*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Ativan side effects are fairly common and can range from mild to severe. Side effects can range from temporary drowsiness and fatigue to confusion and slowed breathing.1
If you are considering Ativan or want to discuss your current medication treatment with a provider, online psychiatry platforms can be a good place to start. Talkiatry is one of the few online psychiatry platforms that can and will prescribe benzodiazepines, like Ativan, which are controlled substances. They offer assessments and prescription consultation, and can answer any questions you have about medication side effects.
Boxed Warning: Lorazepam (Ativan) – Risk of medication misuse or abuse
Lorazepam, the active ingredient in Ativan, has black box warnings. These are the most serious types of warnings from the Food and Drug Administration (FDA).
– Taking lorazepam, a benzodiazepine, with other opioid medications increases your risk for serious side effects that include severe sedation, slower breathing, coma, and death. Lorazepam should not be taken with an opioid unless there are no other options.
– Taking lorazepam can lead to misuse (abuse) and addiction of the medication, which can increase your risk of overdose and death.
– Using lorazepam can lead to physical dependence and this risk increases the longer you take lorazepam. If you suddenly stop taking lorazepam, you can expereince withdrawal. Withdrawal can be life threatening. Lorazepam should only be discontinued by gradual tapering of the dose.
Ativan is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
What Is Ativan (Lorazepam)?
Ativan is a benzodiazepine that is used as an anti-anxiety agent in several anxiety disorders. Ativan and other benzodiazepines work in the central nervous system to reduce activity and stabilize neural cells.2 This action relieves anxiety symptoms, causes mild sedation, and produces calming feelings.1 It is important to discuss with your doctor what anxiety medication feels like before you take Ativan.
Ativan is FDA-approved for short-term management of anxiety, short-term management of insomnia due to anxiety, or procedural sedation. There are also off-label uses for Ativan including treatment of alcohol withdrawal, relief of chemotherapy-induced nausea, and treatment of agitation.2 Off-label uses are not currently approved by the FDA but some studies have shown significant benefits from its use. When prescribed off-label, your doctor should fully explain why they feel Ativan is a good option and the benefits of use should outweigh the risks.
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Common Side Effects of Ativan
Most common side effects of Ativan are dose-dependent, meaning the higher the dose of Ativan, the more intense the side effect will be. Common side effects of Ativan include sedation, weakness, dizziness, and unsteadiness. It is important to avoid driving or operating heavy machinery when taking Ativan.1 It is recommended to take your first dose of Ativan at home to understand how Ativan affects you before using it regularly.
Common side effects of Ativan include:
- Dizziness
- Drowsiness
- Nausea
- Fatigue
- Amnesia
- Ataxia
- Headache
- Vertigo
- Slurred speech
- Nausea
- Constipation
If you have any of these side effects to a severe degree or it is affecting your life, call your doctor.
Dangerous Side Effects of Ativan
Dangerous side effects are less common but require medical attention since they can cause harm if untreated. The risk of serious effects is higher for people who have underlying medical conditions or who use it with other substances.1 It is important to discuss your full health history with your doctor before taking Ativan. This will help identify potential risks of serious side effects before they happen.
Severe side effects of Ativan include:
- Breathing problems
- Confusion
- Memory impairment
- Suicidal ideation/attempt
- Blurred vision
- Seizures or tremor
- Coma
- Hyponatremia (low levels of sodium in the blood)
- Hallucinations
Long-term Side Effects of Ativan
Ativan is most often used for short-term relief of anxiety. When used consistently for long periods of time, additional risks arise. It is important to understand how your doctor wants you to use Ativan. If you will be prescribed Ativan for long than a few weeks, you and your doctor should have regular check-ins to monitor your health.1
Long-term side effects of Ativan include:
- Risk of dependence
- Cognitive impairment
- Worsening of obstructive pulmonary disease
- Unmasking of depression
- Alopecia
- Changes in blood cell counts
- Changes in liver function
The above side effects are a broad overview of possible effects when taking Ativan. It is important to remember that not everyone experiences the same side effects and they are different for everyone. Taking the time to talk thoroughly with your doctor is important. Having regular check-ins will help to address side effects as they happen and give you the opportunity to make adjustments to your medication if necessary.
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Allergic Reactions
It is important to be aware of allergic reactions to Ativan. If you have experienced an allergic reaction to any other benzodiazepine you should not take Ativan. Allergic reactions can happen quickly and require immediate medical attention. When severe, allergic reactions can be life-threatening.
Allergic reactions to Ativan include:
- Swelling
- Trouble breathing
- Skin changes or hives
- Itching
If you experience an allergic reaction, seek help immediately. If you are allergic to Ativan you should work with your doctor to determine an effective alternative. It is not recommended to take any benzodiazepine if you are allergic to one of them.1
Interactions With Ativan
Ativan and other benzodiazepines interact with many other substances, including medications, supplements, and over-the-counter supplements. It is crucial to discuss all medication you take with your doctor before starting Ativan. Interactions can interfere with effects of Ativan or other substances or increase the risk of side effects or adverse effects.
One of the main interactions with Ativan is with opioid medications. Since both types of medications cause sedation and decreased breathing, the risk of dangerously slowed breathing is high. It is important to not take Ativan with other CNS depressants.1
Seven substances you should avoid while taking Ativan include:
- Other benzodiazepines: The risks of CNS depression are increased when Ativan is taken with other benzodiazepines. CNS depression would be slowed breathing, drowsiness, and loss of consciousness, and requires medical help right away.
- Opioids: Oxycodone, Hydrocodone, Tramadol, and Hydromorphone are all examples of opioids that should be avoided while taking Ativan. These drugs can cause further CNS depression and dangerously slowed breathing. It is important to call 911 right away if someone is unresponsive or breathing slowly.
