Lorazepam: Uses, Side Effects, Doses, and More
Dr. Gerardo Sison
With nearly 20 percent of American adults suffering from some form of anxiety, many people have turned to prescription medications to help manage their symptoms. Lorazepam is a prescription drug that is commonly prescribed for the short term treatment of acute anxiety, but there are also other uses for the drug.
What is lorazepam?
Lorazepam is a generic prescription medication that belongs to a class of drugs called benzodiazepines. Lorazepam is a tranquilizing drug that is sometimes referred to as a sedative-hypnotic or anxiolytic medication. Lorazepam is the generic version of Ativan and as either a tablet or as an intravenous injection; the form in which a patient receives lorazepam depends on the condition being treated.
What is lorazepam used to treat?
Lorazepam is approved by the U.S. Food and Drug Administration (FDA) for the treatment of three different conditions: anxiety, insomnia, and seizures.
The most common application for lorazepam is treatment for anxiety disorders. The U.S. Food and Drug Administration has approved lorazepam for the short term treatment of anxiety, with the average prescription for the medication written for two to four weeks.
Unlike longer acting medications like Zoloft or Lexapro, lorazepam is not used for the long term treatment of anxiety due to its potential to be habit-forming. Therefore, lorazepam is most commonly prescribed as an “emergency” or “rescue” drug that is used during a particularly stressful or difficult time, such as after an unexpected layoff. Other applications of lorazepam include the use of the drug to treat a type of acute anxiety attack called panic attacks.
People who are experiencing insomnia due to extreme stress or anxiety may be prescribed lorazepam to help treat the condition for a short period of time. Lorazepam is habit forming and is not appropriate for the long term treatment of insomnia, but it can be used for short periods of time, such as two to four weeks. The longer lorazepam is taken, the more likely the drug is to cause withdrawal symptoms or lead to physical and psychological dependence.
Lorazepam is given in an injectable form for the treatment of severe seizures known as status epilepticus. Seizures associated with status epilepticus can present in two different ways: the first is a single seizure that lasts longer than five minutes, while the second is two or more seizures within a five-minute period without recovery.
How much does lorazepam cost?
As a generic medication, lorazepam is considerably less expensive than its brand name counterpart, Ativan. The medications are equally as effective and contain the same active ingredient, lorazepam, in the same dose, but may have different inactive ingredients. Patients can save considerably by choosing the generic form of the drug.
Approximate Costs of Ativan and Lorazepam (in Dollars)
Ativan 0.5 mg oral tablet
Lorazepam 0.5 mg oral tablet
Ativan 1 mg oral tablet
Lorazepam 1 mg oral tablet
Ativan 2 mg oral tablet
Lorazepam 2 mg oral tablet
What are the benefits of using lorazepam?
While use of lorazepam and benzodiazepines like it is associated with considerable risk, the drug also has a number of important benefits that contribute to its popularity. Lorazepam is a fast acting drug that begins to work within 20 to 30 minutes of being consumed and can provide noticeable results within the first week of treatment.
Patients who are suffering from acute anxiety symptoms will receive needed support more quickly than when using slower-acting anti-anxiety medications, such as Lexapro, which typically take several weeks to provide relief.
Lorazepam can be combined with a prescription for a long term treatment for anxiety like Lexapro, providing a helpful means of support while the longer acting drug takes effect.
How do I know which dose of lorazepam I should take?
Your doctor will determine the proper dose of lorazepam for you based on the condition being treated, other medical conditions you may have, your age, the form of lorazepam taken, U.S. Food and Drug Administration recommendations, and other medications you may be taking.
Both the brand name and generic versions of lorazepam are manufactured in oral tablets at strengths of 0.5 mg, 1 mg, and 2 mg. Lorazepam can also be injected intravenously in a clinical setting and is available in room temperature dosages of 2 mg per ml or 4 mg per ml.
Patients who take lorazepam to manage anxiety symptoms typically use 1 mg to 2 mg of the drug daily, which is divided into several doses. When used to treat insomnia, approximately 2 mg to 4 mg is taken at bedtime.
Lorazepam is known to cause withdrawal symptoms when taken for longer than two weeks, so patients should not discontinue use of the drug abruptly if they have been taking it for at least that length of time. Withdrawal symptoms associated with lorazepam can occur regardless of the dose of the medication that is taken.
If you decide to stop taking lorazepam, ask your doctor to help you to gradually lower your daily dose of the medication based on their recommendations in order to avoid uncomfortable symptoms as much as possible.
How do I use lorazepam to treat anxiety?
Lorazepam is used on a short term basis to treat anxiety. After taking lorazepam, patients typically start to feel the effects of the medication in about 20 to 30 minutes. The effects of the medication may last for up to eight hours. As a result, patients may need to take two to three doses of the drug per day in order to control their anxiety symptoms.
Lorazepam should be used only on a short term basis (typically less than four months) in order to prevent dependence, but it can serve as an effective tool for reducing symptoms of depression while waiting for a longer term drug, such as Lexapro, to take effect.
Are there any side effects associated with lorazepam?
Side effects for lorazepam are generally divided into three categories and include common, less common, and serious side effects.
Common side effects of lorazepam include:
Less common side effects include:
- Lack of coordination
Serious side effects include:
- Psychological and physical dependence
- Suicidal thoughts
- Slowed breathing
- Respiratory failure
- Serious allergic reaction
The long term use of lorazepam or use of lorazepam at a higher than recommended dose can increase your risk of becoming dependent on the drug.
