Apo-Lorazepam Special Precautions

Dependence Liability: Lorazepam should not be administered to individuals prone to drug abuse.
Caution should be observed in patients who are considered to have potential for psychological dependence. It is suggested that the drug should be withdrawn gradually if it has been used in high dosages.
Use in Mental and Emotional Disorders: Lorazepam is not recommended for the treatment of psychotic or depressed patients. Since excitement and other paradoxical reactions can result from the use of these drugs in psychotic patients, they should not be used in ambulatory patients suspected of having psychotic tendencies.
As with other anxiolytic-sedative drugs, lorazepam should not be used in patients with non-pathological anxiety. These drugs are also not effective in patients with characterological and personality disorders or those with obsessive-compulsive neurosis.
When using lorazepam, it should be recognized that suicidal tendencies may be present and that protective measures may be required.
Use in Patients with Impaired Renal or Hepatic Function: Since the liver is the most likely site of conjugation of lorazepam and since excretion of conjugated lorazepam (glucuronide) is a renal function, the usual precaution of carefully titrating the dose should be taken, should lorazepam be used in patients with mild to moderate hepatic or renal disease. In patients for whom prolonged therapy with lorazepam is indicated, periodic blood counts and liver function tests should be carried out.
Geriatrics: Elderly and debilitated patients, or those with organic brain syndrome, have been found to be prone to CNS depression after even low doses of benzodiazepines. Therefore, medication should be initiated with very low initial doses in these patients, depending on the response of the patient in order to avoid oversedation or neurological impairment.