With long-term benzodiazepine use it is unclear whether cognitive impairments fully return to normal after stopping lorazepam use; cognitive deficits persist for at least six months after withdrawal, but longer than six months may be required for recovery of cognitive function.

Lorazepam appears to have more profound adverse effects on memory than other benzodiazepines; it impairs both explicit and implicit memory. Adverse effects are more common in the elderly, and they appear at lower doses than in younger patients. Benzodiazepines can cause or worsen depression. Paradoxical effects can also occur, such as worsening of seizures, or paradoxical excitement; paradoxical excitement is more likely to occur in the elderly, children, those with a history of alcohol abuse, and in people with a history of aggression or anger problems.

Using the smallest dose needed to achieve desired effects lessens the risk of adverse effects. Sedation is the side effect people taking lorazepam most frequently report. In a group of around 3, patients treated for anxiety, the most common side effects complained of from lorazepam were sedation Side effects such as sedation and unsteadiness increased with age.

In some cases, paradoxical effects can occur with benzodiazepines, such as increased hostility, aggression, angry outbursts, and psychomotor agitation. These effects are seen more commonly with lorazepam than with other benzodiazepines.

Frustrating stimuli may trigger such reactions, though the drug may have been prescribed to help the patient cope with such stress and frustration in the first place. As paradoxical effects appear to be dose-related, they usually subside on dose reduction or on complete withdrawal of lorazepam. Benzodiazepines are associated with increased risk of suicide, possibly due to disinhibition.

Among benzodiazepines, lorazepam has relatively strong amnesic effects, [28] [52] but patients soon develop tolerance to this with regular use. This also applies to use for night sedation. High-dose or prolonged parenterally administered lorazepam is sometimes associated with propylene glycol poisoning. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. June Learn how and when to remove this template message Lorazepam should be avoided in people with: Allergy or hypersensitivity — Past hypersensitivity or allergy to lorazepam, to any benzodiazepine, or to any of the ingredients in lorazepam tablets or injections Severe respiratory failure — Benzodiazepines, including lorazepam, may depress central nervous system respiratory drive and are contraindicated in severe respiratory failure.

An example would be the inappropriate use to relieve anxiety associated with acute severe asthma. The anxiolytic effects may also be detrimental to a patient's willingness and ability to fight for breath.

However, if mechanical ventilation becomes necessary, lorazepam may be used to facilitate deep sedation. Acute intoxication — Lorazepam may interact synergistically with the effects of alcohol, narcotics, or other psychoactive substances. It should, therefore, not be administered to a drunk or intoxicated person.

Ataxia — This is a neurological clinical sign, consisting of unsteady and clumsy motion of the limbs and torso, due to the failure of gross muscle movement coordination, most evident on standing and walking. It is the classic way in which acute alcohol intoxication may affect a person. Benzodiazepines should not be administered to already-ataxic patients. Acute narrow-angle glaucoma — Lorazepam has pupil-dilating effects, which may further interfere with the drainage of aqueous humor from the anterior chamber of the eye, thus worsening narrow-angle glaucoma.

Sleep apnea — Sleep apnea may be worsened by lorazepam's central nervous system depressant effects. It may further reduce the patient's ability to protect his or her airway during sleep.

Pregnancy and breast feeding — Lorazepam belongs to the Food and Drug Administration FDA pregnancy category D, which means it is likely to cause harm to the developing baby if taken during the first trimester of pregnancy.

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Symptoms of an overdose may include dizziness, low blood pressure, nausea feeling sick , vomiting, agitation, tremor shaking and rarely convulsions and coma.

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking Esitalo. Tell any other doctors, dentists and pharmacists who treat you that you are taking this medicine. If you become pregnant while taking Esitalo, tell your doctor immediately. Tell your doctor immediately if you have thoughts about killing yourself or other mental or mood changes, or if you are close to or care for someone using Esitalo who talks about or shows signs of killing him or herself.

Persons taking Esitalo may be more likely to think about killing themselves or actually trying to do so, especially when Esitalo is first started or the dose is changed or early after treatment discontinuation.

All mentions of suicide or violence must be taken seriously. Occasionally, the symptoms of depression may include thoughts of suicide or self-harm. It is possible that these symptoms continue or get worse until the full antidepressant effect of the medicine becomes apparent. This is more likely to occur if you are a young adult, i.

If you or someone you know demonstrates any of the following warning signs of suicide-related behaviour while taking Esitalo, tell your doctor immediately, or go to the nearest hospital for treatment; patients and care givers should pay attention to these warning signs: Tell your doctor immediately if you experience symptoms such as restlessness or difficulty in sitting or standing still.

These symptoms can occur during the first week of treatment. Contact your doctor as soon as possible if you suddenly experience an episode of mania. Some patients with bipolar disorder manic depression may enter into a manic phase. This is characterised by profuse and rapidly changing ideas, exaggerated gaiety and excessive physical activity. Sometimes you may be unaware of the above-mentioned symptoms and therefore you may find it helpful to ask a friend or relative to help you to observe the possible signs of change in your behaviour.

Things you must not do Do not take Esitalo to treat any other complaints unless your doctor tells you to. Do not give the tablets to anyone else, even if they have the same condition as you.

Do not stop taking Esitalo, or lower the dosage, without checking with your doctor. Do not change the dose without checking with your doctor, even if you experience increased anxiety at the beginning of treatment.

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