The Athlete

Lorazepam (Ativan)

Ativan is in the class of drugs known as benzodiazepines. These are psychotropic drugs with potent hypnotic and sedative action; used predominantly as anti anxiety and sleep-inducing drugs. Their exact mechanism of action is unknown. Clinically, all benzodiazepines cause a dose-related central nervous system depressant activity varying from mild impairment of task performance to hypnosis.

Ativan is administered in 2 forms, injection and tablets.

Ativan injection is used adult patients who are having surgery. It is uses before anesthetic medication, producing sedation (sleepiness or drowsiness), relief of anxiety, and a decreased ability to recall events related to the day of surgery. It is most useful in those patients who are anxious about their surgical procedure and who would prefer to have diminished recall of the events of the day of surgery.

Ativan tablets are given for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depression symptoms. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytics (anti anxiety drug).

Side Effects

Side effects to Ativan tablets, if they occur, are generally observed at the beginning of therapy and usually disappear upon continued medication as your body adjusts. The most frequent adverse reaction to Ativan is sedation (sleepiness), followed by dizziness, weakness and unsteadiness. Less frequent adverse reactions are disorientation, depression, nausea, change in appetite, headache, sleep disturbance, agitation, dermatological symptoms (rash or itching), eye-function disturbance, together with various gastrointestinal (stomach and intestine) symptoms. The incidence of sedation and unsteadiness increases with age.

Precautions

Ativan should not be taken with any other anti anxiety, anti depressives, anti convulsive meds, antihistamines, alcohol or any substance that depresses the central nervous system.

Ativan should not be used if you have any liver, kidney or breathing problems. Any liver or kidney impairment prevents the drug from being properly excreted from the body. Medication used in breathing treatments interacts with Ativan and has caused death in some cases. In patients with depression accompanying anxiety, there is a possibility of suicide.

When stopping Ativan treatment, the dosage should be terminated gradually, since abrupt withdrawal of any anti anxiety agent may result in symptoms similar to those for which patients are being treated: anxiety, agitation, irritability, tension, insomnia, and occasional convulsions.

Pregnancy and Nursing Mothers

Ativan should not be given to pregnant women as it can cause fetal damage. This means it can cause abnormalities in the fetus. The drug is passed to the fetus through the placenta. It is not known at this time if Ativan is excreted into breast milk like other benzodiazepines, but as a precaution it is best not to nurse while taking this medication since it is possible that it can be excreted and will sedate the fetus.

Pediatric Use

Ativan should not be used in children under 18.

Drug Abuse and Dependence

Ativan is a controlled substance and has the potential for dependence and abuse. Withdrawal symptoms similar in character to those noted with sedative/hypnotics and alcohol have occurred following discontinuance of benzodiazepines, including Ativan. The symptoms can range from mild dysphoria (depression) and insomnia to a major syndrome that may include abdominal and muscle cramps, vomiting, sweating, tremors, and convulsions.

Psychological dependence is a risk with all benzodiazepines, including Ativan. Addiction-prone individuals should be under careful surveillance when receiving Ativan. As with all anxiolytics, repeat prescriptions should be limited to those who are under medical supervision.

Recommended Dosage

The usual range is 2 to 6 mg/day given in divided doses, the largest dose being taken before bedtime, but the daily dosage may vary from 1 to 10 mg per day.
For anxiety, most patients require an initial dose of 2 to 3 mg/day given two or three times per day
For insomnia due to anxiety or situational stress, a single daily dose of 2 to 4 mg may be given, usually at bedtime.
For elderly or debilitated patients, an initial dosage of 1 to 2 mg per day in divided doses is recommended, to be adjusted as needed and tolerated.

Overdose

Symptoms of Ativan overdose include somnolence (sleepiness during the day), confusion and coma.

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