However, in critically ill people, propofol has been found to be superior to lorazepam both in effectiveness and overall cost as a result, the use of propofol for this indication is now encouraged, whereas the use of lorazepam is discouraged. Lorazepam is sometimes used for individuals receiving mechanical ventilation. Lorazepam is noted as being the most tolerable benzodiazepine in those with advanced-stage liver disease. In this setting, impaired liver function is not a hazard with lorazepam, since lorazepam does not require oxidation, in the liver or otherwise, for its metabolism. Lorazepam's anticonvulsant and CNS depressant properties are useful for the treatment and prevention of alcohol withdrawal syndrome. etc.) pose some difficultes with regard to oral administration. Additionally, common seizure characteristics (hypersalivation, jaw-clenching, involuntary swallowing. Oral benzodiazepines, including lorazepam, are occasionally used as long-term prophylactic treatment of resistant absence seizures because of gradual tolerance to their anti-seizure effects, benzodiazepines such as lorazepam are not considered first-line therapies. Lorazepam's anticonvulsant properties and pharmacokinetic profile make intravenous use reliable for terminating acute seizures, but induce prolonged sedation. However, phenobarbital has a superior success rate compared to lorazepam and other drugs, at least in the elderly. Lorazepam is more effective than diazepam and intravenous phenytoin in the treatment of status epilepticus and has a lower risk of continuing seizures that might require additional medication. Intravenous diazepam or lorazepam are first-line treatments for convulsive status epilepticus. Seizures Lorazepam 3mg scored tablets in a blister pack. Withdrawal symptoms, including rebound insomnia and rebound anxiety, may occur after seven days' use of lorazepam. It has a fairly short duration of action. Lorazepam can effectively reduce agitation and induce sleep, and the duration of effects from a single dose makes it an appropriate choice for the short-term treatment of insomnia, especially in the presence of severe anxiety or night terrors. It is fast acting, and useful in treating fast onset panic anxiety. In the US, the FDA advises against use of benzodiazepines such as lorazepam for longer than four weeks. Lorazepam is used in the short-term management of severe anxiety. In 2020, it was the 65th most commonly prescribed medication in the United States, with more than 10 million prescriptions. It is on the World Health Organization's List of Essential Medicines. Lorazepam was initially patented in 1963 and went on sale in the United States in 1977. Due to these concerns, lorazepam use is generally only recommended for up to two to four weeks. In this age group, lorazepam is associated with falls and hip fractures. Older people more often develop adverse effects. If stopped suddenly after long-term use, benzodiazepine withdrawal syndrome may occur. Physical dependence and psychological dependence may also occur. With long-term use, larger doses may be required for the same effect. Among those who are depressed, there may be an increased risk of suicide. When given intravenously, the person should be closely monitored. Ĭommon side effects include weakness, sleepiness, low blood pressure, and a decreased effort to breathe. When given by injection, onset of effects is between one and thirty minutes and effects last for up to a day. It can be given by mouth or as an injection into a muscle or vein. It is also used, along with other treatments, for acute coronary syndrome due to cocaine use. It is also used during surgery to interfere with memory formation and to sedate those who are being mechanically ventilated. It is used to treat anxiety (including anxiety disorders), trouble sleeping, severe agitation, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy-induced nausea and vomiting. Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication.
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