Lorazepam is a benzodiazepine used to treat anxiety disorders or provide temporary relief from anxiety symptoms. It can be used(off-label) to treat a variety of diseases, including social phobia, post-traumatic stress disorder, agitation in acute mania and psychosis, acute alcohol withdrawal, and more.
Lorazepam binds to certain receptor sites in the brain. On the membrane of nerve cells, receptors are particular locations that receive signals from neurotransmitters, which are neurochemicals. The signal is converted to an electrical or other chemical signal by a neurotransmitter once it binds to the receptor and proceeds down the neuron.
Lorazepam’s recommended starting dosage is 0.5 mg three times per day. It can then be increased to a therapeutic dosage of 4-6 mg per day, divided into two doses. The dosage may be increased up to a maximum of 8 mg per day, depending on how severe the symptoms are.
What happens if you take an overdose of Lorazepam?
Oral benzodiazepine overdoses are rarely lethal. Benzodiazepines sometimes cause mortality when taken with other CNS depressants, particularly alcohol, narcotics, and barbiturates.
Drowsiness, confusion, somnolence, weariness, dropped coordination, clumsiness while walking (ataxia), and sluggish reflexes are some of the mild indications of benzodiazepine overdose. When taken alone, benzodiazepines hardly cause death. When some drugs participate in benzodiazepine overdose, severe symptoms such as trouble breathing, slowing heart rate, decreased blood pressure, lack of coordination, and loss of consciousness lead to coma and death.
Sedation and drowsiness are the most often reported, particularly in the early stages of therapy. Other common symptoms include difficulty focusing and remembering things, a dissociative or “spacey” feeling, and trouble with coordination.
In some individuals, benzodiazepines may possess paradoxical effects. In susceptible individuals, the drug stimulates enthusiasm, aggression, hostility, uncontrolled behavior, and wrath, rather than the expected depressive effects. These reactions are especially common in the elderly, people with brain injuries, and people with personality and impulse control difficulties.
Seniors may be more vulnerable due to impaired coordination and reflexes, perhaps leading to falls and injuries.
If you miss a dose, take it right away. If it is near the next planned dose, cancel the missed dose and resume your normal dosing schedule. Avoid taking double the prescribed dose. Lorazepam can be taken before or after meals.
Benzodiazepines and their metabolites are known to cross the placenta and accumulate in the fetal circulation. They are associated with a risk of congenital malformations when used during pregnancy, causing cleft lip and heart deformities in the fetus.
Nursing mothers should not take Lorazepam because it will pass into breast milk and be ingested by the baby. If stopping the drug is not an alternative, breastfeeding should not be started or should be discontinued.
What drugs are contraindicated with lorazepam?
Lorazepam is excreted hepatically by cytochrome P450 by glucuronidation to give an inactive metabolite.
CNS depressants (alcohol, narcotics, barbiturates, and hypnotics) and antihistamines could affect coordination and breathing while increasing drowsiness. Taking lorazepam with oral contraceptives may raise its clearance rate, potentially reducing its effectiveness.
Cimetidine, fluoxetine, ketoconazole, propranolol, divalproex sodium, propoxyphene, and disulfiram; may inhibit the metabolism of Lorazepam, thus increasing the level and pharmacological effects of the drug and producing excessive sedation and other adverse CNS effects.