery

• It may be given to patients prior to surgery or other medical procedures to generate agitation and reduce anxiety.

Alcohol withdrawal

• It is utilized to treat alcohol withdrawal symptoms, helping mitigate the potentially severe effects of abrupt cessation of alcohol consumption.

Muscle spasms

• The muscle relaxes, and the properties of lorazepam make it helpful in relieving acute muscles, palms, or tension.

Chemotherapy-induced nausea and vomiting

• It may be prescribed in combination with other medications to manage the symptoms of nausea and vomiting induced by chemotherapy. ¹ Uses| Researched based study from National Institutes of Health

Mechanism of Action

Lorazepam Mechanism of Action

• Imagine your brain is like a busy office, and messages are passed between co-workers. These messages involve the release of chemicals, and one of them is Gamma-aminobutyric acid (GABA), which acts as a calming note.
• Lorazepam is like a special helper that makes GABA more effective. It does this by helping GABA stick to its place on the receiving neurons more easily.
• When GABA sticks there, it opens a channel like a door that lets negatively charged ions in. Like turning down the level in a loud office, this decreases the likelihood of the receiving neuron sending messages.
• So, lorazepam helps GABA send more calming messages, making the brain less active. This is why it is used to calm anxiety, help with sleep, and manage other conditions where the brain might be too busy. But like any powerful helper, it must be used carefully, as too much or too long can cause issues. ¹ Mechanism of Action| Researched based study from National Institutes of Health, ³ Mechanism of Action| Researched based study from United States Food and Drug Administration

Side Effects

Lorazepam Side Effects

• Drowsiness
• Fatigue
• Unsteadiness
• Blurred vision
• Headache
• Memory issues
• Nausea
• Changes in libido
• Constipation

It’s crucial to keep in mind that not everyone will experience these side effects and that some individuals may experience repercussions that aren’t mentioned in the list. Common side effects include:

Drowsiness

• It has a soothing effect; drowsiness or feeling tired is a common side effect.

Dizziness

• Some people could feel queasy, especially if they stand up suddenly.

Weakness

• A feeling of weakness or lack of energy can occur.

Unsteadiness

• Difficulty maintaining balance or coordination might be observed.

Blurred vision

• It can affect the eye, causing it to be temporarily blurred.

Headache

• Headache can be a side effect for some individuals.

Memory issues

• Some people may experience short-term memory issues or difficulty concentrating.

Nausea

• It might cause a feeling of nausea in some people.

Changes in libido

• Changes in sexual desire or performance can occur.

Constipation

• It can affect the digestive system, leading to constipation in some cases. ² Side Effects| Researched based study from National Institutes of Health

 In the event that any of these side effects linger or get worse, it is imperative to speak with a healthcare provider. Additionally, lorazepam, like other benzodiazepines, carries a risk of dependence and withdrawal symptoms if not used as prescribed.

It is important to take the medication as directed and to contact with your healthcare professional before changing your treatment regimen to avoid withdrawal symptoms. Rarely, people may experience severe allergic or paradoxical reactions, which have the opposite of the desired effect.

Dosage

Dosage & Administration of Lorazepam

This depends on the particular illness being treated, the patient’s reaction to the treatment, and other elements.

Following are some general principles:

Anxiety conditions

• Adults should start with 2 to 3 mg per day split into two or three doses.

Insomnia

• For the short-term management of insomnia, the usual dose is 2 to 4 mg before bedtime.

Seizure disorders

• The initial dose for the treatment is typically higher, around 2 to 4 mg, given two or three times per day.

Preoperative sedation

• The dosage for preoperative sedation can vary and is often in the range of 2 to 4 mg, given 1 to 2 hours before the procedure.

Elderly population

• To reduce the danger of over sedation, lower starting doses are frequently advised. It may start with 0.5 to 1 mg per day.

Administration:

• Typically, it is swallowed whole, with or without food. The tablet should be dissolved whole and not crushed or chewed. The medication must be taken at the same time each day in order to maintain a steady level in the body. ³ Administration | Researched based study from United States Food and Drug Administration

What if I miss a dose?

• If you forget to take a dose, do so as soon as you remember.
• If your next dose is soon due, skip the missed dose and go back to your regular dosing plan.
• Avoid taking two doses at once to make up for a missed one.

How long can I safely take lorazepam?

• Due to the possibility of dependence and withdrawal effects, it is normally only prescribed for short-term use.
• Observe your doctor’s instructions precisely, and discuss with them any worries you may have concerned long-term use.
• Depending on your health situation and medical history, they can provide advice that are tailored specifically for you.

Precautions

Precautions to be Taken when Using Lorazepam

Be aware of several safety concerns when using lorazepam to ensure safe and efficient use.

Here are some critical considerations:

Medical history

• Tell your doctor everything you know about your health, especially if you have a history of substance misuse, depression, breathing problems, or liver disease.

Allergies

• If you are allergic to lorazepam or benzodiazepines, inform your healthcare provider.

Pregnancy and breastfeeding

• Inform your doctor if you are nursing a baby, pregnant, or trying to conceive.
• The medication may negatively impact a nursing newborn if it enters breast milk.

Ageing population

• In older people, the sedative effects could be more pronounced. It could be required to modify the dosage.

Alcohol and substance abuse

• Avoid alcohol and illicit substances while taking lorazepam, as combining the substances can increase sedation and the risk of severe side effects.

Driving and operating machinery

• It can impair cognitive and motor skills. You should hold off on driving and using machines until you are familiar with their effects.

Dependence and tolerance 

• Dependence and tolerance with continued lorazepam use, dependence and withdrawal symptoms may emerge.
• Use it as directed and don’t stop taking it suddenly without talking to a doctor.

Acute narrow-angle glaucoma

• If you have a history of acute narrow-angle glaucoma, inform your healthcare provider.

Psychiatric disorders

• If you have a history of depression or other psychiatric disorders with your doctor, lorazepam may affect mental health. ³ Precautions| Researched based study from United States Food and Drug Administration

Interactions

Drug Interactions with Lorazepam

Many medications may interact with it, reducing their efficacy or raising the possibility of negative side effects. The following list of typical medication interactions is related to it:

Other central nervous system depressants:

• Combining lorazepam with other substances that decrease the central nervous system, such as alcohol, opioids, or certain other sedatives, can increase the risk of excessive sedation, Respiratory depression, and other serious side effects.

Antidepressants and antipsychotics

• Some antidepressants and antipsychotic medications may increase the risk of side effects, and dosage adjustments may be needed.

Anti-convulsant

• Combining lorazepam with other anti-convulsant medications may increase the risk of side effects, and dosage adjustments may be needed.

Certain antibiotics

• The body’s lorazepam levels may increase as a result of taking antibiotics like erythromycin and clarithromycin, which would improve sedation.

Cimetidine

• Cimetidine medication for stomach acid issues may increase lorazepam level adjustments.

Probenecid

• It is used to treat gout and may slow down the elimination of lorazepam from the body.

Oral contraceptives

• Some oral contraceptives may increase the effects of lorazepam.

Valproic acid

• When lorazepam and valproic acid are combined, there may be an increased risk of sedation and other side effects.

You must tell your doctor about all medications you are taking, including prescription, over-the-counter, and herbal supplements. This information helps them to make informed decisions about your treatment plan, including adjusting doses or avoiding potentially harmful interactions. ³ Drug Interactions | Researched based study from United States Food and Drug Administration