GENERIC NAME: Lorazepam
BRAND NAME: Ativan
DRUG CLASS AND MECHANISM: Lorazepam is an antianxiety medication in the benzodiazepine family, the same family that includes diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), flurazepam (Dalmane), and others. Lorazepam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another. GABA inhibits activity in many of the nerves of the brain, and it is thought that this excessive activity is what causes anxiety or other psychological disorders. Because lorazepam is removed from the blood more rapidly than many other benzodiazepines, there is less chance that lorazepam concentrations in blood will reach high levels and become toxic. Lorazepam has fewer interactions with other medications than most of the other benzodiazepines.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: Tablets (white): 0.5mg and 1mg, 2mg

STORAGE: Tablets should be kept at room temperature.

PRESCRIBED FOR: Lorazepam is used for the management of anxiety disorders, the short-term relief of the symptoms of anxiety or anxiety associated with depression. The effectiveness of lorazepam, or other benzodiazepines , have not been adequately studied for treatment beyond 4 months. Lorazepam also has been shown to be effective for improving sleep in people with insomnia, for panic attacks, and as an adjunct (i.e., when added to other medications) to prevent nausea and vomiting in patients receiving cancer chemotherapy.

DOSING: The dose of lorazepam is tailored to the patient's needs. Scheduled doses, given twice or three times daily, are sometimes used for persons with continuous anxiety or at bedtime for insomnia. Alternatively, lorazepam may be prescribed on as as needed basis, the physician instructing the patient to take lorazepam when he/she feels anxious.

DRUG INTERACTIONS: Lorazepam and all benzodiazepines, interact with other medications and drugs that slow the brain's processes such as alcohol, barbiturates, and narcotics. There have been cases of marked sedation when lorazepam was given to patients taking the tranquilizer loxapine (Loxitane); it is unclear if there is a drug interaction at all, but concern is warranted.

PREGNANCY: Lorazepam and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester. Lorazepam is best avoided if at all possible in the first trimester and probably throughout pregnancy.

NURSING MOTHERS: It is not known if lorazepam is secreted in breast milk.

SIDE EFFECTS: The most commonly noted side effects associated with lorazepam are sedation (which is reported in approximately 1 in 6 people), dizziness (1 in 15), weakness, and unsteadiness. Other side effects include a feeling of depression, loss of orientation, headache, and sleep disturbance.

Like all benzodiazepines, lorazepam can cause physical dependence. Suddenly stopping therapy after a few months of daily therapy may be associated with a feeling of loss of self-worth, agitation, and insomnia. If lorazepam is taken continuously longer than a few months, stopping therapy suddenly may produce seizures, tremors, muscle cramping, vomiting, and/or sweating.