Lorazepam use in modern clinical practice
Sedative drugs are prescribed at the initial treatment stage of neurosis and neurotic disorders. Benzodiazepines are safe and effective sedative drugs that have minimum risk of side effects.
In pronounced symptoms of neurosis and neurotic disorders, benzodiazepines are recommended to use in combination with atypical or typical antipsychotics to achieve sedative effect. In modern clinical practice one of the most effective and most commonly prescribed benzodiazepines is Lorazepam drug.
Lorazepam drug has hypnotic, sedative, muscle relaxant, anxiolytic, anticonvulsant effect. Lorazepam drug possesses pharmacological properties:to stimulate benzodiazepine receptors of allosteric center;to reduce the excitability of the subcortical brain structures (hypothalamus, limbic system, thalamus);to slow down spinal, polysynaptic reflexes.
Anxiolytic effect of Lorazepam drug is caused by the impact on the amygdaloid complex in the limbic system, which leads to decrease of emotional stress, relieves feelings of anxiety, worry and fear.
Sedative effect of Lorazepam is due to the influence on the non-specific thalamic nuclei, reticular formation of brain stem, leading to a decrease in the neurologic symptoms (fear, anxiety).
Soporific effect of Lorazepam is achieved due to inhibition of reticular formation in the brain stem.
Anticonvulsant effect is provided due to taurine which inhibits the excitation in the epileptogenic locus and prevents the spread of epileptogenic activity.
Muscle relaxant action of Lorazepam occurs due to slowing down the activity of spinal, polysynaptic, inhibitory, and afferent ways. When using Lorazepam, it is possible a direct slowing down of motor nerves and muscular system functions.
Lorazepam medication does not affect psychotic symptomatology (hallucinations and affective disorders). In Lorazepam use, severity reduction of delusional disorders and affective intensity is observed in rare cases.
Lorazepam drug is prescribed to treat neurosis and neurotic disorders, including depression and premedication period.
In contrast to other benzodiazepines, Lorazepam has more pronounced sedative effect and is prescribed not only as monotherapy but also as combination therapy of neurotic disorders.
Lorazepam drug has sedative, muscle relaxant and soporific effect in premedication period.
Dosage form of Lorazepam
Lorazepam drug is intended for oral administration. Lorazepam tablets can be taken with or without food.
To treat neurosis and neurological disorders, Lorazepam drug is prescribed in daily dose of 3mg (one Lorazepam 1mg tablet three times a day).
If side effects occur when using Lorazepam in daily dose of 3mg, the dosage should be reduced up to Lorazepam 1mg.
If daily dosage of Lorazepam 3mg does not provide the expected therapeutic effect, Lorazepam daily dosage is recommended to increase up to 6mg (one Lorazepam 2mg tablet three times a day).
Maximum daily dose of Lorazepam is 10mg to treat neurosis and neurotic disorders.
To treat insomnia, caused by anxiety or stress, one-two Lorazepam 1mg tablets are recommended to take before bedtime.
Elderly patients (over 65 years) are recommended to start the treatment with daily dosage of Lorazepam 1mg (one Lorazepam 0.5 mg pill two times a day).
In premedication period, 2-4mg of Lorazepam medication is recommended to take 1-2 hours before surgery.
Lorazepam drug should not be used in children (under 12 years).
Lorazepam 4-6mg once daily is recommended for patients, who previously used anxiolytic drugs.
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