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A paradoxical reaction (or paradoxical effect) is an effect of a chemical substance, such as a medical drug, that is opposite to what would usually be expected. An example of a paradoxical reaction is pain caused by a pain relief medication .
Paradoxical reactions are rare in the general population, with an incidence rate below 1% and similar to placebo. [ 8 ] [ 116 ] However, they occur with greater frequency in recreational abusers, individuals with borderline personality disorder , children, and patients on high-dosage regimes.
These effects are paradoxical to the use of benzodiazepines, both clinically and non-medically, in management of mental health conditions. [44] [45] Long-term benzodiazepine use may lead to the creation or exacerbation of physical and mental health conditions, which improve after six or more months of abstinence.
Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication. [14] It is used to treat anxiety (including anxiety disorders ), trouble sleeping , severe agitation , active seizures including status epilepticus , alcohol withdrawal , and chemotherapy-induced nausea and vomiting . [ 14 ]
[12] [13] Paradoxical reactions such as anxiety, delirium, combativeness, hallucinations, and aggression can also occur following benzodiazepine overdose. [14] Gastrointestinal symptoms such as nausea and vomiting have also been occasionally reported. [13]
Paradoxical disinhibition is a paradoxical reaction, an uncommon but recognized phenomenon, characterized by acute excitement and an altered mental state, caused by benzodiazepines. The mechanism is poorly known, but the most accepted theory is that it occurs secondary to inhibition of the restraining influences of the cortex and frontal lobe ...
In rare susceptible individuals, midazolam has been known to cause a paradoxical reaction, a well-documented complication with benzodiazepines. When this occurs, the individual may experience anxiety, involuntary movements, aggressive or violent behavior, uncontrollable crying or verbalization, and other similar effects.
Lorazepam can be made using 2-amino-2′,5-dichlorobenzophenone (a derivative of 2-amino-5-chlorobenzophenone), which is first reacted with hydroxylamine, the obtained product is then reacted with chloroacetyl chloride to give 6-chloro-2-chlormethyl-4-(2′-chlorophenyl)quinazolin-3-oxide, a reaction with methylamine produces ring expansion and rearrangement, which forms 7-chloro-2-methylamino ...