How lorazepam works
Lorazepam is a drug from the group of benzodiazepines and, as such, has anxiety-relieving (anxiolytic), sedative (tranquilizing), muscle-relaxing (muscle-relaxing) and anticonvulsant (anticonvulsant) effects.
Like all benzodiazepines, lorazepam wikr directly at the junctions between nerve cells in the brain. At these so-called synapses, the nerve cells communicate with each other via messenger substances (neurotransmitters).
Lorazepam binds to a subform of the GABA binding site (GABA-A receptor) and increases the opening probability in the presence of GABA. In this way, the inhibitory effect of GABA is enhanced.
Absorption, degradation and excretion
After ingestion, lorazepam is rapidly and almost completely absorbed into the blood. It can cross the blood-brain barrier and thus enter the central nervous system (CNS) – brain and spinal cord.
When is lorazepam used?
The active ingredient lorazepam is used for the short-term treatment of anxiety, tension and agitation states and associated sleep disorders. In addition, it can be used to calm patients before diagnostic or surgical procedures.
Long-term use of benzodiazepines such as lorazepam often leads to dependence problems. It should therefore only be taken for as short a period as possible (two to four weeks maximum).
The most commonly used dosage form of lorazepam is oral tablets. For patients who have difficulty swallowing or simply refuse to take it, there are melting tablets or injection solutions.
Depending on the area of application, a dosage of 0.5 to 2.5 milligrams is usually given throughout the day or in the evening.
What are the side effects of lorazepam?
The side effects of lorazepam mostly result directly from the desired depressant effect:
Children, the elderly, and people with brain diseases may react paradoxically to its use, i.e., with agitation, restlessness, sleep disturbances, or increased anxiety.
What should be considered when taking lorazepam?
Contraindications
Lorazepam must not be used in:
- known benzodiazepine dependence
- myasthenia gravis (autoimmune-mediated muscle weakness)
- Respiratory dysfunction
- hypersensitivity to lorazepam
Drug interactions
The same applies to painkillers, medicines for allergies (anti-allergics) and epilepsy (anti-epileptics), and agents that affect the heart and blood pressure, such as beta-blockers.
Avoid drinking alcohol during therapy with lorazepam as it may increase the central depressant effect.
Age restriction
In emergency medicine, for example in the event of breakthrough status epilepticus (= epileptic seizure lasting longer than five minutes), lorazepam is approved as a solution for injection from the age of one month.
In older age, the duration of action of lorezapam is prolonged, which usually necessitates a reduction in dosage.
Pregnancy and lactation
However, if taken in the last month of pregnancy, “floppy infant syndrome” is more likely to occur, as the active ingredient can cross the placenta unhindered and thus also exerts its effect in the child. More suitable alternatives in pregnancy are therefore promethazine (for acute anxiety), amitriptyline (for sleep disorders) and quetiapine (for psychotic disorders).
How to obtain medication with lorazepam
Lorazepam requires a prescription in Germany, Austria and Switzerland. Moreover, it is even listed as a narcotic (like all benzodiazepines), which means that the prescription of the active ingredient is particularly strictly regulated.
On a normal prescription, lorazepam can only be obtained if the single dose is a maximum of 2.5 milligrams and no other active ingredients are contained in the preparation.
How long has lorazepam been known?
More facts about lorazepam
Lorazepam is a further development of diazepam, another benzodiazepine. Compared to diazepam, lorazepam has a much shorter duration of action and residence time in the body because no active products (active metabolites) are formed during its metabolism.
