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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]
In terms of the mechanism of action of benzodiazepines, their similarities are too great to separate them into individual categories such as anxiolytic or hypnotic. For example, a hypnotic administered in low doses produces anxiety-relieving effects, whereas a benzodiazepine marketed as an anti-anxiety drug at higher doses induces sleep.
It is not recommended during pregnancy or breastfeeding. [17] Its mechanism of action works by increasing the effect of the neurotransmitter gamma-aminobutyric acid (GABA). [20] Diazepam was patented in 1959 by Hoffmann-La Roche. [15] [22] [23] It has been one of the most frequently prescribed medications in the world since its launch in 1963. [15]
More serious symptoms may also occur such as depersonalization, restless legs syndrome, seizures, and suicidal ideation. Benzodiazepine withdrawal can also lead to disturbances in mental function that persist for several months or years after onset of symptoms (referred to as post-acute-withdrawal syndrome in this form).
The mental health and physical health symptoms induced by long-term benzodiazepine use gradually improved significantly over a period of a year following completion of a slow withdrawal. Three of the 50 patients had wrongly been given a preliminary diagnosis of multiple sclerosis when the symptoms were actually due to chronic benzodiazepine use.
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Withdrawal symptoms tend to last between 3 weeks to 3 months, although 10–15% of people may experience a protracted benzodiazepine withdrawal syndrome with symptoms persisting and gradually declining over a period of many months and occasionally several years.
Withdrawal symptoms can, however, occur at standard dosages and also after short-term use. Benzodiazepine treatment should be discontinued as soon as possible through a slow and gradual dose-reduction regime. [22] Chlordiazepoxide taken during pregnancy can cause a postnatal benzodiazepine withdrawal syndrome. [23]