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Ativan and possible adverse effects


Ativan and possible adverse effects

Any of the five intrinsic benzodiazepine effects possessed by lorazepam (agitation reducer/sleep inducer, muscle relaxant, anxiety reducer, inhibitor of new memory formation, and anticonvulsant) may be considered as adverse or side effects if unwanted.Adverse effects can include sedation and low blood pressure; the effects of lorazepam are increased in combination with other CNS depressant drugs.Other adverse effects include confusion, ataxia, inhibiting the formation of new memories, and hangover effects. With long-term benzodiazepine use it is unclear whether cognitive impairments fully return to normal after stopping lorazepam use; cognitive deficits persist for at least six months after withdrawal, but longer than six months may be required for recovery of cognitive function. Lorazepam appears to have more profound adverse effects on memory than other benzodiazepines; it impairs both explicit and implicit memory. In the elderly, falls may occur as a result of benzodiazepines. Adverse effects are more common in the elderly, and they appear at lower doses than in younger patients. Benzodiazepines can cause or worsen depression. Paradoxical effects can also occur, such as worsening of seizures, or paradoxical excitement; paradoxical excitement is more likely to occur in the elderly, children, those with a history of alcohol abuse, and in people with a history of aggression or anger problems. Lorazepam's effects are dose-dependent, meaning the higher the dose, the stronger the effects (and side effects) will be. Using the smallest dose needed to achieve desired effects lessens the risk of adverse effects.

Sedation is the side effect people taking lorazepam most frequently report. In a group of around 3,500 patients treated for anxiety, the most common side effects complained of from lorazepam were sedation (15.9%), dizziness (6.9%), weakness (4.2%), and unsteadiness (3.4%). Side effects such as sedation and unsteadiness increased with age.Cognitive impairment, behavioural disinhibition and respiratory depression as well as hypotension may also occur.

  • Paradoxical effects: In some cases, paradoxical effects can occur with benzodiazepines, such as increased hostility, aggression, angry outbursts, and psychomotor agitation. These effects are seen more commonly with lorazepam than with other benzodiazepines.Paradoxical effects are more likely to occur with higher doses, in patients with pre-existing personality disorders and those with a psychiatric illness. Frustrating stimuli may trigger such reactions, though the drug may have been prescribed to help the patient cope with such stress and frustration in the first place. As paradoxical effects appear to be dose-related, they usually subside on dose reduction or on complete withdrawal of lorazepam.

 

  • Suicidality: Benzodiazepines may sometimes unmask suicidal ideation in depressed patients, possibly through disinhibition or fear reduction. The concern is that benzodiazepines may inadvertently become facilitators of suicidal behavior.Therefore, lorazepam should not be prescribed in high doses or as the sole treatment in depression, but only with an appropriate antidepressant.

 

  • Amnesic effects: Among benzodiazepines, lorazepam has relatively strong amnesic effects,but patients soon develop tolerance to this with regular use. To avoid amnesia (or excess sedation) being a problem, the initial total daily lorazepam dose should not exceed 2 mg. This also applies to use for night sedation. Five participants in a sleep study were prescribed lorazepam 4 mg at night, and the next evening, three subjects unexpectedly volunteered memory gaps for parts of that day, an effect that subsided completely after two to three days' use.Amnesic effects cannot be estimated from the degree of sedation present, since the two effects are unrelated.

 

High-dose or prolonged parenterally administered lorazepam is sometimes associated with propylene glycol poisoning.

A comprehensive list of possible adverse effects

The list below Applies to lorazepam: oral solution, oral tablet

Severity: Major

You should check with your doctor immediately if any of these side effects occur when taking lorazepam:

More common

  • Drowsiness
  • relaxed and calm
  • sleepiness

Incidence not known

  • Abdominal or stomach pain
  • aggressive, angry
  • agitation
  • anxiety
  • attack, assault, or force
  • black, tarry stools
  • bleeding gums
  • blood in urine or stools
  • bluish lips or skin
  • blurred vision
  • change in consciousness
  • chills
  • coma
  • confusion
  • confusion about identity, place, and time
  • convulsions
  • cough or hoarseness
  • dark urine
  • decreased urine output
  • difficulty in breathing and/or swallowing
  • difficulty in speaking
  • discouragement
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • drooling
  • dry mouth
  • excitation
  • false or unusual sense of well-being
  • fast or irregular heartbeat
  • fear or nervousness
  • feeling sad or empty
  • fever with or without chills
  • general feeling of tiredness or weakness
  • headache
  • hives
  • hyperventilation
  • increased thirst
  • irregular, fast or slow, or shallow breathing
  • irritability
  • itching
  • loss of appetite
  • loss of balance control
  • loss of consciousness
  • loss of interest or pleasure
  • loss of memory
  • lower back or side pain
  • muscle pain or cramps
  • muscle trembling, jerking, or stiffness
  • nausea or vomiting
  • not breathing
  • painful or difficult urination
  • pale or blue lips, fingernails, or skin
  • pinpoint red spots on skin
  • problems with memory
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rash
  • reddening of the skin, especially around ears
  • restlessness
  • seeing, hearing, or feeling things that are not there
  • seizures
  • shaking
  • shortness of breath
  • shuffling walk
  • sleeplessness
  • sore throat
  • sores, ulcers, or white spots on lips or in mouth
  • stiffness of limbs
  • sweating
  • swelling of eyes or inside of nose
  • swelling of face, ankles, or hands
  • swollen glands
  • thoughts or attempts at killing oneself
  • tightness in chest
  • trouble concentrating
  • trouble sleeping
  • twisting movements of body
  • unable to sleep
  • uncontrolled movements, especially of face, neck, and back
  • unexplained bleeding or bruising
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting of blood
  • wheezing
  • yellow eyes or skin

If any of the following symptoms of overdose occur while taking lorazepam, get emergency help immediately:

Symptoms of overdose

  • Changes in patterns and rhythms of speech
  • increased sweating
  • loss of strength or energy
  • low blood pressure
  • nightmares
  • shakiness and unsteady walk
  • slurred speech
  • trouble in speaking
  • unsteadiness, trembling, or other problems with muscle control or coordination
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • unusual excitement, nervousness, restlessness, or irritability
  • unusual paleness unusual weak feeling

Severity: Minor

Some of the side effects that can occur with lorazepam may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known

  • Being forgetful
  • clumsiness
  • constipation
  • decreased interest in sexual intercourse
  • disturbed color perception
  • dizziness or lightheadedness
  • double vision
  • drowsiness
  • feeling of constant movement of self or surroundings
  • hair loss, thinning of hair
  • halos around lights
  • hostility
  • inability to have or keep an erection
  • increased in sexual ability, desire, drive, or performance
  • increased interest in sexual intercourse
  • lack or loss of self-control
  • lethargy
  • loss in sexual ability, desire, drive, or performance
  • low body temperature
  • muscle aches
  • muscle twitching
  • muscle weakness
  • night blindness
  • overbright appearance of lights
  • rapid weight gain
  • sensation of spinning
  • shakiness in legs, arms, hands, or feet
  • shivering
  • sleepiness
  • stupor
  • trembling or shaking of hands or feet
  • tunnel vision
  • weak or feeble pulse

 

 



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