Lorazepam (brand name Ativan) is a prescription medication often used to manage anxiety, insomnia, seizures, and symptoms related to alcohol withdrawal. As a member of the benzodiazepine class, lorazepam works by enhancing the activity of a neurotransmitter that calms the brain and nervous system.
While highly effective for short-term relief, this prescription drug carries risks that patients should not overlook. This article will help you understand the potential side effects of lorazepam, how to recognize signs of misuse, and what steps you can take to use it safely.
How Lorazepam Works
Lorazepam slows down brain activity by increasing gamma-aminobutyric acid (GABA) levels, helping reduce feelings of anxiety, induce sleep, relax muscles, and prevent seizures. Because of its rapid onset and calming effect, it is often used for short-term relief during acute stress or panic. However, this same mechanism also underlies many of its side effects, especially when the medication is used long-term or in higher doses.
Common Side Effects
Most people taking lorazepam will experience some mild side effects, particularly during the early stages of treatment. These typically include drowsiness, dizziness, weakness, fatigue, impaired coordination, and blurred vision.
Such symptoms can interfere with daily activities like driving or operating machinery. While these effects often diminish as the body adjusts, persistent symptoms should be discussed with a healthcare provider.
Less Common But Concerning Side Effects
Some individuals may experience more serious effects that impact cognition, emotion, and cardiovascular function. These can include memory problems such as anterograde amnesia, lasting confusion or disorientation, mood disturbances like depression or suicidal thoughts, and vision issues or difficulty concentrating.
Additionally, cases of changes in heart rate—including palpitations or irregular heartbeat—have been reported and should prompt medical evaluation. Among elderly patients, cognitive toxicity is particularly pronounced. Acute lorazepam administration in older long-term users significantly impaired recall and slowed psychomotor performance, even when they reported no subjective worsening in mood or sedation.
Rare and Serious Adverse Reactions
Although rare—typically affecting fewer than 1 in 1,000 users—lorazepam can produce severe, dose-dependent complications. These may include respiratory depression, seizures (particularly during abrupt withdrawal), hypotension, syncope, tachycardia, blood disorders, and acute liver injury, often indicated by yellowing of the skin or eyes (jaundice). Paradoxical effects like agitation, aggression, or hostility—though counterintuitive for a sedative—can also occur, especially in individuals with underlying psychiatric conditions or when taken at high doses.
In intravenous form, lorazepam poses an additional risk of propylene glycol toxicity, which may result in metabolic acidosis, kidney dysfunction, or other serious systemic issues.
Lorazepam Misuse and Addiction
Misuse of lorazepam occurs when someone takes the drug in ways other than prescribed—such as at higher doses, more frequently, or without a prescription altogether. Some people misuse lorazepam to enhance its sedative effects or to self-medicate anxiety, stress, or withdrawal from other substances.
Over time, repeated misuse can lead to addiction, a condition defined by compulsive drug-seeking behavior despite negative consequences. Unlike physical dependence, addiction involves psychological cravings and behavioral changes, such as doctor shopping, social withdrawal, increasing the dose without medical supervision, or continuing use despite harm to work, relationships, or mental health.
When such symptoms appear—or when side effects begin to hint at a deeper issue of misuse—it’s essential to seek professional support. Our men-only Ativan addiction treatment in Utah provides structured, compassionate care to help individuals safely taper off lorazepam, address the root causes of dependence, and begin a sustainable path to recovery.
Tolerance, Dependence, and Withdrawal
With regular use, particularly beyond four weeks, the body can become tolerant to lorazepam’s effects—meaning higher doses are needed to achieve the same result. This tolerance can progress to physical dependence, where the brain adapts to the drug’s presence and struggles to function normally without it.
About one-third of individuals who use benzodiazepines long-term will experience withdrawal symptoms when stopping the medication. These can include anxiety, restlessness, insomnia, tremors, sweating, and, in severe cases, hallucinations, seizures, or psychosis. Lorazepam’s relatively short half-life makes it more likely to produce interdose withdrawal—where symptoms emerge even between scheduled doses.
To safely stop lorazepam, a gradual tapering process is crucial. Healthcare providers often transition patients to a longer-acting benzodiazepine, such as diazepam, before slowly reducing the dose over several weeks or months depending on the individual’s history and level of dependence.
Who Is Most at Risk?
Elderly individuals often experience heightened drowsiness, confusion, and increased risk of falls. Pregnant or breastfeeding women risk passing the drug to their infant, potentially causing sedation or withdrawal symptoms.
People with respiratory disorders such as COPD or sleep apnea may face heightened danger from respiratory suppression. Those with a history of substance use disorder are at increased risk of misuse and dependency.
Drug Interactions
The sedative properties of lorazepam can be dangerously amplified when combined with substances like alcohol, opioids, antihistamines, antipsychotics, antidepressants, or other sleep aids.
Such combinations can lead to extreme drowsiness, respiratory depression, coma, or death. It is essential to disclose all medications and supplements to your healthcare provider before starting lorazepam.
Final Thoughts from Mountain Valley Recovery
Lorazepam can provide effective relief for anxiety and related conditions when used appropriately. However, its potential side effects—from mild drowsiness to serious respiratory or neurological complications—require careful monitoring. If you or someone you know is experiencing adverse effects or struggling with prescription drug misuse, it is important to seek professional medical advice.
At Mountain Valley Recovery, our Ativan addiction treatment in Utah offers compassionate, evidence-based care to help men safely taper off lorazepam, manage withdrawal symptoms, and build lasting recovery. Our team’s focus is not just on helping men overcome physical dependence but also to heal emotionally and rebuild life skills for lasting sobriety.
