If your anxiety is affecting your life, you might want to explore your pharmacological options. Lorazepam is an anti-anxiety medication that has demonstrated an impressive ability to improve mood and help get your anxiety in check, but it can come with some risks.
Starting any new medicine is serious, so we’ve done the research to help you understand what lorazepam is, how to best use it, and how it might affect you to help you make the best decision for your mental health.
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Lorazepam is the generic name for an anxiolytic medication (meaning that it reduces anxiety) belonging to a medicine family called benzodiazepines. It is also known by different brand names such as Ativan, Tavor, and Temesta.
Lorazepam is taken orally as a tablet or liquid and is typically used to treat anxiety and sleeping problems. It can also be given as an injection in emergency situations to treat seizures.
As with all benzodiazepines, lorazepam is used as a short-term solution to help manage anxiety levels due to its risk of abuse.
Instead of being taken daily like other antidepressants or anxiolytics, lorazepam is used on occasions when anxiety arises and only for a short period of time (a few weeks maximum) until more long-term treatment options start to work.
Benzodiazepines reduce anxiety by enhancing the activity of GABA, a neurotransmitter in your brain that induces feelings of calm. The reason why benzodiazepines like lorazepam are used to treat both anxiety and sleep is that GABA also induces feelings of drowsiness, which can help you get a better night’s rest.
A 2010 study¹ looked into how lorazepam affects the brain, using MRIs to see whether the medication modifies a patient’s brain while experiencing anxiety. Patients in the study underwent an MRI scan while participating in an anxiety challenge.
The challenge used the anticipation of electrical shocks to induce feelings of anxiety, and participants were given either 1 mg of oral lorazepam or an oral placebo. The study found that lorazepam reduced cerebral activity in three areas of the brain.
This tells us that lorazepam’s anxiety-reducing effects could occur through the medication reducing brain activity when anxiety is anticipated.
Unlike other anxiety medications that can take up to 8 weeks for their full effects to be felt, lorazepam can provide an effective reduction in anxiety within 30 minutes.
However, while its effects are felt quickly, they are not long-term. You should expect the anxiolytic effects of lorazepam to last for around 6 to 8 hours.
The quick and short-term effects of lorazepam mean that it is only used to manage anxiety symptoms for a short period of time until more long-term treatment options like SSRI medications start to work.
Another reason why lorazepam is not recommended for long-term use is that it carries with it a risk of abuse. When used for non-medical reasons, for longer, or at higher doses than recommended, patients can develop an addiction.
Long-term abuse of lorazepam can have a significant impact on your health and wellbeing and can be a difficult habit to overcome.
As we know, lorazepam is a sedative, and while this can be useful in short doses, over time, your body starts to develop a tolerance to the medication.
The longer you continue to take lorazepam, the higher the dose your brain will require to experience the same feelings of sedation, calm, and anxiety relief. Long-term abuse of lorazepam can result in side effects such as:
Fatigue and sedation
Confusion and disorientation
Loss of appetite
Respiratory suppression and overdose
Lorazepam abuse can also lead to some significant challenges in your personal life and career.
People experiencing severe lorazepam dependency often find themselves in financial trouble, losing their jobs and becoming unemployed, divorced, demonstrating bad parenting (in some cases child abuse or neglect), and legal issues that can lead to incarceration.
If you’re worried that someone you know is addicted to lorazepam, there are a few signs that you can look out for:
Poor physical condition
Loss of muscle control
Over-sleeping or passing out
No longer participating in former activities
Visiting multiple doctors, also known as “doctor shopping,” to ensure prescriptions
Lying about their lorazepam use
If someone has been abusing lorazepam for a long time, they will likely experience withdrawal symptoms once they stop taking the medication. Lorazepam withdrawal symptoms include:
While lorazepam has the potential for abuse, research into lorazepam addiction tells us that benzodiazepine addiction largely occurs in people already struggling with substance abuse.
In these cases, benzodiazepines like lorazepam are used as a secondary drug to fill the addiction to another drug that can no longer be accessed.
On the whole, there are few cases that occur when lorazepam is used for legitimate reasons, like managing anxiety.
When legitimate use of lorazepam does develop into a dependence, it can usually be managed through tapering down the dose, switching medicines, and/or combining treatment with other medications.
If you’re worried about lorazepam dependence, it’s best to talk to your doctor about it. They will be able to offer you alternative anxiety treatment options or, if continuing with treatment, can help you to put tools in place to help avoid dependency.
If, for example, you struggle with chronic anxiety and require lorazepam over a period of time, your doctor may recommend a low-dose prescription.
What does lorazepam feel like? Because of its ability to reduce anxiety and act as a sedative, lorazepam is likely to leave you feeling:
Relaxed and calm
Serene and happy
Tired or drowsy
Lorazepam can be prescribed to adults and children (aged 12 years and older) who experience anxiety or insomnia. However, even if you meet these criteria, there are some conditions that can make lorazepam unsafe and unsuitable to use.
If you have one of the following conditions, your doctor may advise that lorazepam is not a good fit for you:
Because long-term lorazepam use has been linked to kidney disease,² it should be avoided if you have any kind of kidney issues.
Long-term or excessive use of lorazepam can suppress the respiratory system, meaning that patients with respiratory issues could be more susceptible to respiratory failure on lorazepam.
In the same manner, if you are about to have surgery or be put under a general anesthetic, lorazepam will not be prescribed for you due to the increased risk of respiration suppression.
This condition causes muscle weakness, anxiety, and insomnia.
While lorazepam may seem like a good fit for the last two symptoms, because of its ability to affect respiration, lorazepam could put myasthenia gravis patients at higher risk for respiratory distress.
While it may seem odd that lorazepam can be prescribed for anxiety or depression, because of the chronic and constant nature of depression and lorazepam tolerance, long-term use can actually worsen depressive symptoms.
Borderline personality disorder only affects 2.7%³ of adults, but 78% of them will also struggle with addiction or substance abuse at some time in their life.
Because of the increased risk of addiction and the abuse risk of lorazepam, borderline personality patients should avoid lorazepam.
For obvious reasons, patients with previous addiction struggles will likely not be prescribed lorazepam in case it risks their sobriety.
Lorazepam is a Category D medicine according to the U.S. Food and Drug Administration, meaning that it has the potential to cause birth defects and health problems in utero.
To avoid this risk, your doctor will likely recommend that anyone pregnant, breastfeeding, or trying to conceive should avoid lorazepam use.
Your doctor will advise you on the most appropriate and safest lorazepam dose. Typically for anxiety, you can expect a dose from 1 to 4 milligrams per day and 1 to 2 milligrams per day for insomnia.
This dose will fluctuate based on your needs and individual characteristics (size, comorbid risk, etc.). Children’s dosing of lorazepam will also depend on the child’s size and need.
At the end of your treatment period (from a few days to a few weeks), your doctor will likely taper you off lorazepam to avoid any potential withdrawal symptoms and help you stop treatment comfortably.
Lorazepam can have a significant impact on anxiety levels; in the short term, it can be an effective and safe treatment option.
However, you should be aware of the addiction risk of lorazepam when used long term. It’s best to discuss any concerns that you might have about lorazepam with your doctor.
Lorazepam | NHS
Ativan addiction: Side effects of long-term use | American Addiction Center
Ativan abuse symptoms and warning signs | Addiction Center
Is ativan safe during pregnancy? | American Addiction Center