Anxiety is, together with depression, one of the most frequent psychological problems worldwide. Our lifestyle can cause a profound activation and reaction of both mind and body. This anxiety can be a mere temporary discomfort for some, but others may find themselves faced with a disabling obstacle that they are unable to fight.

Fortunately, there are various therapies to help manage it and reduce its effects, both at the psychotherapy and pharmacological levels. Among the latter, we can find one of the most widely known anxiolytic drugs in the population: the Orfidal .

Throughout this article we will see what this drug is, how it works and what it is prescribed for, as well as its possible side effects and contraindications.

What is Orfidal?

One of the most popular and widely used psychopharmaceuticals, Orfidal , is part of the group of drugs with psychoactive effect known as anxiolytics , including benzodiazepines. The main active ingredient of this drug is Lorazepam: actually Orfidal is one of the trade names for this substance.

As a benzodiazepine, Orfidal is mainly prescribed as an anxiolytic drug and is also considered a sedative-hypnotic, in addition to presenting effects at the level of muscle relaxation and as an anticonvulsant. It is a highly effective drug, although it also has some addictive potential and can generate some side effects.

This medicine is part of the benzodiazepines of intermediate life , which means that it remains in the body for a period of time between twelve and twenty-four hours and its effects remain in force relatively long throughout the day.

Mechanism of action

The functioning of Orfidal, whose active ingredient is, as we have said, Lorazepam, is based mainly on a mechanism of action in which the drug acts as an indirect agonist of the receptors of gamma-aminobutyric acid type A.

In other words, Orfidal acts at the neuronal level by favouring and increasing the activity of one of the brain neurotransmitters that plays the greatest role in inhibiting or decreasing neuronal activation, GABA. It is the increase of this last one that makes the anxious clinic decrease and generates effects of relaxation and sedation. The effect is especially relevant in the limbic system , the main area of the brain that governs the emotional sphere, as well as different regions of the cortex which allow the processing of information and reasoning.

The usefulness of this drug is enormous and it is very effective, with the advantage that it usually does not generate excessively disabling side effects and allows us to continue with our daily lives normally.

Therapeutic indications: in which disorders is it used?

The main indication for Orfidal or any drug with the same active ingredient is basically the treatment of short-term anxiety, regardless of whether or not an anxiety disorder exists or whether we are dealing with a reaction to a stimulus or a specific situation. However, this drug should only be used in situations of great stress and anxiety (with medical indication), as it also has its disadvantages and risks.

In addition, as a sedative-hypnotic it is also especially useful when performing a pharmacological treatment for insomnia or other sleep disorders in which insomnia appears by default.

It is also often used during depressive episodes, since sleep problems and the comorbid appearance of clinical anxiety are frequent there, and also in other alterations in which a level of intense emotion appears. It is also used in people with problems derived from abstinence from substances such as alcohol.

It is also not uncommon for it to be used in the treatment of some organic diseases linked to anxiety problems, such as irritable colon or the presence of ulcers, or even to treat problems such as nausea in the treatment of chemotherapy for cancer. Likewise, and although it is not an indication as such, is sometimes used for the treatment of epilepsy due to its anti-convulsive properties.

Side effects

Although highly prescribed and very useful, the truth is that the consumption of Orfidal is not without risk or the emergence of possible undesirable side effects. Likewise, there are specific sectors of the population that should not take it, as it is contraindicated.

The main and most notorious side effects are sedation. Although depending on the case and the situation it can be useful, it is possible that the sedative action of the drug makes it difficult to maintain vigilance during the day and reduces performance and productivity in various areas, as well as feeling fatigued and uneasy. Another possible side effect is the emergence of a state of emotional numbness, and a slight sensation of suffocation.

You may experience loss of muscle tone, confusion or slowing down . In addition, it is not uncommon for dizziness or difficulties in coordinating movements and speech to appear. Although it is sometimes used in depressions with anxious characteristics, the truth is that it can also lead to the appearance of depressive symptoms.

It is not uncommon for memory problems to appear, often at the level of difficulty in learning new things or remembering a specific event, as it also has amnesic properties. It can also generate an alteration at the sexual level, causing a decrease in libido in both sexes or erection problems in men. Vertigo and digestive problems and nausea are also possible.

Less frequent but also possible are hypersensitivity and allergy reactions, lowering of body temperature, hypotension, hyponatremia (lack of sodium) and constipation. Sometimes paradoxical reactions can occur, i.e. contrary to what the drug would generally do: generating anxiety, nervousness, panic, agitation, muscular tension, emotional lability and irritability.

In addition, it is also possible for life-threatening conditions such as thrombocytopenia and agranulocytosis to occur, in which there is a decrease in platelets and white and/or red blood cells in the blood (thrombocytopenia and agranulocytosis).

Contraindications

Orfidal is contraindicated in people with cardiac problems, bradycardia and depressions or cardiorespiratory insufficiencies , given that its action favors the appearance of these types of problems. Also people with liver failure.

Similarly, people with hypoxia or lack of oxygen should also avoid its use. It should also be avoided by pregnant women , at least during the first trimester. It should also not be consumed by children or nursing mothers, since it facilitates the acquisition of dependency and withdrawal syndromes by minors to this drug. Driving or using heavy machinery after consumption due to sedation should be avoided.

The combination with alcohol and other drugs should also be avoided. In addition, if other types of medication are used, it will be necessary to inform the doctor due to the possible interaction between drugs and their possible effects.

Finally, it should be borne in mind that lorazepam is a substance which, like the other benzodiazepines , has an addictive potential . Likewise, the cessation of its consumption should be guided and carried out gradually, never all at once, due to the risk of the appearance of withdrawal syndromes.

Bibliographic references:

  • Spanish Agency for Medicines and Healthcare Products (2018). LEAFLET: INFORMATION FOR THE USER. ORFIDAL 1 MG TABLETS. LORAZEPAM. [Online]. Available at: https://cima.aemps.es/cima/dochtml/p/49796/P_49796.html.
  • Gómez, M. (2012). Psychobiology. Manual CEDE de Preparación PIR.12. CEDE: Madrid.
  • Salazar, M.; Peralta, C.; Pastor, J. (2011). Manual of Psychopharmacology. Madrid, Editorial Médica Panamericana.
  • Vidal Vademecum Spain (2015). Orfidal Comp. 1 mg. Vademecum [Online]. Available at: https://www.vademecum.es/medicamento-orfidal_prospecto_49796.