Lorazepam, brand name Ativan, is a type of benzodiazepine prescribed for relief of sleeplessness and excessive anxiety. According to the Beers' Criteria, lorazepam is a potentially inappropriate medication that may cause serious side effects for older adults. Because several medications may interact with lorazepam, it is important that both the pharmacist and prescribing physician have a complete and current list of all medications. Breathing difficulties, chest pain or seizures, swelling of the face, tongue or throat or hallucinations are a medical emergency and require immediate medical attention.
Because patients may become addicted to lorazepam following consistent use, the drug is not recommended for people with a history of drug dependence. In an evaluation of lorazepam patients with sleep disorders, researchers found a temporary improvement in sleep patterns was followed by a worsening of symptoms and an increase in anxiety following withdrawal from the drug, according to PubMed.gov. During the seven-day trial, some memory impairment, confusion and anxiety were also observed. Doctors whose elderly patients are unable or unwilling to withdraw from use of lorazepam, may require inpatient detoxification, advises the American Family Physician website.
Drowsiness or Dizziness
Drowsiness and dizziness are possible side effects of lorazepam, warns the website Drugs.com. For an older adult with potential sensitivity to drug therapy, mental confusion and unsteadiness may be more likely to occur when taking lorazepam. Alcohol, sleep aids, muscle relaxants and antihistamines may enhance the effects of lorazepam, and should not be taken without consulting your doctor. An adult living alone may feel more comfortable if a live-in companion is available to provide assistance at the onset of the treatment plan.
Weakness and Balance Issues
Although studies to determine the safety of lorazepam do not support limiting its use in older adults, older patients may require a lower dose to prevent weakness and balance issues, according to MayoClinic.com. Older adults who take lorazepam, may have a slower metabolism and be more susceptible to muscle weakness and uncoordination, making the risk of falls particularly worrisome. Hip and leg fractures are associated with the use of lorazepam in the elderly. A slow reaction time and other psychomotor effects from the drug, are known to impair driving ability and can increase the risk of auto accidents.
- Duke Clinical Research Institute: Beers Criteria (Medication List)
- American Cancer Society: Lorazepam
- PubMed.gov: Lorazepam: Effects on Sleep and Withdrawal Phenomena
- AFFP: American Family Physician: Addiction: Part I. Benzodiazepines -- Side Effects, Abuse Risk and Alternatives
- Drugs.com: Lorazepam