The 3 differences between lorazepam and lormetazepam
A summary of the differences between lorazepam and lormetazepam, two types of benzodiazepines.
Anxiety disorders are spreading like wildfire in the general population, as anyone from a globalized country will know firsthand the dizzying pace at which society moves.
It is therefore no coincidence that the consumption of anxiolytics and hypnotics has increased practically everywhere in the world.
Despite being prescription-only, the abuse of these drugs is of increasing concern to public health agencies. For this reason, it is essential to have an accurate understanding of the differences between the drugs used to treat pathologies of a nervous nature. Here we will focus on the differences between lorazepam and lormetazepam..
Main differences between lorazepam and lormetazepam
Lorazepam, alprazolam, oxazepam, temazepam, lormetazepam, triazolam... Undoubtedly, the number of anxiolytics ending in "pam" can generate confusion even in the greatest of experts in the field. Therefore, here we will discuss the 3 differences between lorazepam and lormetazepam, two benzodiazepines widespread in the pharmaceutical world.
First of all, we see it as essential to frame the situation of anxiety and anxiety disorders. the situation of anxiety and its associated disorders.. Several studies show us very interesting data:
- In the United States, anxiety disorders occur in almost 13 % of the population.
- Generalized anxiety disorder is observed in 5% of the world's population.
- The worldwide prevalence of obsessive-compulsive disorder (OCD) is 2.1 %.
- For these reasons, the global consumption of anxiolytics has increased by 4.5% in the last 8 years.
It may seem that a prevalence of generalized anxiety disorder of 5% is very low, but we have to take one thing into account: far from all cases are not diagnosed and we are dealing with a variant that requires permanence.. Many people suffer very strong episodes of anxiety, but if these do not remain over time, they are not considered a disorder as such. Thus, the numbers would surely be inflated if we took into account all the possible meanings of the term "anxiety".
Before explaining the differences between lorazepam and lormetazepam, we have to bear in mind that both drugs are in the benzodiazepine group.. These are defined as psychotropic drugs acting on the central nervous system with sedative, hypnotic, anxiolytic, anticonvulsant, amnesic and muscle relaxant effects.
The Spanish Agency of Medicines and Health Products (AEMPS) published the report on the use of anxiolytics during the years 2000-2018 in Spain, which lists the most consumed active ingredients. At the top of the list we have lorazepam, as it accumulates a consumption of 39.47%. The rest of the news is not positive, since in 2011, the number of Defined Daily Doses (DDD) of this type of drugs corresponded to 82.9 DDD per 1,000 inhabitants per day.
In recent years, things have skyrocketed, as other sources indicate that from 2000 to 2012 the consumption of anxiolytics has increased by 57%. Moreover, the figures in our country are among the highest in Europe, surpassing Germany and the United Kingdom. It is necessary to expose these data, because it is necessary to be careful with this type of drugs and the dependence they generate.
Now, let us look at the differences between lorazepam and lormetazepam.
1. The key to the differences lies in their use.
Although both belong to the benzodiazepine group, lorazepam and lormetazepam are used for relatively different disorders. are used for relatively different disorders.
First, lorazepam is an anxiolytic with sedative, muscle relaxant, Anticonvulsant and amnesic properties. It is highly potent, as its bioavailability (the speed and efficacy with which it reaches the target tissue) is 90% and it reaches its peak concentration two hours after oral administration. According to the drug's own package insert, lorazepam is used in the following cases:
- Short-term treatment of all states of anxiety, associated or not with organic disorders, acting without influencing the individual's activities.
- Sleep disorders.
On the other hand, lormetazepam is a short-acting benzodiazepine with hypnotic, anxiolytic, anticonvulsant, sedative, amnesic and muscle relaxant properties (yes, almost the same as lorazepam). The essential difference of this drug with lorazepam lies in its hypnotic property.. This means that it is used almost exclusively for the short-term treatment of insomnia.
This drug normalizes the time to fall asleep and the duration of sleep, while reducing the number of interruptions to rest during the night. For this reason, it can also be used for sleep induction in pre- and post-operative periods.
As we can see, the essential functional difference between both drugs is that lorazepam can be used in a wide range of situations to combat anxiety. (since it does not severely affect the individual's cognitive abilities), while lormetazepam seeks to make the patient have a deep and uninterrupted sleep.
2. Two types of administration for two different drugs
Following again the medical leaflets of each of the drugs, we can discover even more differential properties between lorazepam and lormetazepam. The doses to be used are, without doubt, a different element between both treatments.
First of all, the administration of lorazepam is recommended (as long as it has been prescribed by a professional) in anxiety disorders in a total concentration of 0.5 mg to 3 mg, distributed in different doses during the day. This dose can be increased or decreased according to the patient's age or psychological needs. In general, treatment should not exceed 8-12 weeks (always being as short as possible). For the treatment of insomnia, a single dose of 1 mg is recommended in the first instance, which can be increased up to 4 mg, always before going to bed.
On the other hand, unlike lorazepam for anxiolytic use, it is recommended that the dose of lormetazepam be a single dose of 1 mg 15 to 30 minutes before the patient goes to bed.. As it has a single hypnotic effect, its administration during the day in small doses is not contemplated. Moreover, in this case, the dose can only be increased up to 2 mg in any case. Even so, as with all benzodiazepines, the treatment should last as short as possible.
3. Differences in popularity
As mentioned above, lorazepam (together with alprazolam) are the flagship benzodiazepines in terms of general consumption. In Spain, for example, lorazepam leads in consumption, with almost 40% of all prescribed anxiolytics.. It is followed by alprazolam (27.96 %) and diazepam (16.46 %). Between the years 2000 and 2011, a total of 20.5 Defined Daily Doses (DDD) of lorazepam per 1000 inhabitants and day were calculated. It was also recorded that its consumption increased by 75 % in this interval.
In the previous paragraph we have not stopped moving in the field of anxiolytics, so it is normal that lorazepam is at the top of the mountain, but things change when we look at hypnotics. Within its own terrain lormetazepam is king, as between the years 2000 and 2011 a total of 18.3 DDD per 1000 inhabitants per day were calculated. Things get more interesting if we take into account that this drug increased its consumption by 103 % in the measured interval.
From all this terminological conglomerate, one thing is clear: the use of lorazepam is more widespread than that of lormetazepam, but both are the dominant drugs within their own group of action.
Summary
As we have seen, the differences between lorazepam and lormetazepam are in the details: one is more focused on sleep therapy and the other on generalized anxieties, they are administered in different ways, and lorazepam is relatively more widespread in the general population. Despite this, being both benzodiazepines, they share many more characteristics than those that differentiate them from each other..
Finally, it should be noted that all these drugs have several complications: they generate dependence, can lead to a rebound effect and can be life-threatening for people with respiratory disorders and other pathologies (such as sleep apnea). For this reason, its administration should only be contemplated under medical prescription and during very strict time periods.
Bibliographic references:
- Lorazepam accounts for 40% of the consumption of anxiolytics in Spain, redacciónmedica.com.
- Pharmacological treatment of mental disorders in primary health care (WHO). Retrieved September 24 from https://www.who.int/mental_health/management/psychotropic_book_spanish.pdf.
- Vicente Sánchez, M. P., Macías Saint-Gerons, D., González Bermejo, D., Montero Corominas, D., & Catalá-López, F. (2013). Evolution of the use of anxiolytic and hypnotic drugs in Spain during the period 2000-2011. Revista Española de Salud Pública, 87(3), 247-255.
(Updated at Apr 12 / 2024)