The active ingredient lorazepam is primarily used to treat patients with anxiety and panic disorders, as it has a calming and anti-anxiety effect. However, taking the active ingredient is associated with several side effects, including fatigue, dizziness, and unsteadiness of gait. If lorazepam is taken over a long period of time, the active ingredient can become addictive. Learn more about the effects, side effects, and dosage of lorazepam here.
Effect of lorazepam
Lorazepam is an active ingredient in the benzodiazepine group, which also includes agents such as alprazolam and diazepam. It is mainly used to treat anxiety and panic disorders. Here, the relatively long half-life of the active ingredient is an advantage, since a long duration of action can thus be achieved. However, lorazepam is usually only used if the symptoms cannot be alleviated with the help of antidepressants or neuroleptics. In addition, lorazepam is also used for sleep disorders when these occur in the context of anxiety and panic disorders. It is particularly useful when a calming effect is also desired during the day. In addition, lorazepam is also prescribed for the prevention and treatment of long-lasting epileptic seizures. The active ingredient binds to specific receptors in the brain, thereby supporting the action of the nerve messenger GABA. As a result, lorazepam reduces anxiety, excitement, and tension, has a sedative effect, and promotes falling asleep and staying asleep.
Side effects of lorazepam
Taking lorazepam can cause a variety of side effects. The following symptoms have been observed particularly frequently:
- Fatigue and drowsiness
- Dizziness
- Drowsiness
- Depression
- Muscle weakness
- Gait unsteadiness
- A slowed reaction
In addition, other side effects may also occur, such as:
- Respiratory depression
- Blood pressure drop
- Nausea
- Constipation
- Blood count changes
- Balance disorders
- Aggressive behavior
- Memory lapses
Rarely, rash, itching and dry mouth also occurred. For a detailed list of all side effects, please refer to the package insert of your medication. While taking the active substance, symptoms may occur that contradict the actual effect. Among other things, restlessness, irritability, anger, nightmares, hallucinations, and psychosis may occur. Such symptoms are called paradoxical reactions. They are particularly common in the elderly as well as in children.
Risk for addiction given
Taking lorazepam, just as with other benzodiazepines, can lead to psychological and physical dependence. This is manifested by the fact that withdrawal symptoms occur after discontinuation of the active substance. Even a few days of use can lead to such withdrawal symptoms. The risk of dependence is closely related to the duration of use and the dosage of the active ingredient. In people with a history of alcohol, medication or drug dependence, the risk of dependence is increased. In this case, you should therefore not take the active substance if possible.
Discontinue lorazepam slowly
Withdrawal symptoms are particularly noticeable when the active substance is stopped suddenly. Affected individuals may then experience the following withdrawal symptoms:
- Sleep disturbances
- Restlessness and anxiety
- Trembling and sweating
- Increased readiness to convulse
- Memory impairment
- Delusions
- Behavioral disorders
- Confusion
- Numbness
- Headache
- Gastrointestinal symptoms such as nausea, vomiting and diarrhea.
- Muscle pain
- Palpitations
To avoid such withdrawal symptoms, the drug should never be discontinued from one day to the next. It is better to gradually reduce the dosage over a longer period of time.
Dosage of lorazepam
Please always discuss the exact dosage of lorazepam with your treating physician – the following dosage information is only a general guideline. As a general rule, treatment with lorazepam should always be as short as possible and the dosage should be as low as possible.Usually, a low dose is started and then increased until the ideal dose is reached. If lorazepam is used to treat anxiety or tension, adults may take between 0.5 and 2.5 milligrams per day. The dose is divided into two to three individual doses. In severe cases, the dose can be increased to up to 7.5 milligrams of lorazepam – but this is only possible if the patient is hospitalized. If lorazepam is used to treat sleep disorders, the entire daily dose should be taken about 30 minutes before falling asleep. Subsequently, a sleep duration of seven to eight hours should be guaranteed. This can prevent side effects such as fatigue and slowed reaction time the next morning. In older patients, lorazepam can have a stronger effect, as the excretion of the active ingredient is slower in them. They may also be more sensitive to the active ingredient, so individualized dosage adjustment is particularly important here.
Overdose – What to do?
If you have taken too large an amount of lorazepam, you should tell your doctor immediately. The overdose may cause symptoms such as drowsiness, lightheadedness, and confusion. In addition, breathing may be decreased and movement may be disturbed. In severe cases, unconsciousness may occur due to overdose of the drug.
Drug interactions with lorazepam
If other medications are taken at the same time as lorazepam, interactions may occur as a result. For example, taking antidepressants, sleeping pills and sedatives, antiepileptic drugs (especially valproic acid), certain antihistamines, opioid painkillers, and neuroleptics (especially clozapine) may increase each other’s effects. Lorazepam itself potentiates the effects of muscle relaxants and non-opioid analgesics. In contrast, macrolide antibiotics, proton pump inhibitors, cimetidine, and use of the contraceptive pill potentiate the effect of lorazepam. Similarly, alcohol may potentiate the effect of benzodiazepine or alter it in an unpredictable manner. Therefore, to be on the safe side, alcohol should not be consumed during treatment. In addition, interactions may also occur with the following medications and agents:
- Beta-blockers
- Anticoagulants
- Asthma medications such as theophylline and aminophylline
- The gout medicine probenecid
Lorazepam: contraindications
Lorazepam must not be taken if there is hypersensitivity to the active ingredient itself or to another active ingredient from the benzodiazepine group. In addition, use is prohibited if the patient is addicted to alcohol, medications, or drugs. In addition, people with narrow-angle glaucoma should also not take the active substance. In patients with certain underlying conditions, lorazepam should only be used after a careful risk-benefit assessment by the treating physician. This includes patients with:
- Liver damage or liver function disorders.
- Renal dysfunction or respiratory dysfunction
- Sleep disorders such as sleep apnea syndrome
- Heart failure
- Low blood pressure
- Epilepsy
- Muscle weakness (myasthenia gravis)
- Problems with the coordination of movement and balance regulation.
In depressed patients, taking lorazepam may increase depression. This may also increase the risk of suicide. Depressed individuals should therefore not receive the drug without an adapted antidepressant therapy.
Pregnancy and lactation
Lorazepam, just like other benzodiazepines, should not be used during pregnancy if possible. Studies suggest that harm to the unborn child may occur as a result of its use. If in doubt, the drug should only be prescribed after a careful risk-benefit assessment by the attending physician. If the mother takes lorazepam shortly before giving birth, this may cause withdrawal symptoms in the infant. It is also not advisable to take lorazepam while breastfeeding, as the active ingredient passes into breast milk. It is broken down much more slowly in infants than in adults, which is why symptoms such as breathing difficulties and weakness in drinking may occur.If the active ingredient must be taken compulsorily during breastfeeding, it is recommended to wean beforehand.
