* Drug and alcohol dependence – There is an increased risk of abuse of lorazepam.

Adverse effects are more common in the elderly, and they appear at lower doses than in younger patients. Otherwise, management is by observation, including of vital signs, support and, only if necessary, considering the hazards of doing so, giving intravenous flumazenil. This explains why one lorazepam dose, despite lorazepam's shorter serum half-life, has more prolonged peak effects than an equivalent diazepam dose. * Amnesic effects: Among benzodiazepines, lorazepam has relatively strong amnesic effects, but patients soon develop tolerance to this with regular use. Call your doctor at once if you have any of these serious side effects:* confusion, depressed mood, thoughts of suicide or hurting yourself; * hyperactivity, agitation, hostility; * hallucinations; or * feeling light-headed, fainting. Thus the effect of benzodiazepines is to enhance the effects of the neurotransmitter GABA. This medication may be habit-forming and should be used only by the person it was prescribed for. Reaction of the above product with acetic anhydride leads to a Polonovski type rearrangement reaction, giving a 3-acetoxylated benzodiazepine, 7-chloro-1,3-dihydro-3-acetoxy-5-(2′-chlorphenyl)-2H-benzodiazepin-2-one. High dose or prolonged parentally administered lorazepam is sometimes associated with propylene glycol intoxication. Coming off long-term lorazepam may be more realistically achieved by a gradual switch to an equivalent dose of diazepam, a period of stabilization on this and only then initiating dose reductions.