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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 .
Symptoms may recur and treatment for some days may be necessary. Catatonia due to abrupt or overly rapid withdrawal from benzodiazepines, as part of the benzodiazepine withdrawal syndrome, should also respond to lorazepam treatment. [55] As lorazepam can have paradoxical effects, haloperidol is sometimes given at the same time. [54] [56]
Paradoxical reactions are rare in the general population, with an incidence rate below 1% and similar to placebo. [ 8 ] [ 120 ] 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.
However, one placebo-controlled study comparing 3 weeks of treatment for insomnia with either loprazolam or triazolam showed rebound anxiety and insomnia occurring 3 days after discontinuing loprazolam therapy, whereas with triazolam the rebound anxiety and insomnia was seen the next day. The differences between the two are likely due to the ...
Shorter acting benzodiazepine compounds are generally associated with a more intense and immediate withdrawal reaction compared to longer acting benzodiazepines. For this reason it is generally recommended to cross from lormetazepam to an equivalent dose of diazepam to gradually taper the dosage.
Lorazepam is preferred to other benzodiazepines and zolpidem due to its longer duration of action. [4] An initial therapeutic effect typically occurs within 10–30 minutes of IV administration lorazepam at doses between 2–4 mg. [5] [4] Higher doses may be used in patients who are unresponsive, to minimise the chance of a false negative ...
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 ...