Abdominal cramps, confusion, depression, perceptual disturbances, sweating, nausea, vomiting, parasthesias, photophobia, hyperacusis, tachycardia, and trembling also occur during benzodiazepine withdrawal, but the incidence of these reactions is lower. Convulsions, hallucinations, delirium, and paranoia also can occur. Benzodiazepines should be withdrawn cautiously and slowly, using a very gradual dosage-tapering schedule. Delayed elimination can either intensify or prolong the actions of adverse reactions of the drug. Benzodiazepines have been associated with falls in the elderly and the consumer advocate group, Public Citizen, has recommended these drugs not be used in the elderly.
Phenytoin can increase the hepatic metabolism of lorazepam, reducing lorazepam serum concentrations.
Patients receiving levodopa for Parkinson's disease can experience decreased control of the symptoms of this disease when benzodiazepines are added to their regimen . Benzodiazepines should be administered cautiously to such patients. Cimetidine, erythromycin, or disulfiram can decrease the hepatic metabolism of lorazepam if administered concomitantly. Probenecid has also been shown to decrease lorazepam clearance and increase its elimination half-life although the clinical significance of this is unclear. Patients receiving lorazepam should be monitored for signs of altered benzodiazepine response when cimetidine, erythromycin, disulfiram, or possibly probenecid is initiated or discontinued.