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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]
The changes are most notable with long acting benzodiazepines as these are prone to significant accumulation in such individuals and can lead to withdrawal symptoms. [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.
In 1989, in a 4- to 6-year follow-up study of 30 inpatient people who used benzodiazepines non-medically, Neuropsychological function was found to be permanently affected in some people with long-term high dose non-medical use of benzodiazepines. Brain damage similar to alcoholic brain damage was observed.
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]
[218] [219] Benzodiazepine use ranges from occasional binges on large doses, to chronic and compulsive drug use of high doses. [220] Benzodiazepines are commonly used recreationally by poly-drug users. Mortality is higher among poly-drug users that also use benzodiazepines. Heavy alcohol use also increases mortality among poly-drug users. [21]
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Doses of diazepam are recommended to be about half of those given to younger people, and treatment is limited to a maximum of two weeks. Long-acting benzodiazepines such as diazepam are not recommended for the elderly. [20] Diazepam can also be dangerous in geriatric patients owing to a significantly increased risk of falls. [62]
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