Lorazepam, also known by the brand name Ativan, is a commonly prescribed medication that is classified as a benzodiazepine. Most often prescribed for the treatment of anxiety disorders (e.g., generalized anxiety disorder, panic disorder, social anxiety, etc.), it may also be prescribed to those who struggle with insomnia, those dealing with nausea and vomiting due to chemotherapy, and those who are going through alcohol detox and experiencing significant withdrawal symptoms.

Anxious


Mild, moderate, or severe side effects can occur with use of Ativan. Many people will experience mild side effects as they get used to the medication but these usually pass on their own. If severe side effects occur, contact the prescribing doctor immediately. If it appears that someone is in an overdose state due to taking Ativan or other benzodiazepines, contact emergency medical help immediately.

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Severity Levels of Ativan Side Effects

  • Common
  • Mild
  • Moderate
  • Severe

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Common Side Effects

For some people, even at low, therapeutic doses, the use of Ativan can cause side effects that are uncomfortable and outweigh the “pros” associated with use. In many cases, however, the initial side effects pass in a few days, recurring only when the dose is increased or when the individual uses other medications or substances.

It is normal for people to experience side effects that may include:

  • Drowsiness or feeling weak
  • Slurred speech
  • Lack of coordination
  • Occasional dizziness

These usually pass within a few days on their own but may recur with dosage increases.

Mild Side Effects

Mild side effects of Ativan may occur in some patients. Though some will fade with the normal effects of using the drug, some will continue and/or worsen and become problematic. If any of the following become intrusive, it is advisable to contact the prescribing physician:

  • Irritability or agitation
  • Stomach cramping
  • Nervousness or anxiety
  • Black or tar-like stools
  • Dark urine and/or less urine output
  • Bleeding gums
  • Altered vision
  • Chills
  • Cough, sore throat, and/or hoarseness
  • Dizziness, especially when standing suddenly
  • Dry mouth and increased thirst
  • Rapid or irregular heartbeat
  • Headache
  • Continued fatigue
  • Loss of balance
  • Change in appetite
  • Nausea
  • Sweating

Moderate Side Effects

It is less common, but sometimes patients who take Ativan experience significant side effects that require immediate attention. If any of the following moderate to severe side effects occur, it is important to contact the prescribing doctor for medical advice right away. If those symptoms are severe or potentially life-threatening, emergency medical help should be sought.

  • Itching, rash, and/or hives
  • Hyperventilation
  • Bluish tint to lips or skin
  • Blood in urine or stools
  • Aggressive or angry behavior
  • Violence or assault
  • Confusion or memory problems
  • Difficulty speaking
  • Feeling discouraged or empty
  • Manic behavior, including euphoria or false sense of ability and wellbeing
  • Feeling fear or panic
  • Fever
  • Irregular or shallow breathing
  • Muscle pain or cramps
  • Lack of interest in relationships, work, or hobbies
  • Vomiting
  • Muscle stiffness or involuntary jerking
  • Insomnia
  • Swelling of face, eyes, throat, or tongue

Severe Side Effects

Though it can be effective for therapeutic treatment in most patients who take the drug for a short period of time, Ativan can trigger a host of serious side effects, especially if it is used outside of a doctor’s prescription. That is, if used in higher doses than prescribed, more frequently than prescribed, in combination with other substances, or without a prescription, the risk of serious side effects may be greater. These effects include:

