What is Lorazepam used for?

Lorazepam is evaluated for the following indications with varying evidence strength: Panic disorder (evidence tier B), Generalized anxiety disorder (evidence tier B), Insomnia (evidence tier C). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Lorazepam?

Common side effects of Lorazepam (≥ 1 in 100): Drowsiness, sedation, Ataxia, impaired coordination, Dizziness, Anterograde amnesia, Cognitive impairment (especially in older adults). See the Safety section for uncommon and serious reactions.

Is Lorazepam safe during pregnancy?

FDA category D. Category D. Contraindicated: associated with birth defects in trimester 1 and «floppy infant» syndrome in newborns from trimester 3 use.

Is Lorazepam compatible with breastfeeding?

Contraindicated: drug is excreted in breast milk.

Who should not take Lorazepam?

Lorazepam is contraindicated in: Myasthenia gravis; Acute alcohol, opioid, or barbiturate intoxication; Severe respiratory failure; Sleep apnea syndrome; Severe hepatic impairment. Full list in the Safety section.

Lorazepam

AEMPS

Anxiolytics, benzodiazepine derivatives

ATC code: N05BA06 (Lorazepam)

Brand names

Ativan, Temesta, Lorenin, Orfidal

Mechanism of action

Lorazepam is a medium-acting benzodiazepine. It potentiates GABA action at GABA-A receptors, increasing chloride channel opening frequency. Effects include anxiolytic, sedative, anticonvulsant, muscle-relaxant, and amnestic activity. Half-life 10-20 hours. Metabolized by direct glucuronidation without active metabolites or CYP involvement – important advantage in older adults, hepatic impairment, and polypharmacy. Frequently prescribed in Spain, UK, and US for anxiety and emergency conditions.

Indications

Generalized anxiety disorder

Second line

Lorazepam is second-line therapy for GAD, used short-term (2-4 weeks) for severe anxiety or panic attacks. Meta-analyses (Mitte 2005, Reinhold 2015) show efficacy comparable to other benzodiazepines. Lorazepam's advantage is absence of active metabolites and glucuronidation metabolism (not CYP) – convenient in older adults, hepatic impairment, and polypharmacy (no significant CYP interactions). CG113 and GAD guidelines list SSRIs/SNRIs and CBT as first-line; benzodiazepines short-term only. Dose 1-6 mg/day in 2-3 doses. In older adults, start at 0.5-1 mg/day.

Lorazepam

Mechanism of action

Indications

Generalized anxiety disorder

Panic disorder

Marketing claims without evidence base

Insomnia

Practical notes

Russian practice note

Drug interactions

Check interaction with another drug

Official sources

Safety

Contraindications

Serious adverse effects

Common adverse effects

PregnancyFDA D

Breastfeeding

Frequently asked