Lormetazepam

Introduced 1980

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Indications

Primary Indications

Severe insomnia (short-term use)

Mechanism

Enhances the activity of GABA at the GABA-A receptor, increasing chloride influx and neuronal hyperpolarization, resulting in sedation and hypnosis.

Dosing

Adult Dosing

insomnia: 0.5–2 mg at bedtime; use the lowest effective dose

Dosage Forms

Tablets: 0.5 mg, 1 mg, 2 mg

Onset Duration

Onset: 30–60 minutes; Duration: 6–8 hours.

Adverse Effects

Common Side Effects

• drowsiness

• dizziness

• ataxia

• anterograde amnesia

⚠️ Serious Side Effects

respiratory depression
paradoxical agitation
dependence and withdrawal symptoms

Warnings

Critical Safety Information

Concomitant use with opioids can cause profound sedation, respiratory depression, coma, and death.

→Risk of misuse, abuse, and dependence
→Avoid abrupt discontinuation after prolonged use
→May cause next-day psychomotor impairment

Interactions

With: Opioids

Risk: Severe CNS depression

Action: Avoid or monitor closely

With: Alcohol

Risk: Additive sedation and respiratory depression

Action: Avoid

With: Other CNS depressants

Risk: Enhanced sedative effects

Action: Use caution

Monitoring

Daytime alertness
Signs of dependence and misuse
Respiratory status in at-risk patients

Special Populations

👶Pregnancy

Avoid unless absolutely necessary; risk of fetal harm and neonatal withdrawal

🤱Breastfeeding

Excreted in breast milk; may cause sedation in infants

👧Children & Adolescents (Under 18)

Not recommended

👴Older Adults (65+)

Increased sensitivity; start with lowest dose

Tapering

Reduce dose gradually over 1–2 weeks to avoid withdrawal symptoms such as rebound insomnia, anxiety, and tremors.

Clinical Notes

Short half-life reduces next-day sedation risk compared to longer-acting benzodiazepines
Best reserved for severe insomnia not responsive to non-pharmacologic interventions
High potential for dependence; avoid long-term use

This medication information is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider before starting, stopping, or changing any medication. Never take medication without a prescription from a licensed healthcare provider.

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