Ativan: one of the best anxiolytics in modern clinical practice Ativan has been used since 1977 and revealed reliable effectiveness and safety in different categories of patients. It cures mental disorders and epilepsy and is used for sedation

Ativan

Ativan belongs to the anxiolytics of the benzodiazepine group. This medicine was introduced in clinical practice in 1977 and comes in different dosage forms, including solid (pills) and liquid (for injections). It has quite a wide range of indications and good tolerability. Therefore, this remedy is often prescribed and is valued by both specialists and patients.

The action and basic indications

An active ingredient of this remedy is lorazepam. This psychotropic substance belongs to 1,4-benzodiazepine derivatives and relieves tension and anxiety, possesses sedative and hypnotic effects. In addition, it has an anticonvulsant action. All this happens due to the interaction of the substance with special receptors in the brain. The list of indications includes the following cases: • Sedation before and during surgeries. The drug is used to reduce fear and tension of the patient and prevent the formation of painful memories about this procedure. • Treatment of anxiety, depression and severe phobias. • Short-term therapy for severe agitation in case of psychosis and depression, when other medicines do not control these symptoms. • Short-term treatment of epileptic status (focal or generalized attacks). Ativan is usually not prescribed for long-term treatment of the above-mentioned conditions due to the possible development of dependence and withdrawal syndrome. Still, it has a quick and powerful action that allows benefiting from its usage in urgent situations.

The basic utilization rules

The remedy comes in ampoules of 1 ml of 0.2% and 0.4% solution, in 0.0005, 0.001 and 0.002 mg tablets and as a solution for oral use with a concentration of 2 mg/ml. The dose is always chosen individually based on the following numbers: • To achieve the needed effect for premedication, the dose is calculated according to the body weight as 0.044 mg per kg. Intravenous administration is performed 15–20 minutes before surgery, which provides amnesia. • In the case of mental disorders, such as acute anxiety conditions or psychomotor excitement, the dose is calculated as 0.05 mg per kg of body weight. If the required effect is not achieved, the same dose can be utilized after 2 hours. The maximum dose is 8 mg of an active substance during 12 hours. • For epilepsy, the usual starting dose for 18-year-old patients and older is 4 mg (2 mg/min). If the attack does not stop or return shortly, the same dose may be given but no more. It’s crucial that a doctor controls the therapy and the effectiveness of the taken medicine. That is why Ativan is in most cases used in hospitals.

Possible adverse effects

The list of adverse reactions that may occur after the administration of the medicine includes: • Allergic reactions, such as skin rash and itching. • Digestive system disorders, like nausea, vomiting, diarrhea or constipation, dry mouth, loss of appetite and liver dysfunction. • Nervous system issues, such as dizziness and drowsiness, fatigue, muscle weakness, memory impairment and depression. • Changes in laboratory tests and activity of enzymes. • In the case of intravenous administration, phlebitis or thrombosis at the injection site may be observed. It’s worth mentioning that the long-term use of this remedy or the violation of the dosage led to physical and mental dependence. That is why a responsible and cautious attitude is required for this type of therapy.

Who cannot use the medicine: main contraindications

The most common contraindications for this remedy include the next situations: • Ativan is not prescribed for patients with hypersensitivity to the active ingredient or other benzodiazepines, and also in a condition of shock. • It is prohibited to use this medicine together with scopolamine, due to increased sedation and the possibility of hallucinations and irrational behavior. • This remedy is not prescribed for newborns and infants, for pregnant women and during the breastfeeding period.

Conclusions

Altogether, Ativan has a powerful sedative effect and is irreplaceable in clinical practice. In addition, it is relatively safe and is rarely associated with adverse reactions if used according to the prescription rules. Therefore, doctors value this medicine and utilize all its benefits. As for the patients, they should stay informed about the possible side effects, including dependence, and follow the recommendations of a specialist.