Lorazepam, like other benzodiazepines, markedly increases the risk of falls and subsequent fractures, especially in older adults or patients with a prior fall history. The interaction is considered unsafe due to the high potential for serious injury.
Benzodiazepines are listed in the Beers Criteria as potentially inappropriate for older adults with fall risk.
Even low doses can cause significant impairment in frail patients.
Consider alternative anxiolytics (e.g., SSRIs, buspirone) or non‑pharmacologic interventions.
Immediate discontinuation is recommended after a new fall or fracture while on lorazepam.
Benzodiazepines potentiate GABA‑A receptor activity, producing sedation, impaired psychomotor coordination, and muscle relaxation. These central nervous system effects diminish balance, reaction time, and postural reflexes, which, in individuals with a prior fall or fracture, dramatically raise the likelihood of repeat falls and bone injuries.
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