The effects of anxiety states maintained over the long term can be emotionally draining for the patient and also interfere with all aspects of daily life. In order to avoid its symptoms and the consequences they entail, it is essential to intervene through psychological and pharmacological therapy.

Benzodiazepines are the drug treatments of choice in these cases. Within this group is lorazepam , which has numerous advantages when accompanying psychological therapy, providing the patient with support for recovery.

What is lorazepam?

Lorazepam is a tranquillising and anxiolytic drug corresponding to the category of high-potency benzodiazepines ; to which five basic properties are attributed:

  • Anxiolytics.
  • Amnesiacs.
  • Sedatives and hypnotics.
  • Anticonvulsant.
  • Muscle relaxants.

This type of anxiolytic drugs have the ability to stabilize the psychic state so that it does not harm or interfere with the daily activities or tasks of the person taking it.

Likewise, one of the advantages that lorazepam presents before other types of benzodiazepines is that it acts on the emotional elements by eliminating them , thus nullifying the tendency to suffer from disorders with an emotional and psycho-reactive base or charge.

This quality makes it a specially recommended medication when accompanying some kind of psychological intervention , besides being combinable with other psychopharmaceuticals or antidepressant treatments.

Uses of this drug

The prescription of lorazepam is mainly limited to the treatment of anxiety disorders and with the aim of alleviating, both in the short and long term, the symptoms that this disorder entails. More specifically, in cases where the symptoms interfere with or limit the patient’s life.

However, it is necessary for the clinical professional to regularly review and evaluate the efficacy of the drug in each patient, since its use in a chronic manner has not been validated by clinical studies and, furthermore, lorazepam is susceptible to provoke both physical and psychological dependence in the person .

Lorazepam is also recommended for the treatment of many other diseases or conditions. These include

  • Irritable bowel syndrome .
  • Epilepsy.
  • Insomnia.
  • Treatment of nausea and vomiting induced by cancer treatment.
  • Management of agitation caused by withdrawal.

Form of administration and dose

Lorazepam comes in two forms: tablets or a concentrated liquid solution to be taken orally. The usual dose is restricted to two or three times a day , i.e. approximately 2.5 mg of the product.

However, in order to achieve the best possible results, it is recommended that the frequency of administration and duration be established by the practitioner on an individual basis. Likewise, if it is necessary to increase the daily dose, it is necessary to do so progressively, thus eliminating possible side effects.

Because of the high tolerance generated by this drug, it is advisable that lorazepam be used only for short periods of two to four weeks . In this way, the risk of physical dependence caused by its long-term consumption is also eliminated, and with it the withdrawal symptoms that it generates. These symptoms are:

  • Anxiety states .
  • Alteration of the senses.
  • Insomnia.
  • Dysphoria .
  • Psychosis and seizures (in the least)

Side effects of lorazepam

As with most medications, regardless of their action or purpose, lorazepam can also be accompanied by a number of side effects and risks.

Although these adverse effects do not necessarily occur in everyone , it is important to be able to recognise them and thus modify the doses or switch to other types of benzodiazepines.

These side effects can be classified as: very frequent, frequent, rare, very rare, or not established.

1. Very frequent

  • Sedation .
  • Feeling tired.
  • Choking sensation.

2. Frequent

  • Asthenia.
  • Muscle weakness .
  • Ataxia.
  • Sense of confusion .
  • Depression.
  • Dizziness.

3. Rare

  • Nausea.
  • Alterations in libido .
  • Impotence.
  • Decreased orgasms.

4. Rare

Shaking .
Erections .

.

5. Very rare

  • Hypersensitivity.
  • Allergic skin reactions.
  • Lack of sodium .
  • Hypothermia.
  • Alterations in the secretion of antidiuretic hormone
  • Hypotension .
  • Constipation.
  • Increase in bilirubin levels .
  • Yellowing of the skin and whites of the eyes
  • Increase in transaminases and phosphatase
  • Thrombocytopenia or decrease in the number of platelets in the blood.
  • Agranulocytosis or decrease in the number of neutrophils in the blood
  • Pancytopenia or reduction of all blood cells.
  • Paradoxical reactions such as anxiety
  • Central nervous system depression.
  • Breathing problems .

In the event that the patient experiences any of the above adverse effects, it is advisable that he goes to the doctor’s office as soon as possible.

Precautions

There are a number of indications or conditions to consider before starting a lorazepam treatment, as it is not indicated for all types of people. In the following cases it is not recommended that it be taken, or at least the patient should be careful of the possible complications that it may cause .

The use of lorazepam is disapproved of in people allergic to this active ingredient, as well as to any of the elements found in this pharmaceutical speciality. The symptoms or adverse effects that the patient may suffer range from breathing difficulties or asthma attacks, to swelling, hives or anaphylactic shock.

Other cases in which the consumption of lorazepam is prohibited are when the person suffers from myasthenia gravis, severe breathing difficulties, sleep apneas or if he/she has severe liver disease.

It is necessary for the patient to inform his doctor if he is taking any other type of medication, including those that can be obtained without a prescription, in order to avoid any possible interference or harmful effect on the body as a result of the combination of drugs.

It is also necessary for the patient to know that both barbiturates and alcoholic beverages exert a depressant effect on the central nervous system, so if they are administered or taken together the sedative effects of the medication are considerably accentuated and harmful.

On the other hand, there are a number of special circumstances under which people should be cautious about taking this medication, or not take it at all. These conditions include pregnancy and breast-feeding; children, elderly and physically frail patients; people with respiratory failure; and driving and use of machinery.

1. Pregnancy and lactation

It is necessary for the patient to inform the medical staff if she is pregnant or if she intends to become pregnant, since the consumption of benzodiazepines is associated with an increased risk of fetal malformations if administered during the first trimester of pregnancy.

In addition, if this drug is given when a woman is late in her pregnancy, lorazepam may cause a number of sequelae in the baby. These effects range from hypoactivity or hypothermia to apnea and breathing and feeding problems. Another adverse effect that lorazepam has on the baby is that the baby is at risk of becoming physically dependent, resulting in postnatal dependence syndrome.

On the other hand, this drug is highly contraindicated during the period of breastfeeding. The effect of benzodiazepines secreted through breast milk may include sedative effects on the baby and inability to breastfeed.

2. Children, elderly and physically weak patients

Under no circumstances should benzodiazepines be administered to children, except for very extreme conditions or illnesses, and the duration of treatment should be as short as possible.

Likewise, given that the elderly and physically weak patients are more predisposed to suffer the effects of the medication , it is recommended that it be administered in very low doses.

3. People with respiratory failure

Like the elderly or those in a situation of physical weakness, patients with some type of respiratory failure should also take this drug in much lower doses, since the risk of suffering respiratory depression is much greater .

4. Driving and use of machinery

Due to the sedative effects of lorazepam, people who need to drive vehicles or operate machinery should exercise caution, as the medication may alter the ability to perform these tasks.