Latest news with #benzodiazepines
Health Line
19-05-2025
- Health
- Health Line
All About Lorazepam Tablets
Lorazepam is a generic prescription drug that's used to treat anxiety and other conditions related to it. Lorazepam comes as a tablet that you swallow. Lorazepam is used for the short-term treatment of different types of anxiety. It's also used short term to treat: temporary relief of anxiety symptoms related to depression anxiety disorders, such as panic disorder and generalized anxiety disorder insomnia (trouble sleeping) related to anxiety To learn more about lorazepam's uses, see the 'What is lorazepam used for?' section. Lorazepam basics Lorazepam tablets belong to a group of medications called benzodiazepines. You'll take these tablets by swallowing them. Note: Lorazepam also comes in other forms, including an injection and a solution that you swallow. Only the oral tablet form of lorazepam is described in this article. If you'd like to learn about lorazepam's other forms, talk with your doctor or pharmacist. Keep in mind that other forms of lorazepam may have other uses. Lorazepam brand-name versions The lorazepam tablet is the generic version of the brand-name drug Ativan. Lorazepam tablet is a generic drug, which means it's an exact copy of the active drug in a brand-name medication. The brand-name medication that lorazepam tablet is based on is called Ativan. Generic drugs are thought to be as safe and effective as the brand-name drugs they're based on. In general, generics usually cost less than brand-name drugs. Brand and generic versions of a drug work in exactly the same way. They both have the same active ingredients. But generic drugs may have different inactive ingredients, such as fillers or binders. These inactive ingredients don't affect how the drug works. If you'd like to know more about using Ativan instead of lorazepam tablets, talk with your doctor. Lorazepam has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the ' What should be considered before taking lorazepam? ' section. Lorazepam uses Lorazepam tablets are used for the short-term treatment of different types of anxiety. They're also prescribed for: temporary relief of anxiety symptoms related to depression short-term treatment of anxiety disorders, such as panic disorder and generalized anxiety disorder short-term treatment of insomnia related to anxiety With anxiety, you may feel nervous, fearful, or stressed in certain situations. These might include events such as a job interview, meeting new people, or public speaking. Anxiety is generally temporary. But if you experience long-term anxiety that lasts more than 6 months, you may have an anxiety disorder. This can interfere with your daily activities and ability to function. It's possible for anxiety to be a normal response to the stressors of daily life. In this case, it doesn't usually need to be treated with medication. But in other cases, anxiety is treated with drugs such as lorazepam. Lorazepam is used short term for anxiety symptoms. It increases levels of the brain chemical gamma-aminobutyric acid. This helps you feel calm and relaxed, and it reduces your anxiety symptoms. Lorazepam isn't recommended for long-term use. Your doctor may also prescribe lorazepam off-label for other uses. (With off-label use, a drug is given for a purpose other than its approved uses.) Examples of off-label uses for lorazepam include: treating nausea and vomiting related to vertigo or chemotherapy reducing anxiety related to pain managing symptoms of alcohol withdrawal Your doctor can give you more information about lorazepam's uses. They can also describe whether the drug is safe for you to take based on your health history. What are lorazepam's side effects? Like most drugs, lorazepam tablets may cause mild or serious side effects. The lists below describe some of the more common side effects that lorazepam may cause. These lists don't include all the possible side effects. Keep in mind that side effects of a drug can depend on: your age other health conditions you may have other medications you may be taking Your doctor or pharmacist can tell you more about the potential side effects of lorazepam. They can also suggest ways to help reduce side effects. Mild side effects Here's a short list of some of the mild side effects that lorazepam tablets can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read lorazepam's prescribing information. Mild side effects of lorazepam tablets that have been reported include: confusion dizziness drowsiness fatigue problems with memory trouble with coordination or balance Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist. Serious side effects Serious side effects of lorazepam tablets can occur, but they aren't common. If you have serious side effects, call your doctor right away. However, if you think you're having a medical emergency, you should call 911 or your local emergency number. Serious side effects of lorazepam tablets that have been reported include: trouble breathing, including slowed or shallow breathing and, in rare cases, respiratory failure (stopped breathing) mental health problems, such as depressed