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Drugs Affecting the Central Nervous System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: The use of Lorazepam during the in 1st and 3rd Trimesters should be avoided because the pregnancy experience in humans, and the reproduction studies in animals have shown an increased risk of congenital abnormalities, neonatal flaccidity and withdrawal symptoms.
Behavioral effects of caffeine coadministered with nicotine, benzodiazepines, and alcohol
Published in B.S. Gupta, Uma Gupta, Caffeine and Behavior, 2020
Studies with humans have generally supported the hypothesis of a mutually antagonistic relationship between caffeine and benzodiazepines. In a brief report, Mattila et al.32 indicated that caffeine blocked the impairment of cognitive skills, increase in muscle relaxation, and subjective calming produced by 10 mg diazepam. Similar results were reported in a more detailed follow-up study.33 Using the benzodiazepine triazolam, Mattila et al.34 found relatively mild sedative effects that were largely reversed by caffeine. Similarly, the alerting effects of caffeine were diminished when triazolam was coadministered. Caffeine, at doses that had little effect when administered alone, has been shown to reverse the effects of both lorazepam and triazolam on learning, performance, and ratings of sedation.35,36 File et al.37 administered a battery of tests that measured psychomotor and cognitive performance, mood-state, and other factors. Lorazepam impaired psychomotor and cognitive performance. On some tests (e.g., digit-symbol substitution), caffeine improved performance and reversed the effect of lorazepam. Caffeine also reversed the self-reported anxiolytic effects of lorazepam. A similar battery of tests was used by Roache and Griffiths38 in a study notable for using a range of doses of both diazepam and caffeine. In a number of tasks, but not all, diazepam and caffeine each blocked the effects of the other. In addition to the type of test, the effects were dependent on the exact doses of each drug.
The types of conditions
Published in Jane Hanley, Mark Williams, Fathers and Perinatal Mental Health, 2019
The treatment is antipsychotic medication or valproate for a manic state, with lithium or carbamazepine as the drugs of choice. Clonazepam or lorazepam are recommended for insomnia. Tricyclic antidepressants are often prescribed for depressive symptoms. Sometimes, in severe cases, where the symptoms fail to react to medication and there is a high element of suicidal ideation, electroconvulsive therapy is an option. The effect is often rapid and allows functions to return more quickly.
Prescribing patterns for treating common complications of spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2023
Shikha Gupta, Mary Ann McColl, Karen Smith, Alexander McColl
According to the available evidence, baclofen and tizanidine are considered first-line treatments for SCI-induced spasticity, while diazepam and dantrium are second-line treatments with varying effectiveness.13,31,41,42 However, lorazepam may be used with patients having adverse effects from diazepam. A small proportion of individuals in our sample were also prescribed general muscle relaxants such as lorazepam, Flexiril or other short-acting benzodiazepines to treat spasticity. These are usually not recommended due to their negative effects on individual’s ability to void and ambulate.7,43 Therefore, it is possible that some patients received general muscle relaxants as an adjuvant to a baclofen pump or chemo-denervation, as per the clinical judgement of prescribing physician, treatment goals, patient preference and their tolerance for adverse events.
Intravenous esketamine leads to an increase in impulsive and suicidal behaviour in a patient with recurrent major depression and borderline personality disorder
Published in The World Journal of Biological Psychiatry, 2022
Thomas Vanicek, Jakob Unterholzner, Rupert Lanzenberger, Angela Naderi-Heiden, Siegfried Kasper, Nicole Praschak-Rieder
After admission bupropion was continued and augmented with escitalopram up to 30 mg p.o.q.d., and trazodone (retard preparation) 150 mg p.o.q.d. in the evening. Non-selective GABA-A receptor positive allosteric modulators (lorazepam and clonazepam) were given as a continuous medication to reduce anxiety, inner tension, and agitation. Zolpidem 10 mg was administered only once since the drug-induced visual and auditory illusions. After all, the patient was severely depressed and reported to suffer from impulsive suicidal thoughts she felt unable to control. Therefore, she was restrained against her will (according to the Austrian Hospitalisation Act). After obtaining informed consent, electroconvulsive therapy (ECT) was started and bupropion XR was discontinued. The patient received a total of seven unilateral ECT treatments with a final stimulation dose of 70% (350 mC). Due to occurrence of side effects in the form of severe headache and cognitive impairment ECT was discontinued, while depressive symptoms and suicidality attenuated during ECT.
Domiciliary alcohol detoxification outcomes: a study from Goa, India
Published in Journal of Addictive Diseases, 2020
Saumitra Nemlekar, Pooja Gaonkar, Anil Rane
The socio-demographic details of our all male sample of 100 are given in the following table (Table 1). The age of start of alcohol was from as early as 12 years to as late as 40 years of age. The daily use of alcohol was in the range of 3–30 units/day. Five patients were prescribed oxazepam and rest was detoxified with lorazepam. Converting the dosages to a single benzodiazepine, the average daily dose (at day one of presentation) used was 5.85 mg lorazepam equivalence.10 Other psychiatric comorbidities were nicotine use (n = 75), mood, anxiety, personality disorders (26% each), psychosis (6%) and cannabis use (3%).53% did not have any medical co-morbidities. Hypertension (15%), liver impairment (19%), CNS related (14%), symptoms due to portal hypertension (8%) and diabetes mellitus (2%) were seen in the others either individually or in combination.