Symptoms of dependence may include:
- Body aches
- Muscle weakness
If you experience an allergic reaction to lorazepam, you should seek medical attention immediately.
Symptoms of an allergic reaction include:
- Rash or hives
- Rapid heartbeat
- Trouble breathing or swallowing
- Swelling of lips, tongue, or face
Does lorazepam come with any warnings for use?
Lorazepam is associated with several warnings for use due to its potential to cause physical and psychological dependence.
People with a history of drug or alcohol abuse or alcohol withdrawal are considered to be at a greater risk of abusing lorazepam, so it is important to tell your doctor if you have experienced substance abuse or addictive tendencies previously.
Lorazepam can cause life-threatening drug interactions, including respiratory depression, when combined with other medications or substances that suppress the central nervous system, including opioids, alcohol, and other benzodiazepines. Make sure to tell your doctor about any prescriptions, over-the-counter medications, supplements, vitamins, or herbs you are taking for appropriate medical advice.
People who have symptoms of depression may find that their symptoms worsen when using lorazepam. If you are suffering from depression, it’s important to pay attention to your symptoms and let someone know if your symptoms worsen or you begin experiencing suicidal thoughts while using the medication.
Because lorazepam is associated with an increased risk of abuse and dependence when used for an extended period of time, the drug is typically prescribed for no longer than four months. Do not extend your use of the drug after the prescription ends without speaking to your doctor.
Lorazepam should not be used by pregnant or breastfeeding mothers due to its potential to cause serious birth defects and life-threatening withdrawal symptoms for the infant.
Are there any withdrawal symptoms associated with lorazepam?
Lorazepam can cause serious withdrawal symptoms and is known to be habit-forming. Patients who experience physical or psychological dependence or addiction are more likely to experience withdrawal symptoms when they stop using the medication, but anyone who has been using lorazepam for two weeks or more is susceptible to experiencing symptoms. Patients who have been taking lorazepam regularly for more than two weeks must gradually wean off the medication under the supervision of a doctor to prevent withdrawal symptoms from occurring. The longer you have taken lorazepam, the more likely you are to experience withdrawal.
Common withdrawal symptoms include:
- Trouble sleeping
Lorazepam can cause severe withdrawal symptoms in patients who experience extreme dependency, particularly when stopping use of the medication abruptly. These symptoms include:
- Panic attacks
Is it possible to overdose on lorazepam?
Lorazepam overdose is not common, but it is possible. Most patients who overdose on lorazepam overdose as a result of the combination of the medication with other substances, such as opioids, other benzodiazepines, or alcohol.
Patients who use the medication regularly over an extended period of time may build up a tolerance and find themselves taking more and more of the medication to produce the same calming effect.
Signs of an overdose include:
- Slurred speech
- Loss of balance or coordination
- Feeling light-headed
- Slow heartbeats
- Extreme drowsiness
- Feeling restless
- Muscle weakness
- Weak or shallow breathing
Medical attention should immediately be sought in the event of an overdose or possible overdose of lorazepam.
Who should not take lorazepam?
Lorazepam is commonly associated with an increased risk of physical and psychological dependence, making it inappropriate for use in certain groups of people.
These groups include:
- People with untreated depression, as use of lorazepam can increase the risk of experiencing suicidal thoughts in people who are depressed. Ask a mental health professional about antidepressant options such as Xanax, or other benzodiazepines like diazepam (Valium) or clonazepam (Klonopin).
- People with a high risk of drug abuse
- Children under the age of 12, as lorazepam is not approved for use in this population. The medication is sometimes used off-label under a doctor’s care, but it should be used with caution, as children are more likely to experience side effects from lorazepam than adults.
- Senior citizens, as older adults are at increased risk of experiencing side effects like drowsiness or dizziness, which increases their risk of falling. Senior citizens may require a substantially lower dose of lorazepam if prescribed the medication by a doctor.
- Pregnant women and breastfeeding mothers, as the use of the medication is known to cause serious birth defects or life-threatening withdrawal symptoms in newborn babies. Pregnant and nursing women should not take lorazepam, as it is present in breast milk.
Additionally, some people with certain medical conditions should not take lorazepam. Make sure to tell your doctor if you have experienced any of the following adverse effects:
- Narrow-angle glaucoma
- Breathing problems, sedation, suicidal thoughts or behavior, sleep apnea, sleepiness, severe impairment, psychosis, kidney/liver disease, depression, unsteadiness, drug or alcohol addiction, changes in blood pressure or hypotension, worsening mood problems, constipation, seizures, glaucoma.
- History of allergic reaction to any benzodiazepine
Do not consume alcohol when using lorazepam, as the combination can contribute to severe respiratory depression.
Lorazepam is a generic version of the brand name drug Ativan. The medication is typically prescribed for the treatment of anxiety, insomnia, or seizures and is commonly associated with side effects that include dizziness, drowsiness, and weakness.
Most patients who take lorazepam for anxiety will take between 1 and 2 mg of the drug per day, broken up into several doses.
Ask your healthcare provider or a healthcare professional if lorazepam is right for you. Patients can save on both generic lorazepam and brand name Ativan with a pharmacy discount card from USA Rx.