mood, hallucinations, and suicidal thoughts boxed warnings: Allergic reaction For some people, lorazepam can cause an allergic reaction. In general, symptoms of allergic reaction can be mild or serious. What might help If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking lorazepam. If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care. If your doctor confirms you've had a serious allergic reaction to lorazepam, they may have you switch to a different treatment. Lorazepam dosage Your doctor will explain how you should take lorazepam tablets. They will also explain how much to take and how often. Be sure to follow your doctor's instructions. Below are commonly used dosages for lorazepam tablets, but always take the dosage your doctor prescribes. Note: Lorazepam is available as a tablet, capsule, or solution that you swallow. It's also available as an injection. This article focuses on the lorazepam tablet. For information on other forms of lorazepam, talk with your doctor. Strengths Lorazepam tablets come in the following strengths: 0.5 milligrams (mg) 1 mg 2 mg Recommended dosages Your doctor may prescribe a low dosage for you when you start the treatment. Then, they may gradually increase your dosage if needed. The maximum recommended dosage of lorazepam is 10 mg per day, but your specific lorazepam dosage will depend on: your age the condition you're treating other medications you may be taking other health conditions you may have whether you experience any lorazepam side effects The typical daily dosage of lorazepam will depend on the condition you're taking it to treat. For anxiety, lorazepam is typically taken two or three times per day, with the largest dose given at bedtime. For insomnia, lorazepam is usually taken once per day at bedtime. Your doctor or pharmacist can tell you more about your dosage and how to take this medication. For more information, you can also refer to this lorazepam dosing guide. Taking lorazepam tablets with other drugs Lorazepam may be prescribed with other drugs to treat anxiety. But it can also be used by itself for anxiety. If you're also taking other medications, your doctor may adjust your dosage of lorazepam. This can help lower your risk of side effects of the treatment. Talk with your doctor for information about taking other drugs with lorazepam. They can tell you how this would affect your dosage and risk for side effects. Questions about taking lorazepam tablets Here are a few common questions about taking lorazepam tablets. What if I miss a dose of lorazepam tablets? If you miss a dose, take it as soon as you remember. But don't double your dose if it's close to your next scheduled dose. In that case, just skip the missed dose and continue with your regularly scheduled dose. If you need help remembering when to take your medications, consider using reminder tools. If you're not sure whether to take a missed dose, ask your doctor or pharmacist. Will I need to take lorazepam tablets long term? No. For anxiety treatment, lorazepam is only used in the short term, for up to 4 months. This drug has risks for dependence, misuse, and addiction. So it's only recommended for short-term use. Talk with your doctor about the risks and benefits of lorazepam treatment and how long you should take this drug. Can lorazepam tablets be chewed, crushed, or split? Yes, you can crush, chew, or split lorazepam tablets. But not all lorazepam tablets are scored (have a line across them). If you need to split lorazepam tablets, talk with your pharmacist. They can give you scored tablets and show you how to split them accurately. Should I take lorazepam tablets with food? Food doesn't change the way lorazepam works in your body. You can take it with or without food. But you can time your doses with meals, if this helps you remember to take them. How long do lorazepam tablets take to work? This drug starts to work soon after you take it. But it may take 2 hours or so before you notice the full effect of your lorazepam dose. Overdose Don't take more lorazepam tablets than your doctor prescribes. Taking more than this can lead to serious side effects. Symptoms of overdose Symptoms caused by an overdose can include: confusion drowsiness lethargy trouble breathing coma What to do if you take too much lorazepam Call your doctor if you think you've taken too many lorazepam tablets. You can also call 800-222-1222 to reach America's Poison Centers or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room. What are some frequently asked questions about lorazepam tablets? Find answers to some commonly asked questions about lorazepam tablets. How is lorazepam similar to clonazepam? Lorazepam and clonazepam belong to the same group of medications, called benzodiazepines. They're both prescription drugs, and they have some similarities and a few differences. These drugs work in similar ways to help manage anxiety symptoms. They also have similar side effects, drug interactions, and warnings related to their use. Lorazepam and clonazepam both have brand-name and generic versions. But they have different active ingredients and dosage forms, and some unique uses. To learn more about the