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Lorazepam: Side Effects, Toxicity & Addiction Treatment

Instructor: Amy Albert

Amy is a Physician Assistant and certified professional coder. She holds a masters degree and has taught at the graduate school level.

Lorazepam, also known as Ativan, is a medication used to treat anxiety and insomnia. Though an effective medication with minimal side effects, its use is limited due to the potential for tolerance and addiction.

Help me!

John is waiting to see his primary care physician. He has been unable to sleep since the sudden death of his brother. His mind is always racing and he feels as though he is on edge. When he lies down to sleep he feels his heart racing and his breathing becomes rapid. A sense of doom overcomes him and he fears that he is losing control. He knows that he cannot tolerate another sleepless night. He is hoping that his physician can prescribe a medication to help him sleep. John's physician prescribes a medication called lorazepam that will not only help him sleep, but will also help his anxiety. Prior to seeing his physician, John has never heard of lorazepam. He wonders what type of medication it is.

What is lorazepam?

Lorazepam, also known as by its trade name Ativan, is a medication used for short term treatment of anxiety and insomnia. Lorazepam belongs to a class of medications known as benzodiazepines. Benzodiazepines are widely prescribed medications used to treat anxiety, insomnia, and panic attacks. Other common benzodiazepines are diazepam (Valium) and alprazolam (Xanax). Lorazepam takes effect in about sixty minutes and produces mild sedation along with a feeling of calmness or peace. It may take up to several days for lorazepam to help with insomnia, though it eases symptoms of anxiety after only one dose.

Common side effects reported with lorazepam are fatigue, drowsiness, dizziness, impaired coordination, and difficulty concentrating. These symptoms usually resolve after the first few doses. More serious side effects such as shortness of breath, increased heart rate, and allergic reaction are less common. Lorazepam should be a short term medication. Experts recommend taking lorazepam for no more than two weeks due to the potential for addiction. Addiction is the physical and mental dependence on a particular medication that results in unpleasant withdrawal symptoms when the medication is stopped. Lorazepam, like all benzodiazepines, has a high risk for addiction.

Do I really want to take this medication?

After John's physician discusses the possible side effects and potential for addiction, he is wary of taking the medication. His physician reassures him that lorazepam is safe when taken as prescribed for the shortest amount of time possible. John's physician prescribes a low dose of lorazepam, 0.5 mg, to take once before bed. John wonders if such a low dose will work. He asks his physician if he can take more than one pill at a time. His physician advises John to take just one pill at a time.

A high dose of lorazepam increases the risk of fatigue and loss of coordination. If an excessively large dose of lorazepam is taken, such as in the case of an overdose, the side effects can include blurred vision, slurred speech, low blood pressure, rapid heart rate, weakness and even coma! John is certain that he will follow his physician's orders.

Is it really that easy to get addicted?

Addiction occurs as a person builds up tolerance. Tolerance is the need for higher doses of medication to get the desired effect as the person continues taking the medication. As a person's tolerance builds, and higher doses of medication are used, there is an increased chance of becoming addicted and experiencing withdrawal. Withdrawal consists of unpleasant physical and physiologic symptoms that occur when an addictive medication is stopped suddenly. Sometimes the withdrawal symptoms can be life threatening.

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