Buy Ativan (Lorazepam) Online Without Prescription

Lorazepam can have anti-anxiety, sedative, antiemetic effects. It helps to relieve muscle spasms through central mechanisms, stops convulsions, improves sleep, eliminates urges to vomit. It has sedative, hypnotic and anxiolytic effect, which is realized at the expense of inhibitory action of gamma-aminobutyric acid in the brain. Seizure syndrome is stopped by the ability to increase the inhibitory processes in the synapses of the cortex, thalamus and limbic system.

Lorazepam is a high-potency benzodiazepine anxiolytic. It was first synthesized and patented in 1963 and marketed in the United States in 1977. The original patent for lorazepam was held by Wyeth, which marketed it in the United States under the trade names Ativan and Temesta. Despite such a venerable age, lorazepam is still one of the most used and prescribed benzodiazepines in the USA and European countries and is included in the World Health Organization's list of most needed medications. In the United States and European countries, lorazepam is also available in injectable form for intravenous and intramuscular administration, as an oral solution and syrup for children, and as patches and gel for application to the skin. However, in the United States, oral forms of lorazepam are not approved in children under 12 years of age (effectiveness and safety in this period are still unknown).

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The benzodiazepine anxiolytic Lorazepam is used to treat the following conditions:

• seizure syndrome;
• muscle spasm;
• sleep disturbance;
• Severe anxiety, panic, restlessness;
• neurosis;
• psychoreactive state;
• depressive disorder with anxiety;
• psychosomatic disorders;
• nausea and vomiting after chemotherapy;
• alcohol delirium and withdrawal in alcoholism.

During therapy with this drug, patients experience significant relief from anxiety and fear.

Lorazepam therapeutic mechanism of action

Lorazepam differs from all other benzodiazepines in its great therapeutic breadth, its powerful anxiolytic action, and its wide range of other pharmacological effects, even at low doses. They believed that lorazepam was more effective than all other benzodiazepines available on the market at the time, and called it a "new generation benzodiazepine." Evidence is given that lorazepam has atypical effects (both behavioral and physiological) that distinguish it from other benzodiazepines. For example, lorazepam has been shown to have an atypical, relatively benzodiazepine-friendly profile of effects on human cognitive function. It is suggested that the atypical profile of lorazepam may be associated with a preferential effect on those benzodiazepine receptor subtypes that have not yet been sufficiently studied.

Lorazepam in psychiatry

Social phobia

Lorazepam is also effective for sociophobia, including both course treatment and single administration before any stressful social situations for the patient. Lorazepam in the context of sociophobia has been shown to have less cognitive toxicity (i.e., produces fewer cognitive side effects) than the antidepressant often used for potentiation in this context, olanzapine, and than another benzodiazepine with longer duration of action and higher probability of cumulation, clonazepam.

Manic states

Lorazepam in mania not only helps to relieve psychomotor agitation, anxiety, aggression, and dysphoria and normalize sleep, but also a true reduction of manic affect, which allows to reduce doses of antipsychotics and normotics, reduce their side effects and avoid overdose and intoxication. And in mild hypomanic states, lorazepam monotherapy may be sufficient to relieve hypomania. In delirious mania (manic delirium), high doses of lorazepam and electrostimulant therapy are first-line therapy due to the poor tolerance of antipsychotics in this category of patients.

Psychosis

The indirect antidopaminergic effect inherent in benzodiazepines due to their potentiating effect on GABAergic neurotransmission has served as the basis for attempts to use them in psychosis, schizophrenia to potentiate the action of antipsychotics. The use of lorazepam in combination with antipsychotics contributes not only to a more rapid relief of psychomotor agitation, anxiety, insomnia and aggression, but also to strengthening of the true antipsychotic effect and a more rapid reduction of hallucinatory and delusional phenomena.

Acute psychomotor agitation, aggressiveness

Lorazepam can ameliorate acute psychomotor agitation, aggressiveness, and insomnia, contribute to the suppression of nightmares, and normalize the phase structure of sleep regardless of the genesis of agitation, aggressive behavior, and insomnia. However, one meta-analysis has shown no efficacy of benzodiazepines, including lorazepam, in controlling this pathology, either as monotherapy or when used in combination with antipsychotics.

Depressive states

Lorazepam does not appear to have true antidepressant activity. Nevertheless, the combination of lorazepam with an antidepressant often leads to potentiation (enhancement) of the latter, reduction of depressive symptoms, and improvement of antidepressant tolerance (reduction of side effects such as nausea, akathisia, initial agitation, agitation, insomnia during antidepressant therapy) and increased compliance of patients. The addition of lorazepam is particularly effective when the proportion of anxiety, insomnia, agitation or dysphoria in the picture of depression is high, i.e., in anxious, agitated or mixed (dysphoric) depressions.

Lorazepam in neurology

Epilepsy and other seizure syndromes

Lorazepam has strong anticonvulsant activity and can be used to relieve epileptiform seizures of any etiology, including, for example, in status epilepticus. The short-term anticonvulsant effect of lorazepam makes it, along with midazolam, a more convenient means of breaking excessively long convulsions compared to diazepam, since the introduction of lorazepam to break convulsions does not reduce the effectiveness of the session the next day, as occurs when using diazepam.

Alzheimer's disease and other dementias

Benzodiazepines are quite commonly used to relieve agitation, anxiety, aggression, and behavioral disorders in dementia patients. In contrast to antipsychotics, they do not cause metabolic disorders, obesity, worsening of diabetes mellitus, hypertension, or vascular atherosclerosis, nor do they cause motor immobility and increased mortality in elderly patients, although they may cause excessive muscle relaxation and sedation, falls, and femoral neck fractures

Insomniac Disorders

Lorazepam has shown equal efficacy with zopiclone in the treatment of insomniac disorders in patients with acute cerebral circulation disorder or brain injury (the dose of lorazepam in this case was 0.5-1 mg before bedtime for 7 days. Of the short- to medium-acting benzodiazepines, lorazepam and oxazepam are the most commonly prescribed medications for insomnia. This medication is usually prescribed to patients with insomnia against a background of resistant depression, due to the fact that lorazepam minimally lowers the seizure threshold.

Lorazepam from current positions: yes or no? (Conclusions.)

1. Lorazepam is a unique high-potency benzodiazepine with a broad spectrum of therapeutic action, including anti-anxiety, sedative-sedative, amnestic, anti-aggressive, anticonvulsant, antimanic, central muscle relaxant, immunosuppressive and anti-inflammatory, antiemetic action, ability to potentiate antipsychotic action of antipsychotics, analgesic action.
2. Good tolerability of lorazepam and absence of tendency to cumulation, active metabolites and dependence of its clearance on liver condition allow its wider application in such vulnerable categories of patients as elderly and old people, patients with liver lesions, drug addicts.
3. The broad spectrum of somatotropic activity makes it advisable to use lorazepam for many pathologies encountered in general practice.
4. The therapeutic potential of benzodiazepines and lorazepam, particularly in psychiatry, is often underestimated - their effectiveness is not at all limited to TR and insomnia.
5. Lorazepam is also capable to stop or prevent a number of side effects of psychotropic drugs, such as akathisia, nausea, tremor, hypertonicity of muscles, acute dystonic reactions, therefore its use is especially justified at the initial stages of psychopharmacotherapy when "early" side effects are most likely to occur.
6. Lorazepam can also be used as a component of premedication before unpleasant endoscopic procedures (fibrogastroduodenoscopy, colonoscopy, etc.), before surgical interventions.