differences between lorazepam and clonazepam, talk with your doctor. They can recommend which drug is best for your condition. Is lorazepam a controlled substance? Yes, lorazepam tablets are a controlled substance. Specifically, they're a Schedule IV controlled medication. The government agency called the Drug Enforcement Administration (DEA) has assigned a schedule to them. This is because, while lorazepam has an accepted medical use, it also carries risks of dependence, misuse, and addiction. With dependence, your body needs a drug in order for you to feel normal. And with misuse, a drug is taken in a way other than how it was prescribed. If you have questions about lorazepam, given that it's a controlled substance, talk with your doctor or pharmacist. What should be considered before taking lorazepam tablet? Before you start treatment with lorazepam, tell your doctor about all the medications you take and any health problems you have. This includes whether you have: memory problems depression suicidal thoughts or behaviors, or have had them in the past balance or coordination problems kidney or liver problems seizures, or have had them in the past Also, tell your doctor if you: are pregnant or planning to become pregnant are breastfeeding or planning to breastfeed drink alcohol regularly Your doctor can discuss with you whether lorazepam tablets are safe for you to take. Interactions Taking medications or receiving vaccines, certain foods, and other things with a certain drug can affect how the drug works. These effects are called interactions. Before taking lorazepam tablets, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions that these items may cause with lorazepam tablets. Interactions with drugs or supplements Lorazepam tablets can interact with several types of drugs. Taking certain drugs with lorazepam may increase side effects, which can be serious, in some cases. Examples of these drugs include: This list does not contain all the types of drugs that may interact with lorazepam tablets. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with the use of lorazepam tablets. Other interactions Some herbs and supplements can cause sedation (sleepiness). Taking these products with lorazepam tablets can increase the side effects of lorazepam. Some examples of herbs that cause drowsiness include: chamomile kava lavender valerian root Always discuss any over-the-counter products you're taking with your doctor to help prevent serious side effects. Also, avoid using cannabis (marijuana) while you're taking lorazepam. Taking lorazepam with cannabis or prescription drugs that contain cannabidiol can cause serious sedation. And this may increase your risk of breathing problems and other dangerous side effects. Your doctor or pharmacist can provide more information about this interaction and others. Boxed warnings Lorazepam tablets have boxed warnings. A boxed warning is the most serious warning from the FDA. The medication's boxed warnings are described below. Risk of dependence: Taking lorazepam tablets can cause physical dependence. With dependence, your body becomes used to the drug and needs it for you to feel normal. This risk is higher with long-term use of lorazepam. Suddenly stopping lorazepam after continued use over a long period can cause withdrawal symptoms. Withdrawal symptoms can be serious, and withdrawal may increase the risk of seizures. Misuse and addiction: Lorazepam tablets have a risk of misuse and addiction. With misuse, a drug is taken in a way other than how it was prescribed. With addiction, a drug is taken even if it's causing harm. Misusing lorazepam increases your risk of overdose and, in some cases, even death. Use with opioid drugs: Taking lorazepam tablets with opioids can cause dangerous side effects. These include slowed or shallow breathing, sleepiness, coma, and even death. Some examples of opioids include hydrocodone and buprenorphine. Other warnings Lorazepam tablets may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take lorazepam tablets. Some factors to consider include those in the list below. Help is out there If you or someone you know is in crisis and considering suicide or self-harm, please seek support: Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at Caring counselors are available to listen and provide free and confidential support 24/7. Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7. Not in the United States? Find a helpline in your country with Befrienders Worldwide. Call 911 or your local emergency services number if you feel safe to do so. If you're calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely. If you're not in the same household, stay on the phone with them until help arrives. Use with alcohol Drinking alcohol while taking lorazepam tablets can cause dangerous side effects. These include: trouble breathing sedation (sleepiness) respiratory failure coma You should avoid drinking alcohol while you're taking lorazepam. If you drink alcohol regularly, ask your doctor if lorazepam is safe for you to take. Pregnancy and breastfeeding You should avoid taking lorazepam if you're pregnant or breastfeeding. The drug