Lorazepam

Understanding Lorazepam

Although there are countless medications that have roots in ancient times, anxiety treatments are the result of pure pharmaceutical innovation of the 21st century. Lorazepam shares its roots with other drugs in the same class, which were first synthesised by a Polish-American chemist named Leo Sternbach in 1955, while he was working at Hoffmann-La Roche. This revolutionary breakthrough led to a rapid development of more refined compounds that can be used for managing previously untreatable conditions.

In the case of lorazepam, it was first synthesised in the 1970s and has been marketed under various brand names globally, including Ativan and Loreev XR. It is classified as a benzodiazepine with anxiolytic and sedative-hypnotic properties. This medication is available in a number of strengths, including the standard lorazepam 2mg hard tablets.

Lorazepam mechanism of Action

This medication works by enhancing the activity of the gamma-aminobutyric acids (GABA), which are the primary inhibitory neurotransmitters in the central nervous system (CNS). Lorazepam's exertion on the CNS through the enhancement of the GABA neurotransmitter effectively reduces the neural excitability by inhibiting nerve transmission in the brain, effectively calming down the patient.

The pursuit to understand its mechanism of action was part of a larger pharmacological discovery in the 1960s and 70s. Following its approval in 1977, its mechanism of action helped map out the effects of GABA, the CNS's key inhibitory messenger.

Nowadays, lorazepam is available under a number of different brand names that produce exactly the same effects. Once the original patent for Ativan expired, other pharma companies could use the same formula to create generic versions of the treatment. The point of this is to ensure that more people have access to affordable healthcare.

What Are Benzodiazepines?

Well-known medications like lorazepam, diazepam, and alprazolam belong to the benzodiazepine class of drugs. This class mainly revolves around psychoactive drugs which have a core chemical structure that is the fusion of a benzene ring and a diazepine ring. They are among the most widely used medications for certain conditions that relate to neurological hyperactivity due to their rapid efficiency.

Many GPs and patients alike often prefer using medications like lorazepam for managing acute, short-term conditions like severe anxiety, panic attacks, insomnia and muscle spasms. Their main role often revolves around slowing down the messages between the brain and the body. With its modest duration of 6 to 8 hours, lorazepam is an intermediate-lasting benzodiazepine. This balanced duration allows for prolonged relief without causing long-term effects.

Clinical Uses of Lorazepam

Below are some of the most common applications for this medicine.

Generalised Anxiety Disorder (GAD)

GAD symptoms of excessive concern and tension, as well as severe, incapacitating anxiety, can be temporarily alleviated with a lorazepam 2mg tablet.

Anxiety-related Insomnia

Due to its relaxing effect, patients who experience recurrent episodes of insomnia caused by a racing mind or anxious thoughts at bedtime can also use this medication to get a good night's rest.

Preoperative Sedation

This medication is commonly administered before surgical procedures to relieve pre-surgical anxiety.

Status Epilepticus

Lorazepam is a first-line treatment for prolonged, life-threatening seizures (status epilepticus) due to its potent anticonvulsant properties.

Alcohol Withdrawal

It is utilised in managing the acute symptoms of alcohol withdrawal syndrome, including agitation, tremors, and the risk of withdrawal seizures.

Comparing Benzodiazepines

There are a number of benzodiazepines, like lorazepam, which have been regarded for their effectiveness. Other well-known treatments like diazepam and alprazolam closely relate to its effectiveness in managing similar conditions. Below are some of the most well-known benzodiazepines and their usage.

Drug	Onset of Action	Duration	Common Uses	Notes
Lorazepam	20 to 30 minutes	6 to 8 hours	Anxiety related insomnia, Preoperative sedation, episodes of seizure	Preferred treatment for the elderly, less accumulation, few risks of withdrawal
Diazepam	60 minutes	4 to 6 hours	Anxiety episodes, muscle spasms, severe insomnia	Risk of accumulation, lower risk profile, long-lasting half-life.
Alprazolam	30 to 60 minutes	4 to 6 hours	General anxiety disorder, panic attacks, post-traumatic stress disorders	Faster relief, used recreationally to create euphoric states.

This table shows a comparison between different benzodiazepines and highlights the advantages that lorazepam has over other medications.

Dosage and Usage

Although this medication has seen success in managing different kinds of neurological conditions, each individual case requires a tailored approach in order to overcome it. For most adults experiencing anxiety, the standard dosage can be divided between two or three administrations. Patients that are experiencing anxiety-induced insomnia can take a lorazepam dosage just before their bedtime.

