What is lorazepam?
There are families ofdrugs in neuropsychiatryused very frequently. Among these, benzodiazepines. Lorazepam is a clear and popular example.
Lorazepamis a medicine, which acts on the central nervous system (CNS) with depressant effects. That is, it inhibits nerve function, relieving symptoms of anxiety associated with depression, sleep disorders, withdrawal syndromes and other psychiatric conditions. (1)
Note: Lorazepam can be administered orally, intravenously (IV), or intramuscularly (I.M.). It comes in 0.5, 1, and 2 mg, bank-colored tablets.
What is lorazepam for?
Lorazepam, like others of its kind (e.g., diazepam), are known torelax the patient’s mind. It is useful, but the person should be careful when taking it. Next, we will explain its use in depth.
1. Anxiety and nervousness
The mechanism of action of lorazepam is tobind to the receptors of the neurotransmitter GABA (similar to diazepam), responsible for slowing down the speed and frequency of electrical discharges from the CNS.
In this sense, the physiological cause of anxiety is an imbalance of neurotransmitters,such as GABA. The amygdala, responsible for regulating feelings of fear, anger and anxiety, is also involved.(two)
Therefore, the binding of the drug to the GABA receptor decreases its symptoms, making it an anxiolytic. It alsoacts as a muscle relaxant, since one of the symptoms of anxiety is muscle tension.
To highlight: Its use as a muscle relaxant is also useful to treat patients with alcohol withdrawal syndrome.
Lorazepam treatment involves doses of 2 to 3 mg, two or three times a day. For alcohol withdrawal symptoms, doses of 2 to 4 mg per hour are used, if necessary, orally, I.V. or I.M.
2. Sleep disorders
Lorazepam is a treatment for sleep disorders (for example, insomnia due to depression)tag. The logic is simple: if you decrease brain activity enough to relax the body, it makes it easier for the patient to fall asleep.
Note:In people under 65 years of age, 3-4 doses of 0.5 mg to 2 mg per day are recommended. People over 65 years of age should take 0.5 to 1 mg before going to bed, orally.
Lorazepam contraindications
There are certain risk groups in which it is not recommended to treat them with lorazepam. Next, we will explain them.
1. Allergy to components
Cases have been reported, where patients developed itching, rashes,sensitivity to light, and other dermatologic reactions. But, the cases are very few, with a frequency of 1:3,500 to 1:20,000.(3)
2. Respiratory and liver failure
Before taking lorazepam, you should notify your doctor if you have any liver (such as cirrhosis), renal (kidney failure), or respiratory deficits.
Important: People with severe respiratory disease, such as severe obstructive pulmonary disease (COPD) or sleep apnea syndrome, are at risk of severe respiratory depression.
3. Myasthenia gravis
If you suffer from this disease , notify your doctor about ittag. Taking CNS depressants can cause severe muscle weakness, which would be counterproductive in these patients.
4. Pregnancy and lactation
The use of lorazepam during the first trimester of pregnancy may increase the risk of the fetus developing neonatal abstinence syndrome, where the baby becomes dependent on the drug, as does the mother.
5. Children and older adults
The knowledge about the use of benzodiazepinesin adults and the elderly is extensive. However, research relevant to children and adolescents remains scarce.
To highlight: The Food and Drug Federation (FDA) states that there is no conclusive evidence on the safety of the drug in children under 12 years of age. In addition, lorazepam is known to reach breast milk, so it is also not recommended as a treatment for infants. (4)
What side effects does lorazepam have?
No drug is free of adverse effects. Prolonged use of lorazepam brings a risk of dependence, as the main complication. But there are also others, which we will explain below:
1. Upset stomach
They are relatively common. They are characterized by loss of appetite and intestinal transit disorders (constipation).
2. Drowsiness, dizziness and tiredness
Possibly due to an exaggerated effect of lorazepam, making the patient’s daily routine difficult. If so, notify your doctor immediately and stop treatment.
3. Confusion and agitation
They are paradoxical reactions. Let us remember that the modulator center of emotions and aggressiveness lies in the limbic system, the same region where lorazepam acts.
To highlight: Behavioral changes may occur, as can cognitive deficits (e.g., anterograde amnesia). They are associated with continued use of lorazepam.
Therefore, it is considered suitable that the duration of treatment should be between2 to 4 weeks.
4. Alterations in libido
Note: In 1988, it was published in the American Journal of Psychiatry that short-term use (1 week) of lorazepam caused an abrupt decrease in libidoin the patient. After discontinuing treatment, the patient’s libido returned within a week.(5)
Key Conclusions
- Lorazepam is a benzodiazepine, an anxiolytic used to treat anxiety, insomnia, muscle spasticity, and alcohol withdrawal syndrome.
- It exerts its effects at the CNS level. There is a high risk of physical dependence on it, so its use should not be prolonged beyond what is necessary.
- Patients with organic deficits, pregnant women, infants and children should not take lorazepam.
- It can produce adverse reactions, such as insomnia, behavioral changes, hyper-aggressiveness, etc.
University Professional in the area of Human Resources, Postgraduate in Occupational Health and Hygiene of the Work Environment, 14 years of experience in the area of health. Interested in topics of Psychology, Occupational Health, and General Medicine.