Lorazepam (commonly known by the brand name Ativan) is a widely prescribed benzodiazepine used to treat anxiety, panic disorders, and related conditions.
In the United States alone, it accounted for nearly 7 million prescriptions in 2023, with more than 2 million patients receiving the drug. While lorazepam can be effective for short‑term relief of acute anxiety or stress‑related symptoms, it also carries risky side effects and safety concerns that patients should understand before starting treatment [1].
Common issues range from drowsiness and dizziness to more serious risks such as dependence, withdrawal, and complications when combined with other medications or alcohol.
What is Lorazepam?
Lorazepam is a prescription benzodiazepine medication, commonly used to treat anxiety disorders, insomnia related to anxiety, acute panic attacks, seizures, and sometimes given before medical procedures. It is administered in multiple forms, including a tablet, solution, and extended-release capsule.
It works by increasing the effects of gamma‑aminobutyric acid (GABA), a neurotransmitter that slows brain activity, producing a calming, sedative effect. Over millions of people are prescribed Ativan each year for short‑term or intermittent use. It acts relatively quickly and has a high risk of dependence, often chosen for acute anxiety symptoms rather than long‑term management [2].
Despite its effectiveness, lorazepam carries significant risks, especially when used for extended periods or at higher doses. It also has a high potential for dependence and addiction. Tolerance can develop within weeks, and the risk of addiction and overdose is especially high when combined with alcohol, opioids, or other central nervous system depressants.
Common Side Effects of Lorazepam
Lorazepam has several common side effects affecting nearly 1 out of every 100 users. These are usually mild and tend to improve with time [3]:
- Drowsiness or sedation
- Dizziness or lightheadedness
- Weakness or fatigue
- Unsteadiness or impaired coordination
- Headache
- Blurred vision
- Nausea or stomach upset
- Confusion or difficulty concentrating
Serious Side Effects of Lorazepam
More serious side effects, which occur in fewer than 1 in 1,000 users, often require medical care. Speak with your prescribing doctor if you notice any of the following [3]:
- Your skin or the white parts of your eyes turn yellow, indicating a liver problem
- You keep falling over, feeling clumsy, and having poor motor skills, even if you do not take the medication daily
- You begin seeing or hearing things that are not there (hallucinations)
- You begin believing things that are not true (delusions)
- You have drastic mood swings, talking more or feeling overexcited, restless, agitated, or aggressive
*Reduced or stopped breathing, loss of consciousness, gargling sounds, and blue or purple fingertips often indicate the signs of an overdose.
Signs of An Allergic Reaction to Lorazepam
In extremely rare cases, Lorazepam can cause an allergic reaction such as anaphylaxis shock. This requires immediate medical attention, and you should call 911. Signs of an allergic reaction to Ativan include:
- Swollen lips, tongue, mouth, or throat
- Breathing extremely fast or struggling to breathe (may feel as if you are choking for air)
- Tight throat and difficulty swallowing
- Skin, fingertips, or tongue turn blue, grey, or pale
- Extreme confusion, dizziness, or drowsiness
- May have a swollen, itchy, and blistered rash
Risks of Lorazepam: Who Should Avoid It?
Lorazepam is not safe for everyone, and certain groups of people may face higher risks of serious side effects or complications. Your doctor will weigh these factors with you before prescribing it.
People with certain medical conditions, those taking other medications that interact with lorazepam, and individuals more sensitive to sedatives may need alternative treatments or lower doses.
Individuals who should avoid Lorazepam or take it with extra caution include:
- Children and adolescents: Lorazepam is rarely prescribed to children and teens as safety and effectiveness are not well established, and many professionals cite the risk of dependence.
- Elderly: Those who are 65+ may be at an increased risk of sedation, falls, confusion, and memory problems.
- Pregnant and breastfeeding women: Can harm the developing fetus and may cause neonatal withdrawal if used late in pregnancy. It also passes into breast milk and can affect the baby.
- History of substance use disorder: Higher risk of dependence or addiction.
- Respiratory issues: Best to avoid if you have sleep apnea or severe lung disease due to effects on depressed breathing.
- Liver or kidney problems: Can experience stronger or longer-lasting effects due to slower metabolism.
- Mixing with other sedatives or alcohol: Risk of extreme drowsiness, respiratory depression, or overdose.
Drug Interactions of Lorazepam
Ativan has known interactions with over 400 drugs, including around 30 that have major interactions, hundreds with moderate interactions, and many more with minor interactions.
These interactions can change how lorazepam or the other medication works and may increase the risk of side effects, especially those affecting the central nervous system (CNS), such as sedation, dizziness, confusion, and dangerously slowed breathing.
Some of the most common or important drug interactions include:
- Other CNS depressants: Opioids like oxycodone or morphine, other benzodiazepines, and certain sleep medicines can greatly increase sedation and respiratory depression.
- Antidepressants and antipsychotics: Combining these with lorazepam can increase drowsiness and impair coordination.
- Alcohol: Should be avoided entirely with lorazepam, as it significantly increases dangerous side effects like respiratory depression and extreme sedation.
View the complete list of known lorazepam drug interactions here.
Benzodiazepine Addiction Treatment in Michigan
Rushton Recovery understands the complex nature of drug & alcohol recovery. We prioritize your well-being, safety, and comfort during treatment. Our detox and residential treatment center in Michigan offers a healing space to embark on your recovery journey from benzodiazepine dependence.
We offer evidence-based therapies designed to evolve with your individual needs and address the root of your substance abuse. Let our team help you get clean, repair relationships, and equip you with the skills to achieve long-term recovery.
Contact our Admissions team to learn more and begin treatment.
Sources
[1] ClinCalc. 2023. Lorazepam.
[2] Mayo Clinic. Lorazepam.
[3] NHS. 2023. Side effects of lorazepam.