To overcome a condition, a medical professional will enquire about a patient's medical history, age, liver function and tolerance level in order to create a tailored approach for their condition. Typically, the smallest effective dosage is used, with stronger variants available should the standard dosage be insufficient.

Lorazepam should only be taken orally with water. In most cases, a GP will encourage patients to take this treatment after a light meal, as heavy fat/sugar meals will delay the onset of this treatment. Once the regimen has been completed, a patient can safely discontinue this medication by slowly decreasing the administered dosage at the end of their treatment.

Possible Lorazepam Side Effects

Like any other medication, this medication is likely to cause some discomfort at the beginning of the treatment. Some of the most common side effects include:

• Drowsiness
• Dizziness
• Tiredness
• Weakness
• Unsteadiness

These side effects can be managed by following the regimen assigned by a medical professional, staying hydrated, and taking the treatment at the same time every day. Although rare, lorazepam can also cause some patients to experience a number of severe negative reactions like agitation, aggression, severe sedation, and respiratory depression. Should these effects become more recurrent, patients are encouraged to consult a medical professional about adjusting the strength of their treatment.

To avoid these negative effects, it is crucial to use the standard Lorazepam 2mg dosage responsibly while avoiding mixing with other treatments such as antidepressants, opioids, muscle relaxants, and other benzodiazepines.

Precautions and Avoiding Dependence

Although many patients have used this treatment to overcome certain conditions like anxiety and seizures, lorazepam may not be usable by everyone due to its primary risk of physical and psychological dependence. In many cases, patients who also abruptly discontinue this medication can experience withdrawal symptoms such as nausea, agitation, and perspiration.

To ensure that a patient is not exposed to any risk, many medical professionals will administer lorazepam in smaller strengths at the beginning and near the end of the treatment. For patients who take hard tablets at home, responsible use of this medication is crucial. Patients should also avoid double dosing, when a dose is missed, wait until the next scheduled dosage. Taking more than advised can increase the likelihood of side effects.

Lorazepam should not be used by those who have allergic reactions to other benzodiazepines, have liver/kidney problems, or have been diagnosed with myasthenia gravis. Similarly, those with breathing problems, a history of addiction, or balancing problems should consult a GP about starting this treatment.

Cost of Lorazepam

Like most medication, the cost depends on a number of factors. Some of these include the number of tablets included in each package, as well as the price each medical dispensary sells it for. In every case, purchasing from a local clinic can be costly and requires visiting a GP beforehand. Online telehealth services make it possible to access treatments like this one without timely appointments and consultations.

The following price range shows the average cost of lorazepam when it is accessed via the internet:

Pack Size (Tablets)	Strength	Price Range (GBP)
30	2 mg	£38 - £40
60	2 mg	£58 - £60
90	2 mg	£83 - £85

The price for a Lorazepam 2mg is generally calculated with the number of tablets inside each pack, with larger packs offering lower unit costs per dosage. In order to save money, many patients have made the switch to online pharmacies where healthcare is more affordable and more convenient.

Frequently Asked Questions

What is lorazepam?

This medication is an effective solution that belongs to the benzodiazepine class of drugs. Lorazepam is primarily used for the short-term management of anxiety disorders and is also used for insomnia. It can also be used as a sedative before medical procedures and for the control of recurrent seizures.

Is 1mg of lorazepam a small dosage?

There are a number of weaker variants available for this medication. Lorazepam is available in a number of strengths, including 1mg and 2mg. While the standard 2mg dosage is able to manage different conditions like anxiety and insomnia, weaker variants are aimed towards new users of the treatment or people with an underlying health condition.

How long does lorazepam take to work?

There are a number of factors that can affect the onset of a lorazepam 2mg tablet. Typically, one oral tablet takes around 30 minutes to affect the body. Depending on the tolerance of an individual and the severity of a condition, this time could be delayed.

What are the ingredients in lorazepam?

Lorazepam is the main ingredient and active compound of the brand name treatment. Other ingredients in this drug include magnesium stearate, lactose monohydrate, polacrilin and microcrystalline cellulose. The complete list of ingredients can be found on the patient information leaflet.

Is addiction possible?

Yes, incorrect and prolonged use of lorazepam can increase the likelihood of addiction. To ensure that this medication does not become harmful to patients, a GP will create a tailored plan with a strict dosage schedule that should be followed closely.

Are withdrawal symptoms possible and how can I manage them?

Stopping lorazepam abruptly after prolonged use can significantly increase the likelihood of withdrawal symptoms like anxiety, insomnia, and irritability. In most cases, gradually decreasing the dosage until treatment is stopped prevents withdrawal and ensures safe usage.