isn't safe to take during pregnancy because it can harm an unborn baby. Lorazepam can also pass into breast milk, and it's unsafe for breastfed children. Let your doctor know if you're pregnant or breastfeeding. They'll recommend other treatments for your condition that are safer for you. Can lorazepam tablet be misused? Yes, lorazepam is sometimes misused. In fact, the drug has boxed warnings about the risks of misuse, dependence, and addiction. A boxed warning is a serious warning from the FDA. With misuse, a drug is taken differently than how it was prescribed. For example, it may be taken more often or at a higher dose than prescribed. With dependence, your body becomes used to the drug and needs it in order for you to feel normal. And with addiction, a drug is taken even if it's causing harm. Misusing lorazepam to become 'high' can increase your risk of dangerous side effects. These include overdose, addiction, and in some cases, death. Additionally, taking lorazepam tablets in ways other than how they're prescribed can be dangerous. This includes taking them by snorting, rather than by swallowing, as is intended. Be sure to take lorazepam exactly as your doctor has prescribed. Lorazepam isn't recommended for long-term use. Taking lorazepam in higher doses or for longer than recommended can increase your risk for overdose, misuse, dependence, and addiction. This is why it's important to take the drug exactly as your doctor prescribes. If you're not getting relief from your anxiety symptoms with lorazepam, tell your doctor. They can discuss ways to manage your symptoms. But don't change your dosage of lorazepam on your own. Lorazepam cost and savings Whether you have health insurance or not, cost may be a factor when you're considering lorazepam. What you'll pay for lorazepam may depend on several things, such as your treatment plan and the pharmacy you use. Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you'd pay for lorazepam when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.) Learn more about saving on your prescriptions. What should I know about lorazepam vs. alprazolam? Lorazepam and alprazolam have brand-name and generic versions. The brand name for lorazepam is Ativan, and the brand name for alprazolam is Xanax. Both medications belong to a group of drugs called benzodiazepines, and they work in similar ways. These drugs have different active ingredients, but they're both used to treat anxiety symptoms. And they both come as tablets that you'll take by mouth. Both lorazepam and alprazolam have similar side effects and drug interactions. Be sure to ask your doctor which drug is right for you. » Get a detailed comparison of lorazepam (Ativan) vs. alprazolam (Xanax). Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
New York Times
14-05-2025
- Health
- New York Times
When They Couldn't Get Benzos Anymore, Quitting Was Torture
Tasha Hedges took Xanax for 20 years to treat her anxiety and panic attacks, exactly as a psychiatrist had prescribed it. Then in 2022, that doctor unexpectedly died. A general practitioner continued her prescription but retired shortly afterward. The next doctor moved to Canada. Finally, Ms. Hedges found a new psychiatrist. 'The first thing he did was start yelling at me that I had been on Xanax too long,' said Ms. Hedges, 41, who lives in Falling Waters, 'He ripped me off my meds.' Discontinuing the drug typically requires decreasing the dose slowly over months or even years, a process called tapering. Ms. Hedges stopped cold turkey. Debilitating withdrawal symptoms followed: hot flashes, cold sweats, restless legs, the shakes and teeth grinding. 'It was a nightmare,' she said. Two years after discontinuing the medication, she is still dealing with the fallout. 'My brain has not been the same.' In social media groups and websites such as BenzoBuddies, people like Ms. Hedges say they have become physically dependent on benzodiazepines. Many then get cut off from their medication or taper too quickly, and face dangerous and potentially life-threatening withdrawal symptoms that can linger long after the drugs are discontinued. Some doctors, fearful of the risks and stigma associated with these drugs, refuse to prescribe them at all. 'Benzos generate as much anxiety in the prescriber as they do in the patient,' said Dr. Ronald M. Winchel, an assistant clinical professor of psychiatry at Columbia University. 