Lorazepam interaction

File, S., Bond, A. and Lister, R., Interaction between effects of caffeine and lorazepam in performance and self ratings. Journal of Clinical Psychopharmacology 2, 102-106, 1982. 

Oxycodone/Lorazepam/Ethanol Multiple oral doses of pregabalin were coadministered with oxycodone, lorazepam, or ethanol. Although no pharmacokinetic interactions were seen, additive effects on cognitive and gross motor functioning were seen when pregabalin was coadministered with those drugs. 

Most benzodiazepines undergo oxidative metabolism in the liver that may be enhanced by enzyme inducers (e.g. carbamazepine, phenytoin) or slowed by inhibitors (sodium valproate, fluoxetine, fluvoxamine). Oxazepam, lorazepam and temazepam are directly conjugated and are not subject to these interactions. 

Cobb CD, Anderson CB, Seidel DR. Possible interaction between clozapine and lorazepam [Letter]. Am J Psychiatry 1991 148 1606-1607. 

Saano, V., Hansen, P.P., and Paronen, P., Interactions and comparative effects of zoplicone, diazepam and lorazepam on psychomotor performance and on elimination pharmacokinetics in healthy volunteers, Pharmacol. Toxicol., 70, 135, 1992. 

Anderson GD, Gidal BE, Kantor ED, et al. Lorazepam-valproate interaction studies in normal subjects and isolated perfused rat liver. Epilepsia 1994 35(l) 221-225. 

Krystal JH, Karper LP, Bennett A, D Souza DC, Abi-Dargham A, et al. 1998. Interactive effects of subanesthetic ketamine and subhypnotic lorazepam in humans. Psychopharmacology (Berl) 135 213-229. 

A thorough review of the pharmacokinetics of haloperidol, with special emphasis on interactions, has been published (58). The interactions include one with lorazepam. 

The potentiation of sedative effects from benzodiazepines when combined with centrally acting drugs with antihistamine properties (for example first-generation antihistamines, tricyclic antidepressants, and neuroleptic drugs) can pose problems (143). Antihistamines that do not have central actions do not interact with benzodiazepines as in the case of mizolastine and lorazepam (144), ebastine and diazepam (145), and terfenadine and diazepam (143). 

Nevertheless, some interactions of benzodiazepines with muscle relaxants used in anesthesia have been described. Diazepam has been reported to potentiate the effects of tubocurare (163) and gallamine (164) and to reduce the effects of suxamethonium (164). However, in 113 patients undergoing general anesthesia, intravenous diazepam 20 mg, lorazepam 5 mg, and lormetaze-pam 2 mg did not potentiate the neuromuscular blocking effects of vecuronium or atracurium (162). 

Patat A, Perault MC, Vandel B, Ulliac N, Zieleniuk I, Rosenzweig P. Lack of interaction between a new antihistamine, mizolastine, and lorazepam on psychomotor performance and memory in healthy volunteers. Br J Clin Pharmacol 1995 39(l) 31-8. 

Wesnes K, Simpson PM, Jansson B, Grahnen A, Weimann HJ, Kuppers H. Moxonidine and cognitive function interactions with moclobemide and lorazepam. Eur J din Pharmacol 1997 52(5) 351-8. 

Ochs HR, Greenblatt DJ, Verburg-Ochs B. Propranolol interactions with diazepam, lorazepam, and alprazolam. Clin Pharmacol Ther 1984 36(4) 451-5. 

Prior use of benzodiazepines or opiates limits the psychotomimetic effects of ketamine. There has been a double-blind, placebo-controlled study of the role of lorazepam in reducing these effects after subanesthetic doses of ketamine in 23 volunteers who received lorazepam 2 mg or placebo, 2 hours before either a bolus dose of ketamine 0.26 mg/kg followed by an infusion of 0.65 mg/kg/hour or a placebo infusion (438). The ability of lorazepam to block the undesirable effects of ketamine was limited to just some effects. It reduced the ketamine-associated emotional distress and perceptual alterations, but exacerbated the sedative, attention-impairing, and amnesic effects of ketamine. However, it failed to reduce many of the cognitive and behavioral effects of ketamine. There were no pharmacokinetic interactions between subanesthetic doses of ketamine and lorazepam. 

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