- Clozapine: Clozapine can also cause excessive sedation, low blood pressure, delirium, and slowed breathing, and the risk of these effects would be compounded if it is used with Ativan..
- Valproate: Valproate taken at the same time as Ativan, causes Ativan to last longer in the body and have stronger effects. Your doctor might recommend a lower dose than normal of Ativan if you are also taking valproate.
- Probenecid: Probenecid will also cause Ativan to last longer in the body and have stronger effects. Your doctor might recommend a lower dose than normal of Ativan if you are also taking Probenecid.
- Theophylline: Theophylline will cause Ativan to not work as well. This may cause Ativan to not provide relief for anxiety symptoms at normal doses.
- Alcohol: Any amount of alcohol consumed with Ativan can cause increased CNS depression. This can increase the risk of dangerously slowed breathing and lack of consciousness. If you are prescribed Ativan, do not drink alcohol.
Who Experiences the Most Side Effects on Ativan?
Certain groups of people are more likely to experience side effects when taking Ativan. Elderly patients who take Ativan are at higher risk for experiencing sedation, which can increase the risk of falls. Patients with reduced liver or kidney function are also at higher risk of experiencing side effects.1 It is important to discuss your health history with your doctor before taking Ativan to determine if you are at increased risk of experiencing side effects.
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Ativan Frequently Asked Questions (FAQ) About Side Effects
Many people have lots of questions before taking the medication. These can include how long side effects last, what doses are more likely to cause effects, and whether are there risks to taking Ativan long-term. Your doctor or pharmacist should be able to answer these questions for you before you begin treatment. It is important to have all of your questions about Ativan’s side effects answered so you will know how to use it correctly.
How Long Do Ativan Side Effects Tend to Last?
Side effects from Ativan usually only last for the time that Ativan is active in your body, or about 8 hours. Over time as you become more used to the medication you may see a reduction in the severity of short-term side effects. However, with long-term use, other side effects, like memory loss, can become worse.
Do Ativan Side Effects Vary Based on the Dosage?
In general, the side effects of Ativan are dose-dependent and increase as the dose of medication taken increases. It is also important to remember that side effects can increase if other CNS depressant doses increase as well. If your doctor decides to increase your dose of Ativan, you should proceed with caution and be aware of the increased risk of side effects.1
Ativan Withdrawal
Ativan withdrawal is a serious risk that comes with continued use due to a physical dependence on the medication. The main symptoms include anxiety, hypertension, panic attacks, mania, seizures, and suicidality. It is important to know that immediate medical care is required if any of these symptoms present. The risk of benzodiazepine withdrawal increases for those who take higher doses and have had a longer duration of treatment with benzodiazepines.1
Creating a discontinuation plan is a key part of preventing withdrawal symptoms of Ativan. Your doctor will create a plan that slowly reduces the dose of Ativan over time. Withdrawal symptoms are most severe when a person stops a benzodiazepine immediately or greatly reduces the dose in a short amount of time.1
Other Warnings & Precautions For Taking Ativan
Other warnings when taking Ativan can include its risk for abuse. It is important to only take the medication as prescribed and to never share the medication with anyone. Abusing Ativan or any prescription medication is dangerous and can be harmful. A person can also develop tolerance to Ativan with continued use. This can cause the need for increased doses and increase the risk of side effects.1
Precautions for taking Ativan include:
- Use while pregnant/breastfeeding: Ativan can be transferred to a baby through the placenta and breastmilk. Discuss the risks of using Ativan while pregnant or nursing. Ativan use can cause withdrawal symptoms in newborns, or sedation side effects in nursing babies.1
- Use in older adults: Older adults using Ativan are at a much higher risk of experiencing sedation side effects. This can put patients at increased risk of harm. Caution should always be used when older adults take any benzodiazepine.1
Questions to Ask Your Healthcare Provider About Ativan Side Effects
Ativan can be beneficial for treating symptoms of anxiety, but caution and care must be taken. Spend time speaking at length with your doctor to understand all risks of its use. Create a plan for side effects that may occur and what to do.
Questions to ask your care team when considering the side effects of Ativan may include:
- Can I use Ativan along with therapy to treat anxiety?
- What will taking Ativan feel like?
- Is it safe for me to drive while taking Ativan?
- How long will it take for me to adjust to taking Ativan?
- Will taking Ativan affect my job or school?
- Am I at risk for more severe symptoms if I am already taking medication for anxiety, depression, or other mental health conditions?
- Will a previous history of addiction make me more susceptible to dependency?
- What is the best dosage to ensure fewer side effects?
- Are there drugs I am taking that could have negative interactions?
- When should I reach out to you if I am experiencing side effects?
- Is there anything I should tell my therapist about this new medication?
- How often can I expect to use Ativan?
- Is there a maximum amount that I can take in a day?
- What does it mean to take only as needed?
In My Experience
Taking Ativan can be beneficial in controlling anxiety symptoms. It is important to understand it is not for everyone, and there are risks of side effects for each person. Minimizing your risk of side effects is important to ensure safe use of the medication.
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
Online Psychiatry
Circle Medical Anxiety and Depression Treatment. Meet with an online doctor today! All prescriptions are based on necessity determined by a medical professional. Diagnosis and prescription over video. Insurance accepted. No membership or hidden fees. Same day appointments. Visit Circle Medical
Plushcare There are many effective medications for anxiety and depression, including Zoloft and Lexapro, which a Plushcare doctor can prescribe. In as little as 15 minutes, you can speak with a board-certified doctor from PlushCare to receive anxiety or depression treatment. Plushcare DOES NOT prescribe controlled substances. Visit Plushcare
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Best Online Psychiatry Services
Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.