Risk Profile Education for Patients Prescribed Ativan (Lorazepam)

Key Risks to Discuss with Patients

Elderly patients are significantly more sensitive to the sedative effects of benzodiazepines and require careful monitoring and dose adjustment, according to the American College of Critical Care Medicine 1

Controlled substances should be stored safely away from individuals at risk of misuse and/or overdose, as recommended by the Infectious Diseases Society of America 2
Family members should be educated on the medications, their risks, and signs of overdose, as recommended by the Infectious Diseases Society of America 2
The poison control number should be readily visible, as recommended by the Infectious Diseases Society of America 2
Clinicians should teach patients and their caregivers about opioid overdose and the use of naloxone to reverse overdose; a naloxone rescue kit should be readily available when prescribing benzodiazepines, especially when combined with opioids, as recommended by the Infectious Diseases Society of America 2

For older adults, a recommended approach is withdrawing 25% of the daily benzodiazepine dose each week, though more gradual tapering may be necessary for long-term users, according to Praxis Medical Insights 3

Monitoring should be increased in frequency when factors that increase risk for opioid-related harms are present, especially when benzodiazepines are co-prescribed with opioids, as recommended by the Centers for Disease Control and Prevention 4

Non-pharmacological approaches such as cognitive-behavioral therapy, supportive psychotherapy, and problem-solving therapy should be considered as alternatives or adjuncts to medication, according to Praxis Medical Insights 3
Integrative strategies including relaxation techniques, music therapy, and mindfulness may help manage anxiety, according to Praxis Medical Insights 3
For older adults with anxiety, alternative pharmacological options may include buspirone or certain antidepressants, which have less risk of cognitive impairment and falls, according to Praxis Medical Insights 3