'Do I start it? Is it the right context? Is it safe? Is my patient going to abuse it? What will my colleagues think?' Prescriptions for benzodiazepines like Xanax, Ativan and Valium have been trending down since 2016, in part because of doctors' concerns. Even so, these medications are considered quick and efficacious, and they remain among the most commonly prescribed drugs in the country to treat conditions including anxiety and sleep disorders. In 2019, an estimated 92 million benzodiazepine prescriptions were dispensed in the United States, according to the Food and Drug Administration. Current guidelines recommend prescribing the lowest effective dose for the shortest possible duration, usually less than four weeks. But patients tend to stay on them longer than that. A F.D.A. review found that in 2018 about half of patients took them for two months or longer. Sometimes patients stay on them for years without regular check-ins to see if the drugs are still needed or well tolerated, said Dr. Edward K. Silberman, a professor emeritus of psychiatry at the Tufts University School of Medicine who has frequently written about benzodiazepines. Because patients can develop a physical dependence within several weeks of steady benzodiazepine use, going off the drugs — even after a short period — requires a gradual process. However, many practitioners are not well trained in tapering the prescriptions. To make the process clearer, in March experts at the American Society of Addiction Medicine released new guidelines for dosage reduction that were developed with funding from the F.D.A. 'It's absolutely insane to pressure people to get off and to withdraw people abruptly,' Dr. Silberman said. Jody Jarreau, 60, started taking Klonopin for insomnia 25 years ago while he was living in Dallas. When his psychiatrist quit practicing for medical reasons, he eventually found another who suggested that he take two other benzodiazepines, Xanax and Valium, and work toward weaning off the Klonopin. After about six months of taking all three drugs, Mr. Jarreau grew frustrated and decided to take matters into his own hands. He weaned himself off the Klonopin and Xanax. He is still trying to get off the Valium, with the help of his general practitioner and a coach from the Benzodiazepine Information Coalition, a nonprofit group. Initially, Mr. Jarreau said, he tapered too quickly off the drugs, and developed headaches, nausea and agoraphobia, which is an excessive and irrational fear of being in open or unfamiliar places. But one of the toughest withdrawal symptoms has been thoughts of suicide. 'There's kind of like this background noise that says, You know, just take yourself out,' he said. 'It'd be easier.' He says that he had never experienced any of these symptoms before cutting back on the drugs. In 2023, advocates for those injured by benzodiazepines gave a name to the varied long-lasting symptoms that may emerge during the use, the tapering or the discontinuation of the drugs: benzodiazepine-induced neurological dysfunction, or BIND. Not everyone will experience BIND, they acknowledge. And with the right tapering plan, experts say, side effects can be minimized. 'These are very good and safe drugs when given to the right person in the right dose for the right period of time,' said Dr. Carl Salzman, a professor of psychiatry at Harvard Medical School and the former chairman of the American Psychiatric Association's benzodiazepine task force. But even though benzodiazepines have been around since the '60s, some doctors are unaware of how best to help their patients stop taking these drugs. This is in part because there is no one-size-fits-all tapering strategy. It is the withdrawal symptoms, some patients say, that make it necessary for them to continue to access these drugs while slowly tapering. Dr. Silberman recalled one patient who needed to shave flakes off her pill with a razor blade to slowly decrease her dosage and minimize difficult side effects. The A.S.A.M.'s new guidelines for reducing a patient's dosage of a benzodiazepine draw heavily from clinical experience given the sparse and limited research on tapering. They recommend that clinicians assess the risks and the benefits of ongoing benzodiazepine prescribing at least every three months, and, when tapering, consider reducing the current dose by 5 to 10 percent every two to four weeks. The guidelines also say patients who have been taking benzodiazepines for years may require more than a year of tapering, and should be monitored even after the drug has been discontinued. 'Most of us were never warned about the chances of dependency and long-term complications,' said D.E. Foster, a researcher who contributed to the new guidelines and is an advocate for people like himself who have struggled with benzodiazepine complications. Slow tapering can be difficult, he added, 'but abrupt tapering can be dangerous.' The A.S.A.M. guidance came too late for LaTasha Marbury, 49, who lives in Purchase, N.Y., and had become physically dependent on Klonopin. In 2022 she visited an addiction detox facility because she was desperate to stop taking the drug, which she had started for insomnia. Practitioners at the facility weaned her off it in just five days. Afterward, she cried hysterically and felt hopeless, she said. She experienced night terrors that felt 'almost like a lion is in the room but you can't see it and you're fighting it,' an inability to sit still and deep depression. She visited another addiction facility in Florida where she received an antidepressant. Within weeks she began to feel much better. Now, she said, 'I sleep like a freaking baby.' And she wonders: Was this, rather than the benzodiazepine, the drug that she should have been prescribed all along? 'When I think about it — what I went through — I cry,' she said. 'It wasn't a physical pain but it was a mental pain. And I'm thankful to be alive.'
