Lorazepam, a benzodiazepine, is prescribed for anxiety, insomnia, and certain seizures. A recognized effect is inducing tiredness. This drowsiness is a common and expected outcome of its action on the central nervous system.
How Lorazepam Induces Tiredness
Lorazepam works by interacting with GABA-A receptors in the brain. GABA is a natural inhibitory neurotransmitter, reducing neuronal activity. When lorazepam binds to these receptors, it enhances GABA’s calming effects.
This enhancement leads to an increased flow of chloride ions into brain cells. The influx of chloride ions makes neurons less responsive to excitatory signals, dampening brain activity. This process results in a calming and sedative effect, contributing to drowsiness, reduced alertness, and sleep.
Factors Affecting Drowsiness
The intensity and duration of tiredness from lorazepam are influenced by several factors. Higher doses typically lead to more pronounced and prolonged drowsiness. Individual differences in metabolism, including genetic variations such as those in the UGT2B15 gene, affect how long sedative effects persist and drug clearance.
Combining lorazepam with other substances significantly increases drowsiness. Alcohol intensifies its depressant effects, leading to severe sleepiness and impairments. Opioid medications can cause profound sedation and breathing problems when taken with lorazepam, a serious combination. Sedating antihistamines, other sleep aids, and certain antidepressants or antipsychotics also exacerbate sedative effects.
Older adults may be more sensitive to the sedative effects of lorazepam. This increased sensitivity is due to age-related changes in drug metabolism and heightened brain sensitivity to benzodiazepines. This can result in a longer-lasting effect and a greater risk of side effects like unsteadiness.
Managing and Addressing Tiredness
Given the potential for drowsiness, safety precautions are important when taking lorazepam. Avoid activities that require full alertness, such as driving or operating heavy machinery, until you understand how the medication affects you. Cognitive and motor impairment can persist for up to 24 hours or more after administration.
Adjusting the timing of the dose can help manage daytime sleepiness. If prescribed for anxiety, taking the largest dose before bedtime can be beneficial. For individuals using lorazepam for insomnia, it is typically taken once daily just before sleep. While the body may gradually adjust to some level of drowsiness over time, any changes to the medication regimen should be made under medical guidance.
If tiredness becomes excessive, debilitating, or significantly interferes with daily routines, it is important to contact a healthcare professional. Seeking medical advice is also warranted if any new or concerning symptoms develop. Individuals should never adjust their lorazepam dosage or discontinue the medication without first consulting their prescribing physician, as sudden changes can lead to withdrawal symptoms.