Lorazepam: Uses, Dosage, Side Effects & More

Lorazepam, commonly known by its brand name Ativan, is a benzodiazepine medication primarily prescribed to treat anxiety, insomnia, and seizures. It promotes a calm and relaxed state by soothing the mind and nervous system.

Lorazepam is also used before surgery or medical procedures to reduce anxiety and nervousness. It works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that reduces neural activity to produce a calming effect. This article provides essential information about Lorazepam, its uses, and important considerations for safe use.

What is Lorazepam?

Lorazepam is a benzodiazepine medication approved by the FDA for the treatment of anxiety disorders, insomnia, and seizures, including status epilepticus, a potentially life-threatening condition [1]. It is also used as a preoperative sedative to reduce anxiety. By enhancing GABA activity, Lorazepam helps calm the nervous system. Due to its potential for addiction and adverse effects if misused, it is typically prescribed for short-term use under medical supervision.

US Brand Name

The US brand name for Lorazepam is

• Ativan [2].

• Lorazepam Intensol

• Loreev XR

 

Warnings

Lorazepam carries significant warnings that users must understand before taking it. High doses or misuse can lead to side effects such as drowsiness, dizziness, nausea, and confusion. This medication should only be taken under the guidance of a healthcare provider.

Prolonged or high-dose use of Lorazepam may result in physical dependence, addiction, and withdrawal symptoms upon abrupt discontinuation. To address these risks, the US Food and Drug Administration (FDA) requires a Boxed Warning on all benzodiazepine medications, highlighting the potential for abuse, addiction, dependence, and withdrawal reactions. Always consult your doctor before starting or stopping Lorazepam and follow the prescribed dosage carefully.

Before Taking This Medicine

Before starting Lorazepam or if your doctor has prescribed it, ensure your healthcare provider is fully informed about your medical history and current health status. Disclose any use of medications, alcohol, or other substances. Additionally, provide the following information to your doctor:

• Inform your doctor if you have any allergies, including to Lorazepam or other benzodiazepines such as alprazolam (Xanax) or diazepam (Valium).

• If applicable, mention any allergies to aspirin or tartrazine (a yellow dye).

• List all medications, supplements, or herbal products you are currently taking.

• Report any mental health conditions, such as depression or anxiety.

• Disclose any history of seizures, sleep disorders, or other relevant symptoms.

• Inform your doctor if you are taking medications for liver conditions.

• If you are pregnant or breastfeeding, notify your physician.

How should I take Lorazepam?

Always take Lorazepam exactly as prescribed by your doctor. It can be taken orally, with or without food. If using the liquid form, measure the dose accurately with the provided measuring device—never estimate. Take it at the same time each day to maintain consistency. If you feel anxious, do not increase your dose without consulting your doctor.

Dosing Information

Lorazepam dosage varies based on individual factors such as body type, medical condition, and concurrent medications. For younger adults, a typical starting dose is 2–3 mg per day, divided into multiple doses, with adjustments made by your doctor as needed. Always consult your healthcare provider before starting or changing your dose.

What Happens If I Miss a Dose?

If you miss a dose of Lorazepam, take it as soon as you remember. However, if it’s nearly time for your next dose, skip the missed dose and continue your regular schedule. Never double your dose, as this can lead to serious complications.

What Happens If I Overdose?

Overdosing on Lorazepam can be dangerous and may cause serious effects, including respiratory depression, confusion, ataxia (loss of coordination), hypotension (low blood pressure), coma, excessive drowsiness, or, in rare cases, death [1]. The risk of severe sedation and respiratory issues increases significantly if Lorazepam is combined with opioids. Concurrent use of these drugs should be avoided unless no alternatives are available.

What Should I Avoid While Taking Lorazepam?

• Avoid alcohol while taking Lorazepam, as it can intensify drowsiness, dizziness, or severe side effects like slowed breathing. 

• Do not drive, operate machinery, or engage in activities requiring full attention until you understand how Lorazepam affects you. 

• Avoid other sedatives, sleeping pills, or opioid medications unless approved by your doctor, as these combinations can cause profound sedation or life-threatening respiratory depression.

Lorazepam Side Effects

Lorazepam has many side effects when taken in a large dose or consistently. Some of which are:

• Feeling tired and out of my mind

• Weakness and less energy

• Heavy head and headache

• Improper sight

• Nausea and stomachache

• Loss of appetite

• Sudden mood changes

• Depression symptoms

• Trouble in walking

Related/Similar drugs

Below is a list of medications related to or similar to Lorazepam, often used to treat anxiety, depression, or other conditions. Each drug has unique characteristics, uses, and potential side effects.

Cymbalta (Duloxetine)

Cymbalta is an SNRI antidepressant used to treat depression, anxiety, nerve pain, and fibromyalgia. It works by balancing serotonin and norepinephrine levels in the brain to improve mood and reduce pain signals. Typically taken once daily at a starting dose of 60 mg, it may cause side effects such as nausea, dry mouth, sleepiness, sweating, dizziness, or fatigue. Abrupt discontinuation may lead to withdrawal symptoms, so it should be tapered under medical supervision.

