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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.
In a 1983 study, only 5% of patients who abruptly ceased taking long-acting benzodiazepines after less than eight months demonstrated withdrawal symptoms, but 43% who had been taking them for more than eight months did. With alprazolam, a short-acting benzodiazepine, taken for eight weeks, 65% of patients experienced significant rebound anxiety.
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.
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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).
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]
The mechanism of action of mood stabilizers is not well understood. Common non-antipsychotic mood stabilizers include: Lithium (Lithobid, Eskalith), the oldest mood stabilizer; Anticonvulsants Carbamazepine (Tegretol) and the related compound oxcarbazepine (Trileptal) Valproic acid, and salts (Depakene, Depakote) Lamotrigine (Lamictal)