Society advances by leaps and bounds, and with it, the number of individual responsibilities and concerns intensify. It is clear that today there are more tools than ever to deal with pathologies of an emotional nature, but even so, a routine full of stimuli and problems takes its toll on health. For this reason, the prescription of medications to combat anxiety disorders and depression is becoming more and more common . This is the case of benzodiazepines, a family of psychotropic drugs with sedative effects to calm the patient’s mood.
Among them is the well-known lorazepam, a drug that we will see in detail in the following lines. These compounds, which serve to address short-term nervous disorders, are not a definitive solution. How to stop taking lorazepam once the worst is over? Here we show it to you.
Lorazepam addiction: will and pharmaceuticals
In the first place, and to contextualize the terrain on which we are going to move, we consider it essential to show certain figures on mental health collected by the World Health Organization (WHO):
- Depression is one of the most common disorders in the general population, as it is estimated to affect 300 million people on Earth.
- This, in westernized societies, translates to 3% of the population.
- Anxiety disorders affect 18% of Americans and 20% of Spaniards.
- Mental disorders account for 16% of the global burden of illness and injury among people aged 10-19 years.
All these figures, at least hopeless, translate into a massive consumption of anxiolytics (such as lorazepam) and antidepressants . Studies estimate that around 12% of women and 6% of men in any household have used (with or without a prescription) benzodiazepines in the last 30 days.
In addition, it is estimated that at least 2% (4 million people) of the US population have regularly used benzodiazepines for more than 5 years continuously. Of course, after such prolonged exposure to the drug, it becomes very difficult to live without it.
Once we have contextualized the importance of drugs such as lorazepam in disorders in the general population, it is time to fully delve into the mechanism of action of these drugs.
How do benzodiazepines work?
Benzodiazepines, in general, are a group of psychopharmaceuticals widely described since their introduction in general medicine in 1960, as they have a proven therapeutic effect in the treatment of anxiety.
All benzodiazepines work by promoting increased production of a natural chemical found in brain mechanisms, gamma-aminobutyric acid (GABA). This is a neurotransmitter, that is, a compound that transmits nerve signals from one neuron to another. GABA’s message is clearly inhibitory, as it sends a signal at the cellular level to the neurons to reduce their signal transmission speed. As 40% of neuronal complexes respond to gamma-aminobutyric acid, a natural calming and sedative effect is produced in the brain, i.e. hyperarousal is prevented.
Lorazepam, like the rest of the benzodiazepines, has a sedative, muscle relaxant, anticonvulsant and amnestic effect . Its peak of action is reached two hours after oral administration and does not present pharmacokinetic variations depending on the age of the patient.
How do you know if you are addicted to lorazepam?
Professional portals, such as benzo.org.uk, offer information and help available to the general population who may have to deal with benzodiazepine addiction at some point. Some symptoms that a dependency on these drugs is developing are the following:
- Using benzodiazepines in “therapeutic doses” prescribed for months or years.
- Need for these drugs to perform basic vital activities.
- Prolong treatment, even though the focus for which they were prescribed has already been resolved.
- Difficulty in giving up the drug due to the appearance of withdrawal symptoms.
- Anxiety between doses.
- Appearance of anxiety, panic, agoraphobia or depression despite the use of these medications.
In general, when a patient goes to the doctor and presents a picture of generalized anxiety when the drug in question is not prescribed, we can begin to suspect a case of addiction. In addition, the consumption of benzodiazepines generates tolerance, so that higher doses are necessary each time to reach the desired effect.
How to stop excessive consumption
“Stop taking it”, “have a lot of will” or “take a vacation” are advice that, for an addict, are totally empty. To address withdrawal from lorazepam and other benzodiazepines, various systematic studies have collected therapies that are effective . Here we present them to you.
1. Gradual decline
It cannot be expected that a patient who has been consuming benzodiazepines overnight for 10 years will stop needing them. Therefore, it is necessary to use a gradual reduction scheme of the drug, which must be endorsed by a professional both medical and psychological.
This framework of action will depend entirely on the emotional state of the patient, his age, the dose consumed and many other factors.
2. Psychosocial intervention
Various studies have compared the abandonment of benzodiazepines and their efficacy when accompanied or not by psychosocial therapy. The results are evident, since the therapeutic activities favor a decrease in dependence on this drug.
Psychological interventions, such as those that teach how to manage anxiety, manage insomnia without the use of medical solutions, or even monitor patients with addiction through letters, calls, or continued offers of help, promote lorazepam and other benzodiazepine cessation .
Psychotherapy, that is, therapy that seeks changes in the patient’s behavior and habits, associated with supervised abstinence, also promotes non-adherence to these drugs between 3 and 12 months after the end of treatment.
3. Drug use
Studies have shown that the use of the anticonvulsant drug carbamazepine helps to cope with benzodiazepine addiction if accompanied by a gradual tapering off of benzodiazepine use. Other research indicates that imipramine, a tricyclic antidepressant, can also promote nonadherence to these drugs.
There are other compounds, such as melatonin, trazodone or valproic acid that have been shown to be effective in treating these addictions. Yes, in some cases willpower is not enough, and the stigmatization of the patient for taking a pharmacological route can be counterproductive. Sometimes, a little help is necessary to face certain pathologies.
Conclusions
As we have seen, scientific research transcends the typical advice that addicted people are more than tired of hearing. To deal with an addiction to lorazepam (really, to any substance), the integration of multidisciplinary knowledge between psychologists and doctors is needed .
In general, a gradual dose reduction is required, as well as prolonged psychological care so that the patient learns to manage their anxiety and understand their withdrawal symptoms, and in some cases, the prescription of other less aggressive drugs that help decrease dependency.
We do not want to end this opportunity without making it clear that no matter how much an addiction is fought, if the underlying reasons for it are not addressed, there is a danger of falling back into a vicious circle with other substances.
Faced with anxiety disorders, depression or any other emotional pathology, you are not alone. Thousands of professionals are at your disposal to tackle any pathology you may suffer.
Bibliographic references
- Aguiluz, J., Álvarez, M., Pimentel, E., Abarca, C., & Moore, P. (2018). How to deal with a patient with benzodiazepine dependence in primary care? Strategies for detoxification. Medwave, 18(01).
- Barajas-Calderon, HI, Razo-Lopez, JR, Rodriguez-Rico, RA, & Pineda-Sanchez, JP BENZODIAZEPINE DEPENDENCE AND ADDICTION.
- Depression, WHO. Collected on August 13 at https://www.who.int/es/news-room/fact-sheets/detail/depression
- Gonzalez Gomez , C. , Martinez Galdamez , ME , Campello Marquez , E. , Martin Pacheco , JF , Alvarez Garcia , A. , & Arazo Guerrero , O. (2017). Prevalence of benzodiazepine consumption in a military population group. Military Health, 73(3), 184-186.
- Benzodiazepines: how they work in the body, benzo.uk. Collected on August 13 at https://www.benzo.org.uk/espman/bzcha01.htm#:~:text=Todas%20las%20benzodiazepines%20act%C3%BAan%20augmentando,cerebral%20(neuron)% 20to%20other
- Adolescent mental health, WHO. Collected on August 13 at https://www.who.int/es/news-room/fact-sheets/detail/adolescent-mental-health
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.