Lorazepam
Known brand names include Ativan.
A benzodiazepine (Schedule IV controlled substance) taken by mouth for anxiety, or given IV or IM to stop status epilepticus and to sedate patients before surgery.
Known brand names include Ativan.
A benzodiazepine (Schedule IV controlled substance) taken by mouth for anxiety, or given IV or IM to stop status epilepticus and to sedate patients before surgery.
Lorazepam attaches to a site on the receptor for GABA, the brain's main calming chemical. Once attached, it helps GABA bind more tightly to the same receptor, which strengthens GABA's calming signal. The more of these receptors it occupies, the stronger its effects: less anxiety, sleepiness, and fewer seizures.
Taken as a pill, it reaches its peak level in about 2 hours, and about half is gone in about 12 hours. After an injection, memory loss for events is strongest within 15 to 20 minutes when given by vein and within 2 hours when given into a muscle, and the intended effects usually last 6 to 8 hours. The liver turns it into an inactive form that leaves in the urine. Because it slows brain activity, combining it with opioids can cause deep sedation, slowed breathing, coma, and death.
Lorazepam, taken as a pill, treats anxiety disorders and gives short-term relief from anxiety, including anxiety that comes with depression. As an injection, it stops a long, dangerous seizure called status epilepticus. The injection is also given to adults before surgery to make them sleepy, ease their worry, and blur their memory of the day.
The tablets are taken by mouth, and their safety and effectiveness have not been shown in children younger than 12. The injection goes into a vein or a muscle, with breathing support equipment on hand. Its use for status epilepticus has not been proven in children. Everyday stress and tension usually do not need treatment with it, and its benefit beyond 4 months has not been studied.
Sleepiness, dizziness, weakness, and unsteadiness are what people notice most, and they are more likely with age. Memory gaps, confusion, slurred speech, and sometimes agitation instead of calm can also happen. The label treats slowed or stopped breathing as dangerous, especially with opioids. It also warns about addiction and overdose, seizures and long-lasting withdrawal after stopping suddenly, depression and suicidal thoughts, and injury when the injection goes into an artery.
This is the boxed warning, the warning the FDA label prints first.
Use with opioids can cause profound sedation, respiratory depression, coma, and death; limit doses and durations and monitor closely. Benzodiazepines carry risks of abuse, misuse, and addiction. Continued use causes physical dependence; abrupt stop or rapid dose cuts can cause life-threatening withdrawal, so taper gradually.