My symptoms are ADD, anxiety, a general underlying fear based aura, tense muscles, aches and pains, trouble focusing, easily frustrated, and excessive sweating. In fact I didn’t realize how intense the symptoms were until I got a lorazepam from the dentist and took it. Suddenly I am totally relaxed and focused, no pain, muscles relaxed, sweating greatly reduced, no anxiety or fear in any form at all. However I know this is not a medicine you can take long term. Does anyone know of one that would have similar effects on my brain?

Chosen Answer:

Ativan (lorazepam) can be taken long term. I am not sure exactly where you heard that is can only be taken short term but that simply is not factual, it is opinion.

Don’t misunderstand me, using lorazepam long term is not ideal and it is generally avoided but many people have used it long term with few, if any, ill effects. For example the official Canadian Psychiatric Association/L’Association des psychiatres du Canada treatment guidelines for anxiety list lorazepam as a second-line treatment although it can be used at any time for short term use.

Lorazepam is in a class of drugs called benzodiazepines. Other benzodiazepines include
Xanax (alprazolam), Valium (diazepam), Rivotril, Klonopin (clonazepam), Tranxene (clorazepate),
Librium (chlordiazepoxide), Lectopam (bromazepam), and Serax (oxazepam).

Lorazepam is used for many medical problems although it is most commonly used for anxiety, acute epileptic convulsions including status epilepticus, sedation, nausea/vomiting caused by chemotherapy, insomnia, alcohol detox, muscle spasms, and many more.

Lorazepam acts on a neurotransmitter called GABA, the principal inhibitory neurotransmitter. Using lorazepam makes it more difficult for a neuronal action potential to occur resulting in less neuronal firing. Many other substances act on GABA including alcohol.

You were likely given a large dose of lorazepam for sedation. If a person takes lorazepam or a related drug often they develop selective tolerance. That simply means that the body adapts to SOME of the effects of lorazepam particularly the sedation and any euphoria. Tolerance to the anticonvulsant effects also occurs more slowly and contrary to common belief there appears to be no formation of tolerance to the anxiolytic (anti-anxiety) effects. Thus it can be used long term and countless studies, including some for 2 years or more have shown lorazepam to be effective.

There are two primary reasons why lorazepam is typically thought to only be effective shot term:

1) Many people (including doctors) think it is only effective short term and have only read about studies using lorazepam for 1-4 weeks. It is very expensive to have a good long term study of a drug and it often takes a long time before the studies actually come out. Actually almost every medication used long term has not been tested for long term use.

2) 1/3- 1/2 of long term users (ie 2+ years) develop significant PHYSICAL dependence. This is NOT the same as addiction (although many people wrongly think it is addiction). That just means the body has physically adapted and for proper functioning the body needs the medication. It is a normal response. It is not a problem as long as the drug is stopped slowly. There is a small risk of actual addiction (addiction is PSYCHOLOGICAL dependence- where people have no control over using and will not stop even if using causes major consequences). Unless you have a personal history of substance abuse then your risk is almost zero and if you have no family history of abuse then it is almost unheard of. Most people who abuse drugs like lorazepam are addicted to other drugs.

The best thing to do is see a doctor (ideally a psychiatrist) and talk about your ADHD and anxiety (most of your other symptoms are symptoms of anxiety). Tell the doctor that you took lorazepam and it was very helpful. The doctor may want to try some alternative medicines to see if they help before using lorazepam. Or he may give you lorazepam and something else with the hope you can stop the lorazepam if the other medication works. Or he may write you a script for lorazepam, monitor how you do, how well it works, and any side effects.

The key to determining if continued use of any medication is appropriate is based on efficacy and side effects/complications. If you have good results with minimal issues then long term use is perfectly fine.

I absolutely recommend you get some help for the ADHD and anxiety, especially since it sounds like they cause many symptoms and are impacting your life significantly. Don’t just keep being miserable, especially since lorazepam may be something that can really help you.

And other GABAnergic drugs that have similar actions to lorazepam have the same risks of physical dependency, most have HIGHER risks of abuse, but in general everything that works in a way like lorazepam is more/less the same. Drugs like Ambien, barbiturates, chloral hydrate, Miltown, and alcohol are some of the best known drugs with actions like lorazepam.
by: Mathieu
on: 21st February 11