What is Lorazepam

Lorazepam is a medication that belongs to a group of drugs known as Benzodiazepin. It is sold under the brand name Ativan among others.

Benzodiazepine (Benzos) is a family of psychoactive drugs. They operate on the nervous system causing a change in mood, cognition, behavior, or perception. Similar to other Benzos, Ativan acts quickly on the central nervous system by increasing the availability of gamma-aminobutyric acid (GABA) to the brain. 

It is scheduled as a Schedule IV drug under the Controlled Substances Act in the U.S. and internationally under the United Nations Convention on Psychotropic Substances. This means that the drug comes with a low potential for abuse and low risk of dependence and is medically beneficial. Lorazepam was first introduced by Wyeth Pharmaceuticals in 1977 and has been since a very common prescription for the treatment of several health issues. In terms of medical use, Benzos are one of the most ordinerede lægemidler i verden. Ifølge IQVIA ™ var der 45,0 millioner alprazolam-, 26,4 millioner lorazepam-, 29,2 millioner clonazepam-, 12,6 millioner diazepam- og 7,0 millioner temazepam-recepter udleveret i USA

Generally, Lorazepam is effective in treating symptoms of anxiety disorders such as including panic attacks, unjustified fears, sleeplessness, agitation, and restlessness. It is best prescribed as a short term treatment to prevent any complications. It can also help with status epilepticus (continuous seizures). Lorazepam is sometimes used as a sedative for individuals receiving mechanical ventilation.

Despite the positives of the medical uses, Lorazepam can cause several side effects, especially when abused recreationally. Benzos such as Ativan can create desirable and euphoric effects which leads to non-medical use.

 

Lorazepam Side Effects

Ativan may cause serious side effects including:

  • severe drowsiness,
  • thoughts of suicide or hurting yourself,
  • unusual changes in mood or behaviour,
  • confusion,
  • aggression,
  • hallucinations,
  • worsened sleep problems,
  • sudden restless feeling or excitement,
  • muscle weakness,
  • drooping eyelids,
  • trouble swallowing,
  • vision changes,
  • upper stomach pain,
  • dark urine, and
  • yellowing of the skin or eyes (jaundice)

With long-term benzodiazepine use, it is unclear whether cognitive impairments completely recovers to regular after quitting lorazepam use; cognitive deficiencies continue for at least six months after withdrawal, and sometimes even longer. The higher the doses the more severe the effects are. These effects can include respiratory depression and CNS problems. High doses can also lead to physical and psychological dependency especially when used for longer than 4 weeks. The high potency and short half-life of Ativan can increase the chances of dependency. A person who abuses Ativan or is dependent on the drug tries to get prescriptions from several doctors and might even forge ones themselves. Others might steal medicine from other people. In many cases, people obtain their Benzos from illegal sources who smuggle the drugs. In 2017, there were 47,546 alprazolam, 11,430 clonazepam, 4,451 diazepams, 2,315 lorazepam, and 236 temazepam reports from federal, state, and local forensic Laboratories. For 2018, preliminary estimates indicate there were 40,035 alprazolam, 9,900 clonazepam, 3,421 diazepams, 1,901 lorazepam and 204 temazepam reports from Federal, state and local forensic laboratories.

 

Lorazepam Withdrawal – Lorazepam and Alcohol Addiction

With regular use, tolerance to the drug is developed and higher doses are required to experience the desired relief. In cases of dependence, abrupt quitting of the dug can lead to withdrawal symptoms. The most frequent symptoms of tilbagetrækning fra benzodiazepiner er:

  • søvnløshed
  • gastrisk problemer,
  • tremors, agitation,
  • frygt,
  • muskelspasmer

 De mindre hyppige effekter er irritabilitet,

  • Sved
  • Depersonalization
  • Derealisation
  • Overfølsomhed over for stimuli
  • Depression
  • Suicidal behaviour
  • Psykose
  • Krampeanfald
  • Delirium tremens

Symptoms and signs of lorazepam withdrawal typically climax two to four days after quitting the drug and can last up to a week.

