Long-term therapy may lead to cognitive deficits, especially in the elderly, which may only be partially reversible.

The combination with alcohol increases these impairments. To minimise the risk of physical/psychological dependence, lorazepam is best used only short-term, at the smallest effective dose. edit PharmacodynamicsRelative to other benzodiazepines, lorazepam is thought to have high affinity for GABA receptors, which may also explain its marked amnesic effects. However, in critically ill patients, propofol has been found to be superior to lorazepam both in effectiveness and overall cost; as a result, the use of propofol for this indication is now encouraged, whereas the use of lorazepam for this indication is discouraged. Some antidepressants, anti-epileptic drugs such as phenobarbital, phenytoin and carbamazepine, sedative antihistamines, opiates, antipsychotics and alcohol when taken with lorazepam may result in enhanced sedative effects. Otherwise, management is by observation, including of vital signs, support and, only if necessary, considering the hazards of doing so, giving intravenous flumazenil. edit WithdrawalOn abrupt, or overly rapid discontinuation of lorazepam, anxiety and signs of physical withdrawal have been observed, similar to those seen on withdrawal from alcohol and barbiturates. You may report side effects to FDA at 1-800-FDA-1088. The higher doses and the longer periods benzodiazepines are taken increase the risk of developing a benzodiazepine dependence. It is given before a general anaesthetic to reduce the amount of anaesthetic agent required, or before unpleasant awake procedures, such as in dentistry or endoscopies, to reduce anxiety, to increase compliance, and to induce amnesia for the procedure.