Lorazepam
Overview
Lorazepam is a versatile benzodiazepine medication used for anxiety disorders, insomnia, active seizures (status epilepticus), and as a pre-anaesthetic medication for sedation.
Mechanism of Action
Similar to other benzodiazepines, it potentiates the actions of GABA, the major inhibitory neurotransmitter in the central nervous system. This results in generalized depression of the central nervous system, providing anxiolytic, sedative, anticonvulsant, and muscle relaxant properties.
Dosage and Administration
For anxiety, the usual oral dose is 1 mg to 2 mg divided into two or three doses daily. Intravenous lorazepam is a first-line treatment for halting status epilepticus. Like alprazolam, long-term use is discouraged due to dependence risks.
Side Effects
Common side effects include sedation, dizziness, weakness, and unsteadiness. In the elderly, it can significantly increase the risk of falls and cognitive impairment. Sudden withdrawal can precipitate seizures.
Contraindications
Contraindicated in patients with known hypersensitivity to benzodiazepines, severe respiratory failure, or sleep apnea syndrome. Extreme caution is advised in elderly or debilitated patients.
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