  • Tolerance: Building a tolerance to Ativan can occur after just a few weeks of regular use of the drug. Also called physical dependence, this simply means that the patient will require a steadily increasing dose of lorazepam in order to continue to experience the initial therapeutic effects. This is not a problem in and of itself. Most people can simply taper off the dose slowly when it is time to stop using the medication with a doctor’s supervision. However, tolerance is often the foundational step that leads to serious and life-altering side effects such as overdose and addiction.
  • Withdrawal symptoms: When there is physical dependence, should the patient abruptly stop use of Ativan, the result can be a withdrawal syndrome defined by both physical and psychological withdrawal symptoms. These can be life-threatening, and it is not recommended that anyone attempt to undergo the detox process without medical supervision.
  • Overdose: The signs of Ativan overdose are serious and life-threatening, and they require immediate medical attention. There is no effective home remedy for the problem, and without medical treatment, benzodiazepine overdose can be fatal. Signs of overdose include:
  • Heavy sweating
  • Low blood pressure
  • Lack of energy or strength
  • Extreme difficulty with walking or controlling muscles
  • Altered speech patterns and/or difficulty speaking
  • Appearing “out of it” and nonresponsive
  • Loss of consciousness
  • Shallow or stopped breathing
  • Addiction: A Schedule IV drug, lorazepam is officially described as a drug with a low potential for abuse and dependence; however, tens of thousands of Americans every year struggle with an addiction to lorazepam and other benzodiazepines. Defined by both a psychological dependence and a physical dependence, it is impossible for the person to moderate use of the drug despite the negative consequences that develop. Because there is no cure for addiction, the only long-term solution is medical detox followed by intensive therapeutic treatment and aftercare support.

Treatment for Benzodiazepine Addiction

Ativan use can very easily morph into abuse and, from there, addiction can quickly follow. This is not a character flaw or a moral failing but a brain disorder that requires intensive medical treatment.

Medical detox is not a standalone treatment for addiction to Ativan, but it is a necessary first step to stabilize in recovery without use of any drug. Inpatient care is recommended for the detox process in order to ensure round-the-clock medical monitoring and support.

Therapeutic treatment that includes traditional personal therapy and support groups is essential for those addicted to Ativan. Learning how to implement positive coping mechanisms rather than turn to drugs to manage mental health symptoms and insomnia is an important part of creating a new life without drugs. Long-term follow-up care and support ensure that these coping mechanisms become second nature and that the client is always supported in the process of living a healthy and sober life.

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Frequently Asked Questions

Ativan is a brand name for lorazepam, a benzodiazepine prescribed to reduce anxiety and panic attacks, overcome insomnia, prevent seizures from epilepsy or other seizure disorders, and ease irritable bowel syndrome (IBS). Prescriptions come as tablets or an injectable solution that is most often found in hospitals, especially the emergency room to prevent seizures.

Like other benzodiazepines, Ativan can be very habit-forming, especially if the medication is taken daily for longer than two weeks. Even when taken as prescribed, Ativan can lead to physical dependence and tolerance, so the person taking it may experience some withdrawal symptoms when they end their prescription. For some people, this can lead to addiction.

What are the signs of addiction?

When a person struggles with addiction to any substance, including Ativan, they are likely to display behavioral changes, including drug-seeking behavior, compulsively ingesting the substance (even if they are trying to stop), and becoming defensive or lying when questioned about the substance abuse.

Ativan is a short-acting benzodiazepine, so it begins to work on the brain almost immediately, but the half-life is two hours; after four hours, the major psychiatric effects have dissipated. Short-acting benzodiazepines are often a target of abuse because the euphoria associated with taking them takes hold very quickly.

Withdrawal symptoms can occur in people who take Ativan as prescribed, but they are more likely to occur in people who struggle with Ativan addiction. This is because the body is used to a certain level of the drug to produce GABA neurotransmitters and reduce anxiety or panic. Psychological side effects, like rebound anxiety and insomnia, depression, and cravings, are more likely to occur during withdrawal among people who struggle with Ativan addiction.

Intoxication is a sign of Ativan abuse, and if a person regularly appears to be intoxicated, this may be a sign of addiction. Signs of intoxication on Ativan include:

  • Slurred speech
  • Loss of physical coordination
  • Reduced inhibitions
  • Impaired cognition and memory
  • Vertigo
  • Shaking or tremors
  • Respiratory depression, or shallow or irregular breathing
  • Slowed reflexes
  • Acting high or drunk
  • Paradoxical excitement, including aggression, anxiety, and mood swings
  • Changes in vision
  • Depression or suicidal ideation

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Are there risks of long-term use?

