Lorazepam (trademarked as Ativan or Orfidal) is a high-potency, intermediate-duration, 3-hydroxy benzodiazepine drug, often used to treat anxiety disorders. Lorazepam has all six intrinsic benzodiazepine effects including the ability to: reduce anxiety, interfere with new memory formation, reduce agitation/induce sleep, treat seizures, treat nausea and vomiting, and relax muscles. Lorazepam is used for the short-term treatment of anxiety, insomnia, acute seizures including status epilepticus, and sedation of hospitalized patients, as well as sedation of aggressive patients. Lorazepam is also the most common benzodiazepine used to decrease the likelihood of agitation and seizures in patients who have overdosed on stimulant drugs. After its introduction in 1977, lorazepam’s main use was to treat anxiety. Among benzodiazepines, lorazepam has a relatively high physical addiction potential. Lorazepam also has misuse potential; the main types of misuse are for recreational purposes or continued use against medical advice. Lorazepam’s ability to reduce agitation, induce sleep, and interfere with the formation of new memories are sometimes used to aid in date rape in a manner similar to GHB. Long-term effects of benzodiazepines include tolerance, dependence, a benzodiazepine withdrawal syndrome, and cognitive impairments which may not completely reverse after stopping treatment; however, for most patients, cognitive impairment is not severe. Withdrawal symptoms can range from anxiety and insomnia to seizures and psychosis. Due to tolerance and dependence, lorazepam is recommended for short-term use, up to two to four weeks only. Adverse effects, including inability to form new memories, depression, and paradoxical effects such as excitement or worsening of seizures, may occur. Children and the elderly are more sensitive to the adverse effects of benzodiazepines. Lorazepam impairs body balance and standing steadiness and is associated with falls and hip fractures in the elderly.
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