Lorazepam side effects
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Lorazepam Side Effects: A Comprehensive Overview
Common Side Effects of Lorazepam
Lorazepam, a benzodiazepine commonly used for anxiety, sedation, and as a premedicant, is associated with several side effects. Commonly reported side effects include sedation, dizziness, weakness, unsteadiness, and disorientation, which can significantly impair psychomotor abilities and driving performance 38. In a study involving elderly patients, oversedation, amnestic disorders, confusion, depression, and ataxia were frequently observed . These side effects often resolve upon discontinuation of the drug.
Cognitive and Psychomotor Impairment
Lorazepam has been shown to impair cognitive and psychomotor performance. Studies have reported significant increases in sedation and impairment of psychomotor tasks, such as mental arithmetic and letter cancellation tasks, as well as car driving abilities 68. In a double-blind trial, lorazepam produced significant cognitive side effects, including memory impairment and confusion, particularly in older adults . These effects were not significantly influenced by individual differences in pharmacokinetics.
Rebound Phenomena
Withdrawal from lorazepam can lead to rebound phenomena, including rebound insomnia and rebound anxiety. In a sleep-laboratory study, subjects experienced increased sleep latency and total wake time above baseline levels during the withdrawal period, along with heightened daytime anxiety 17. These rebound effects highlight the potential for dependency and the challenges associated with discontinuing lorazepam.
Adverse Effects in Specific Populations
Elderly Patients
Elderly patients are particularly susceptible to the side effects of lorazepam. A retrospective study found that lorazepam use in elderly patients often led to oversedation, confusion, and drug-induced pseudodementia, which was sometimes misdiagnosed as true dementia . These adverse effects necessitate careful monitoring and consideration when prescribing lorazepam to older adults.
AIDS Patients
In a study involving hospitalized AIDS patients, lorazepam was found to be ineffective in treating delirium and was associated with treatment-limiting adverse effects, leading to the early termination of the lorazepam treatment arm . This suggests that lorazepam may not be suitable for managing delirium in this patient population.
Children
In pediatric patients, lorazepam was found to induce significant sedation immediately after surgery, with better amnesia compared to other premedicants like diazepam and trimeprazine. However, no cardiorespiratory depression or other untoward side effects were reported, indicating its suitability as a premedicant for children .
Conclusion
Lorazepam is effective for inducing and maintaining sleep and managing anxiety, but it is associated with a range of side effects, including sedation, cognitive and psychomotor impairment, and rebound phenomena upon withdrawal. These side effects are particularly pronounced in elderly patients and may limit its use in certain populations, such as those with AIDS. Careful consideration and monitoring are essential when prescribing lorazepam to mitigate these adverse effects.
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