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A box of Lorazepam Orion (Lorazepam) tablets. 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]
[citation needed] For example, the equivalent dose of diazepam in an elderly individual on lorazepam may be half of what would be expected in a younger individual. [7] [8] Equivalent doses of benzodiazepines differ as much as 20 fold. [9] [10] [11]
Low- or normal-dose dependence was not suspected until the 1970s, and it was not until the early 1980s that it was confirmed. [69] [70] Low-dose dependence has now been clearly demonstrated in both animal studies and human studies, [71] [72] and is a recognized clinical disadvantage of benzodiazepines. Severe withdrawal syndromes can occur from ...
A benzodiazepine can be placed into one of three groups by its elimination half-life, or time it takes for the body to eliminate half of the dose. [189] Some benzodiazepines have long-acting active metabolites , such as diazepam and chlordiazepoxide, which are metabolised into desmethyldiazepam .
Nevertheless, as long as the drug is present it will exert subtle effects within the body. These effects may become apparent during continued use or may appear as withdrawal symptoms when dosage is reduced or the drug is stopped. [citation needed] ***Equivalent doses are based on clinical experience but may vary between individuals. [34]
[35] [36] However a 2016 study found no association between long-term usage and dementia. [37] As with alcohol, the effects of benzodiazepine on neurochemistry, such as decreased levels of serotonin and norepinephrine, are believed to be responsible for their effects on mood and anxiety.
Early studies showed a link between calcium and the release of vasopressin by the secondary messenger system. [52] Vasopressin levels are reduced after the ingestion of alcohol. [53] The lower levels of vasopressin from the consumption of alcohol have been linked to ethanol acting as an antagonist to voltage-gated calcium channels (VGCCs).
The consensus is to reduce dosage gradually over several weeks, e.g. 4 or more weeks for diazepam doses over 30 mg/day, [1] with the rate determined by the person's ability to tolerate symptoms. [120] The recommended reduction rates range from 50% of the initial dose every week or so, [121] to 10–25% of the daily dose every 2 weeks. [120]