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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]
An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics (drugs used to relieve pain). Equianalgesic charts are used for calculation of an equivalent dose (a dose which would offer an equal amount of analgesia) between different analgesics. [1]
Abuse of benzodiazepines occurs in a wide age range of people and includes teenagers and the old. The abuse potential or drug-liking effects appears to be dose related, with low doses of benzodiazepines having limited drug liking effects but higher doses increasing the abuse potential/drug-liking properties.
Typical Oral Dosage Formulations (mg) Approx. Equivalent Oral Dose to 10 mg Diazepam [b] (mg) Peak Onset of Action (hours) Elimination Half-life of Active Metabolite (hours) Primary Therapeutic Use Adinazolam: Deracyn: Research chemical: 1–2: 3: anxiolytic, antidepressant: Alprazolam
The consensus is to reduce dosage gradually over several weeks, e.g. 4 or more weeks for diazepam doses over 30 mg/day, [1] with the rate determined by the person's ability to tolerate symptoms. [120] The recommended reduction rates range from 50% of the initial dose every week or so, [121] to 10–25% of the daily dose every 2 weeks. [120]
Threshold dose is the minimum dose of drug that triggers minimal detectable biological effect in an animal. [1] At extremely low doses, biological responses are absent for some of the drugs. The increase in dose above threshold dose induces an increase in the percentage of biological responses. [ 2 ]
A prescription is needed for possession of all benzodiazepines. Temazepam formulations containing 20 mg or greater of the drug are placed on List 1, thus requiring doctors to write prescriptions in the List 1 format. [219] In East Asia and Southeast Asia, temazepam and nimetazepam are often heavily controlled and restricted.
Severe withdrawal syndromes can occur from these low doses of benzodiazepines even after gradual dose reduction. [ 78 ] [ 79 ] An estimated 30–45% of chronic low-dose benzodiazepine users are dependent and it has been recommended that benzodiazepines even at low dosage be prescribed for a maximum of 7–14 days to avoid dependence. [ 80 ]