Lorazepam

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

What is Lorazepam?

Lorazepam is a solid drug that belongs to the group of benzodiazepines and has an anxiolytic, sedative, anticonvulsant, hypnotic and muscle-relaxing effect. The areas of application mainly include anxiety and panic disorders. Lorazepam is also used for the treatment of status epilepticus and for the prophylaxis of epileptic seizures. Lorazepam is rarely used in sleep disorders.

The chemical formula of lorazepam is C15H10Cl2N2O2. The melting point of the substance is around 166-168 degrees Celsius. The lethal dose 50 for oral administration in rats is 4500 mg x kg ^ -1. When administered intraperitoneally, it is 1810 mg x kg ^ -1 in rats. The molar mass of lorazepam is 321.16 g x mol ^ -1.

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

Pharmacological effect

Lorazepam is absorbed quickly and almost completely, regardless of the type of application. In the case of oral administration, 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. The reason for this is that the substance does not have to be absorbed 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 stomach contents. The half-life of the substance is eleven to eighteen hours with normal liver function. Because of its 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 - the administration of lorazepam intensifies this effect and the state of excitement of the nervous system is reduced overall.

Medical application & use

The dosage of lorazepam depends on the respective area of ​​application and is usually between 0.25 mg and 7.5 mg daily. When using Lorazepam, the dosage must always be tailored to the patient. Older and debilitated patients in particular are at risk of excessive sedation.

In people under the age of 18, 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 no longer able to remember things that happened during the active 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 twitches), the emergency treatment of status epilepticus, the treatment of acute catatonia and the treatment of epilepsy when other anti-epileptic drugs are ineffective.

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

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Risks & side effects

Lorazepam interacts with various other drugs and luxury foods. With the simultaneous use of sleeping pills and sedatives, antiepileptics, neuroleptics, agents containing morphine, AT-1 receptor antagonists (used to lower blood pressure), H2 receptor antagonists (used to inhibit gastric acid secretion), erythromycin, clozapine, anticoagulants (Anti-coagulants), oral contraceptives ("pill"), proton pump inhibitors, valproic acid, muscle relaxants, alcohol and antihypertensive drugs (blood pressure lowering drugs), the effect is significantly increased.

Various side effects can occur during treatment with lorazepam.These include extreme tiredness, impaired reactions, 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, light sensitivity, an increase in liver values, impaired concentration, agranulocytosis, reactions such as anger and aggressiveness, a drop in hemoglobin, impotence, anorgasmia and thoughts of suicide can occur.

Other side effects are possible. Participation in road traffic, operating heavy machinery and working without a secure footing should not be carried out or only after consultation with a doctor.

Therapy with lorazepam should not be stopped abruptly, as otherwise tremors, sweating, palpitations and excitement may occur, which can lead to life-threatening seizures.

Lorazepam can lead to addiction. Long-term therapy can lead to cognitive deficits, but these are reversible after discontinuation of the medication. There is a risk of abuse.

Lorazepam should not be used during pregnancy and breastfeeding, or only if absolutely necessary, as it can damage the unborn child. Withdrawal symptoms may also occur in an infant if the mother was treated with lorazepam near the time of birth.