Lorazepam

Grand mal seizures after abTupt withdrawal Abrupt withdrawal oflorazepam has been linked with 2 reports of grand mal seizures, A 38-year-old woman was brought to the emergency room with tonic-clonic activity of the arms and legs, and urinary incontinence, Neurologic ex.amination showed generalized hyperactive deep tendon reflexes. with a down-going Babinski reflex, EEG showed grade 3, generalized, nonspecific dysrhythmia, The patient had been taking loraz.epam 2mg qid for the past 6 months, but stopped taking it 60 hours before her first seizure, It was concluded that a primary seizure disorder was unlikely and that the abrupt withdrawal of lorazepam had caused the seizures, In another case, a 39-year-old woman was admitted to hospital for management of a dyskinesia and depression, The next evening she had a grand mal seizure with tonic-clonic movements of her arms and legs lasting about 90 seconds. Her eyes deviated to the Jeft, and there were no overt signs of incontinence. Arterial blood gases showed a POl of 57mm Hg and a pH of 7,31, The metabolic acidosis was thought to be secondary to the patient's seizure activity, Upon stabilization on phenobarbital, she did not have further seizures, An EEG disclosed minimal abnormalities of background activity, with occasional theta components and an excessive amount of beta activity. Although the patient had been prescribed lorazepam 2mg qid 5 months earlier, she admitted to having taken 2mg every 2-4 hours for the past 4-6 weeks, This fact strongly suggested abrupt withdrawal of lorazepam after hospitalization as the cause of her grand mal seizures, de 10 Fuente. j ,R, etaL Mayr, Clink Proceeding, 55: 190

(Mar' Apr 19801

Two more cases of withdrawal seizures A 22-year-old woman with no history of

seizures or brain damage had taken 7, Stng of lorazepam for 4 years for anxiety. One day after stopping therapy, she developed myoclonic jerking in her arms, and later a tonic-clonic seizure. An EEG showed no abnormality, She was placed on an anticonvulsant, but, as she had no further seizures, it was withdrawn gradually. In a second case, a 27-year-old woman also had a tonic-clonic seizure 24 hours after not taking her daily dose oflorazepam 7,5mg, which she had been on for 4 years, She was admitted to hospital. an EEG proved norma!, and she was discharged without drugs. However, at home she restarted lorazepam. Two months later she abruptly stopping taking it and experienced a tonic­clonic seizure 24 hours later, Off lorazepam. she remained anxious and lremorous for a few weeks, bul had no further seizures. Bowe,J .G.: I3ritish MedicalJournal280: 116,111U May (980)

6 Reactions Jun 27 1980 0157 -7271/80/0627 -0006/0 $00.50/0 © ADIS Press