Like other benzodiazepines, there are risks to taking Ativan for a long time. First, taking this drug consistently for more than two weeks can lead to dependence, tolerance, addiction, and withdrawal symptoms. However, there are additional risks to taking the drug for a long time, especially at high doses associated with self-medicating.

A person who already struggles with anxiety, or depression with concurrent anxiety, is likely to experience worsening symptoms from taking this potent drug for a long time. The brain’s chemistry changes over time, and Ativan becomes necessary to moderate mood; this can lead to worsening depression, panic attacks, anxiety, irritability, restlessness, and suicidal thinking, which can occur while the person has Ativan in their system (paradoxical effects) and when the body comes down from the drug (rebound effects).

Withdrawal from Ativan after long-term abuse can lead to dangerous symptoms like seizures. A person who abuses Ativan without a prescription is also at risk of overdosing, which could reduce breathing and lead to a coma or death. Low blood pressure is a side effect of large doses of Ativan, so a person could damage their cardiovascular system with long-term abuse.

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Are there safer drug alternatives to Ativan?

The choice of treatments for anxiety disorders is ultimately a discussion between the individual and their physician. Concerns about addiction to Ativan or other benzodiazepines should be addressed in this way. However, for people who are concerned about the habit-forming potential of Ativan, there are other medications that can treat anxiety too.

When anxiety is associated with depression, some antidepressants may be able to treat both conditions. Selective serotonin reuptake inhibitors (SSRIs) and some tricyclic antidepressants have shown effectiveness in treating both depression and anxiety.

Other drugs that may be prescribed instead of benzodiazepines like Ativan include buspirone (under brand names BuSpar and Vanspar), which can treat some anxiety disorders, although they are not great alternatives for all anxiety disorders. Beta-blockers, which were developed as a heart medication, have also shown some success treating certain anxiety disorders.

For people who take Ativan to treat insomnia, other sleep medications like Ambien or Lunestra may be effective for short-term treatment; however, these medications may also become addictive, are dangerous when mixed with other drugs like alcohol or prescription medications, and can cause sleep-activity like walking, driving, having sex, or eating while asleep.

Ultimately, a person who takes Ativan for a mood disorder or insomnia should take the drug only as long as prescribed and work concurrently with a therapist to get appropriate long-term psychological treatment for underlying issues.

People who take Ativan for chronic health issues like epilepsy or IBS may take larger doses and take the drug for longer than two weeks. This is because the medication is not prescribed to treat symptoms of an underlying mental health condition, but instead prevents dangerous symptoms from the disease. It is important to work with a doctor on these chronic diseases and inform the physician of any concerns about addiction or history of substance abuse.

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What treatment options work best for Ativan addiction?

Medically supervised detox, followed by rehabilitation, is the best treatment plan to overcome Ativan abuse. When a person begins detox, their physician or psychiatrist will either replace Ativan with a long-acting benzodiazepine (usually Valium) and then work on tapering the medication over several weeks, or they will develop a tapering regime for Ativan. This depends on how long the individual has struggled with Ativan addiction, how large their dose of the drug is, and how often they ingest the drug.

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Can Ativan cause withdrawal symptoms?

When a person stops taking Ativan without the help of a taper, they are more likely to experience withdrawal symptoms. Some of these include:

  • Rebound anxiety and insomnia
  • Headache
  • Restlessness
  • Confusion or cognitive problems
  • Depersonalization
  • Derealization
  • Depression or dysphoria
  • Numbness or tingling in the extremities
  • Tremors
  • Abdominal cramps, nausea, and vomiting
  • Hallucinations, delusions, and paranoia
  • Tachycardia (rapid heartbeat)
  • Hyperthermia (increased body temperature)
  • Seizures

A person who has struggled with Ativan addiction for a long time is more likely to develop benzodiazepine withdrawal syndrome, a condition in which withdrawal symptoms are more intense and last longer. It is very important to work closely with medical professionals to safely detox from drugs like Ativan.

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