 

Lorazepam Overdose Drug

Lorazepam abuse can also lead to an overdose which is generally not fatal unless Lorazepam is mixed with other opioids or alkohol.

In mild cases, symptoms include drowsiness, mental confusion, paradoxical reactions, dysarthria and lethargy. In more serious cases, and especially when other drugs or alcohol were ingested, symptoms may include ataxia, hypotonia, hypotension, cardiovascular depression, respiratory depression, hypnotic state, coma, and death. In a undersøgelse baseret på 6.148 tilfælde var der anslået 212.770 (95% CI = 167.163, 258.377) beredskabsbesøg årligt tilskrevet bivirkninger, der involverede benzodiazepiner. Mere end halvdelen var besøg, der involverede ikke-medicinsk brug af benzodiazepiner (119,008; 55,9%, 95% CI = 50,0%, 61,9%).

In 2019, 16 per cent of overdose deaths involving opioids also involved benzodiazepines. There also reports of self-harm and suicidal tendencies among Benzo abusers. These numbers demonstrate the dangers of Benzos despite their stature. Even when prescribed medically they can still cause complications and lead to dependency. Recent years have seen an increase in illicit use of Benzos as demonstrated by the increased rates of trafficking and smuggling. In the United States, Lorapezam is considered to be among the top ten prescription medicines that are diverted from the licit market. 

For a safe recovery from using Lorazepam, medical supervision is advised to help the individual with a gradual reduction of the dosage. Medications can also help in relieving withdrawal physical side effects such as pains and agitation. If you need help with Benzodiazepine addiction, have a look at our internet side. The dangers of medicinmisbrug og afhængighed er konstant stigende. Folk er ofte belastet af mentale og psykologiske problemer og er derfor tilbøjelige til at misbruge stoffer, der kan lindre deres smerter. Alligevel kan disse stoffer skabe større sundhedsmæssige problemer og kan endda føre til døden.

 

Referencer

Brunton L, Hilal-Dandan R, Knollmann B, Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 13th ed. McGraw-Hill, New York, NY2018

https://doi.org/10.15585/mmwr.rr6501e1er

Fraser AD (oktober 1998). “Brug og misbrug af benzodiazepiner”. Therapeutic Drug Monitoring. 20 (5): 481–9. doi:10.1097/00007691-199810000-00007PMC 2536139PMID 9780123.

Shorter E (2005). “Benzodiazepines”. A Historical Dictionary of Psychiatry. Oxford University Press. pp. 41–2. ISBN 978-0-19-517668-1.

https://www.rxlist.com/ativan-drug.htm

“Lorazepam”drugs.com. American Society of Health-System Pharmacists. June 29, 2016. Arkiveret from the original on 5 June 2016. Retrieved 15 July 2016.

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Shorter, Edward (2005). “B”En historisk ordbog for psykiatri. Oxford University Press. ISBN 978-0-19-029201-0Arkiveret from the original on 2017-03-28.

Lader M (1984). “Short-term versus long-term benzodiazepine therapy”. Current Medical Research and Opinion. 8 (Suppl 4): 120–126. doi:10.1185/03007998409109550PMID 6144459.

Walker M (2005). “Status epilepticus: an evidence based guide”BMJ. 331 (7518): 673–677. doi:10.1136/bmj.331.7518.673PMC 1226249PMID 16179702.

Battaglia J (2005). “Pharmacological management of acute agitation”. Drugs. 65 (9): 1207–1222. doi:10.2165/00003495-200565090-00003PMID 15916448S2CID 692414.

Riss J, Cloyd J, Gates J, Collins S (2008). “Benzodiazepines in epilepsy: pharmacology and pharmacokinetics”Acta Neurologica Scandinavica. 118 (2): 69–86. doi:10.1111/j.1600-0404.2008.01004.xPMID 18384456S2CID 24453988.