Active Ingredients

Lorazepam – Effect, Application & Risks

Lorazepam

Lorazepam is a substance from the benzodiazepine group . It is used as an anxiolytic, sedative , hypnotic , anticonvulsant , and muscle relaxant. Furthermore, lorazepam is misused in the drug scene. It is subject to the Narcotics Act from an active ingredient quantity of more than 2.5 mg per unit.

What is Lorazepam?

Lorazepam is a solid drug that belongs to the benzodiazepine group and has anxiolytic, sedative, anticonvulsant, hypnotic and muscle relaxant effects. The areas of application mainly include anxiety and panic disorders . Lorazepam is also used to treat status epilepticus and to prevent epileptic seizures . Lorazepam is rarely used for sleep disorders.

The chemical molecular formula of lorazepam is C15H10Cl2N2O2. The melting point of the substance is around 166-168 degrees Celsius. The lethal dose for the rat is 4500 mg x kg^-1 when administered orally. In the case of intraperitoneal application, it is 1810 mg x kg^-1 in the rat. The molar mass of lorazepam is 321.16 gx mol^-1.

Lorazepam, like all benzodiazepines, is open to abuse. Preparations with active ingredient quantities of more than 2.5 mg lorazepam per unit are therefore subject to the Narcotics Act. Lorazepam requires a prescription.

Pharmacological action

Regardless of the route of administration, lorazepam is rapidly and almost completely absorbed. When given orally, the average absorption half-life is between 10.8 and 40.4 minutes. After intravenous injection, the effect occurs very quickly – after just one to two minutes. This is due to the fact that the substance does not have to be resorbed first, but is applied directly into the bloodstream.

The duration of the effect is relatively long with lorazepam: the effect lasts for five to nine hours. In particular, the duration of action depends on the dosage and the type and amount of gastric contents. The half-life of the substance is eleven to eighteen hours with normal liver function. Due to the long duration of action, lorazepam is well suited for the treatment of panic disorders.

Lorazepam is able to cross the blood-brain barrier . The substance then binds to specific receptors in the brain . By binding to the membrane receptor, the effect of the neurotransmitter GABA is increased. GABA has an overall inhibitory effect – this effect is increased by the administration of lorazepam and the state of excitement of the nervous system is reduced overall.

Medical Application & Use

The dosage of lorazepam depends on the area of ​​application and is usually between 0.25 mg and 7.5 mg daily. When using lorazepam, the dosage must always be individually tailored to the patient. There is a risk of excessive sedation, especially in older and weakened patients.

In people under 18 years of age, lorazepam is only used to treat epileptic seizures, to prevent multiple seizures in a row. At higher doses, especially after intravenous administration, anterograde amnesia often occurs . The patient is then unable to remember things that happened during the cast time. This effect is desirable and is used in unpleasant therapeutic interventions.

The indications for lorazepam include the treatment of panic attacks , the treatment of severe anxiety and panic disorders, the treatment of acute delirium (in combination with haloperidol ), the treatment of severe fasciculations (involuntary muscle twitching), the emergency treatment of status epilepticus, the treatment of acute catatonia and the treatment of epilepsy when other antiepileptic drugs are ineffective.

Furthermore, lorazepam is administered as a premedication before some diagnostic and therapeutic interventions and is used for anxiolysis in cardiac arrhythmias . Lorazepam is also used in addiction therapy.

Risks & side effects

Lorazepam interacts with various other drugs and stimulants. With the simultaneous use of sleeping pills and tranquilizers , antiepileptic drugs, neuroleptics , morphine-containing drugs, AT-1 receptor antagonists (used to lower blood pressure ), H2-receptor antagonists (used to inhibit gastric acid secretion), erythromycin , clozapine , anticoagulants (anticoagulants), oral contraceptives (“the pill”), proton pump inhibitors , valproic acid , muscle relaxants, alcohol and antihypertensives(blood pressure reducers) there is a significant increase in the effect.

Various side effects can occur during treatment with lorazepam . These include severe tiredness , reduced responsiveness, drowsiness, loss of libido , hypotension (low blood pressure), muscle weakness , skin reactions, and dry mouth .

Very rarely, psychoses , unsteady gait , confusion , muscle cramps , visual disturbances , sensitivity to light , an increase in liver values , difficulty concentrating , agranulocytosis , reactions such as anger and aggressiveness , a drop in hemoglobin , impotence , anorgasmia and suicidal thoughts can occur.

Other side effects are possible. Participation in road traffic, the operation of heavy machinery and work without a secure footing should not be carried out or only after medical consultation.

Therapy with lorazepam should not be ended abruptly, otherwise tremors , sweating , tachycardia and agitation can occur, which can lead to life-threatening seizures .

Lorazepam can lead to dependency. Cognitive deficits may occur with long-term therapy, but these are reversible after discontinuation of the medication. There is a risk of abuse.

Lorazepam should not be used during pregnancy and lactation , or only when absolutely necessary, as it can harm the unborn child . Furthermore, an infant may experience withdrawal symptoms if the mother was treated with lorazepam near the time of delivery .

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.