From the Guidelines
Lorazepam (Ativan) is primarily used to treat anxiety disorders, insomnia, and acute seizures, as well as for sedation before medical procedures, managing alcohol withdrawal symptoms, and controlling severe agitation. The medication works by enhancing the effect of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity, resulting in a calming effect on the central nervous system 1.
Key Uses of Lorazepam
- Anxiety disorders: typical dosages range from 0.5 to 2 mg taken 2-3 times daily, with lower doses often recommended for elderly patients
- Insomnia: lorazepam can be used to help with sleep, but it is generally recommended for short-term use only
- Acute seizures: lorazepam may be administered intravenously at a dose of up to 2 mg maximum, as stated in the guidelines for delirium management in adult cancer patients 1
- Sedation before medical procedures: lorazepam can be used to help patients relax before procedures, with a suggested starting dose of 1 mg s.c. or i.v. stat.
- Managing alcohol withdrawal symptoms: lorazepam can be used to help manage symptoms of alcohol withdrawal, but it should be used with caution and under medical supervision
- Controlling severe agitation: lorazepam can be used to help control severe agitation, especially in patients with delirium, as mentioned in the guidelines for delirium management in adult cancer patients 1
Important Considerations
- Lorazepam can be habit-forming when used long-term (generally beyond 2-4 weeks), and should not be stopped abruptly as withdrawal symptoms may occur
- Side effects may include drowsiness, dizziness, weakness, and impaired coordination, so patients should avoid driving or operating machinery until they know how the medication affects them
- The medication typically begins working within 15-30 minutes when taken orally and even faster when given intravenously
- It is essential to use the lowest effective dose and to monitor patients closely for any adverse effects, especially in older or frail patients, or in patients with chronic obstructive pulmonary disease (COPD) 1
From the FDA Drug Label
Lorazepam Oral Concentrate USP is indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms. Lorazepam Oral Concentrate is a prescription medicine used: to treat anxiety disorders for the short-term relief of the symptoms of anxiety or anxiety that can happen with symptoms of depression
Lorazepam (Ativan) is used for:
- Anxiety disorders
- Short-term relief of anxiety symptoms
- Short-term relief of anxiety associated with depressive symptoms 2 2
From the Research
Uses of Lorazepam
Lorazepam, also known as Ativan, is used for various purposes, including:
- Nighttime sedation: Lorazepam was found to be a potent nighttime sedative, with 1 to 1.25 mg being equivalent to 100 mg sodium pentobarbital for measures of sleep quality and duration 3.
- Preoperative sedation: Lorazepam is used as a preoperative night sedative to reduce anxiety and provide a good night's sleep before surgery 4, 5.
- Anxiety treatment: Lorazepam is effective in managing anxiety states, including symptoms such as anorexia, sleep disturbances, depression, irritability, and fatigue 6.
- Inducing and maintaining sleep: Lorazepam is moderately effective in inducing and maintaining sleep, although it can cause side effects such as memory impairment and confusion 7.
Dosage and Efficacy
The efficacy of lorazepam varies depending on the dosage:
- A dose of 1 to 1.25 mg is equivalent to 100 mg sodium pentobarbital for nighttime sedation 3.
- A dose of 2 mg is effective as a preoperative night sedative, with a significant improvement in sleep quality and duration 4.
- A dose of 4 mg has a wider therapeutic index, but can cause more side effects such as clumsiness, confusion, and sleepiness 4, 5.
- Low doses of lorazepam (less than 2 mg) are effective in managing anxiety states and are well-tolerated with minimal side effects 6.