Paroxetine (Paxil)

Paroxetine is the tablet primarily used for depression, anxiety, panic attacks, OCD, PTSD, etc. The drug is an SSRI medication and can only be taken with a doctor’s consultation. The pill’s primary function is to increase serotonin levels in the brain, resulting in a more relaxed and calm mind and body.

Ozempic (Semaglutide)

Ozempic is an injectable medication primarily used for management of Type 2 diabetes as well as to control weight. However, the healing agent is typically administered slowly and incrementally, tailored to the individual’s body. Some of its common side effects are also ones that exacerbate patients’ conditions, e.g., vomiting, nausea, constipation.

Diazepam (Valium)

Diazepam is a benzodiazepine used to treat anxiety, muscle spasms, seizures, and alcohol withdrawal. It helps calm the brain and nerves by boosting the effect of a natural chemical called GABA. Diazepam works quickly and is often used short-term. Common side effects include drowsiness, tiredness, and unsteadiness. Long-term use can lead to dependence, so it should only be taken as prescribed and not stopped suddenly without medical advice.

Xanax (Alprazolam)

Xanax, a fast-acting benzodiazepine, is prescribed for anxiety and panic disorders. It works by increasing GABA activity to reduce nervousness quickly. Due to its high potential for addiction, it is typically prescribed for short periods. Common side effects include drowsiness, lightheadedness, and difficulty concentrating. Sudden discontinuation can cause withdrawal symptoms, so it should be used under strict medical guidance.

Venlafaxine (Effexor)

Venlafaxine, an SNRI antidepressant, is used to treat depression, anxiety, panic attacks, and social anxiety disorder. It increases serotonin and norepinephrine levels to improve mood and reduce anxiety. Common side effects include nausea, sweating, dry mouth, dizziness, and trouble sleeping. Some may experience increased anxiety or restlessness initially. Dosage is typically adjusted gradually to help the body adapt.

Lexapro (Escitalopram)

Lexapro is used to treat depression and generalized anxiety disorder. It balances serotonin levels to improve mood and reduce anxiety. Taken once daily, it may take a few weeks to show full effects. Side effects include nausea, dizziness, trouble sleeping, and tiredness, with some experiencing temporary increases in anxiety early on. These effects often subside with continued use.

Buspirone

Buspirone is an anti-anxiety medication that relieves anxiety symptoms without causing strong sedation or addiction, unlike benzodiazepines. It affects brain chemicals linked to mood and anxiety and is typically taken two or three times daily. Full benefits may take a few weeks. Common side effects, usually mild, include dizziness, headache, nausea, and restlessness.

What Other Drugs Will Affect Lorazepam?

Lorazepam can be affected by many substances, which are responsible for depressing the central nervous system. So, when combining or mixing the drug with opioids, sedatives, muscle relaxants, antipsychotics, or alcohol, it may lead to a serious condition. The medicine can also interact with other drugs, such as valproic acid and probenecid, which can enhance lorazepam levels. [4].

Does Lorazepam Interact with My Other Drugs?

Yes, Lorazepam can interact with other drugs. Consuming it or mixing the medicine with opioids, alcohol, and other substances can cause many side effects, making you feel dizzy. If you are taking this medicine, be sure to consult your doctor first.

FAQs

1. What exactly does Lorazepam do?

Lorazepam, a benzodiazepine, calms the mind and relaxes the body by enhancing GABA activity in the brain. It is primarily used to treat anxiety, insomnia, and seizures, helping to reduce symptoms such as nervousness and tension. It is not typically used for headaches or body aches unless they are related to anxiety.

2. Is Lorazepam basically Xanax?

No, while both lorazepam and Xanax (alprazolam) are benzodiazepines used to treat anxiety, they differ in their effects. Lorazepam has a longer duration of action, while Xanax acts more quickly but wears off faster. Their uses and side effect profiles may also vary, so they are not interchangeable.

3. What will 1 mg of Lorazepam do?

A 1 mg dose of Lorazepam typically reduces anxiety, promotes calmness, and induces relaxation. The effects depend on individual factors, such as body weight and tolerance, and should only be taken as prescribed by a doctor.

4. What is the most common side effect of Lorazepam?

The most common side effect of Lorazepam is drowsiness. This can make you feel sleepy or lethargic, which is why driving, operating heavy machinery, or engaging in activities requiring full attention should be avoided while taking it.

5. How will Lorazepam make you feel?

Lorazepam typically produces a calming and relaxing effect, helping to reduce anxiety and promote sleep. You may feel less tense and more at ease, but effects vary based on dosage and individual response.

6. Who cannot take Lorazepam?

Individuals with conditions such as severe respiratory issues, liver disease, or a history of alcohol or substance abuse should avoid Lorazepam. It is also not recommended for those with certain allergies, pregnant or breastfeeding individuals, or those taking conflicting medications, unless approved by a doctor.

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Sources:

[1] https://www.ncbi.nlm.nih.gov/books/NBK532890/

[2] https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/017794s044lbl.pdf

[3] https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class

[4] https://medlineplus.gov/druginfo/meds/a682053.html