What is lorazepam (Ativan)? How does it work?
Lorazepam (Ativan) is thought that excessive activity of nerves in the brain may cause anxiety and other psychological disorders. Gamma-aminobutyric acid (GABA) is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another that reduces the activity of nerves in the brain. It is thought that lorazepam and other benzodiazepines may act by enhancing the effects of GABA in the brain to reduce activity. Because lorazepam is removed from the blood more rapidly than many other benzodiazepines, there is less chance that lorazepam concentrations in blood will reach high levels and become toxic. Lorazepam also has fewer interactions with other medications than most of the other benzodiazepines.
The FDA approved lorazepam in March 1999.
What are the uses for lorazepam?
- Ativan (lorazepam) is used for the management of anxiety disorders, the short-term relief of symptoms of anxiety or anxiety associated with depression.
- Ativan is effective for panic attacks, short-term and long-term treatment of insomnia and is used in combination with other medications to prevent nausea and vomiting resulting from chemotherapy.
- Ativan also is administered before anesthesia for sedation and used for prevention and treatment of alcohol withdrawal.
- It also is used for treating seizures (status epilepticus)
What are the side effects of lorazepam?
The most common side effects associated with Ativan are:
Other side effects include:
- A feeling of depression
- Loss of orientation
- Sleep disturbances
- Low blood pressure (hypotension)
- Impotence (erectile dysfunction, ED)
- Changes in appetite
- Sleep apnea
Possible serious side effects include:
- Like all benzodiazepines, Ativan can cause physical dependence. Suddenly stopping therapy after a few months of daily therapy may be associated with a feeling of loss of self-worth, agitation, and insomnia. If Ativan is taken continuously for longer than a few months, stopping therapy suddenly may produce seizures, tremors, muscle cramping, vomiting, and sweating.
Panic attacks are repeated attacks of fear that can last for several minutes.
What is the dosage for lorazepam?
- The dose of lorazepam is tailored to the patient's needs.
- The usual dose for treating anxiety is 2-6 mg orally every 8 to 12 hours as needed.
- Insomnia is treated with 2-4 mg given at bedtime.
Which drugs or supplements interact with lorazepam?
- Ativan and all benzodiazepines accentuate the effects of other drugs that slow the brain's processes such as alcohol, barbiturates, narcotics, and tranquilizers, and the combination of Ativan and these drugs may lead to excessive sedation. There have been cases of marked sedation when Ativan was given to patients taking the tranquilizer loxapine (Loxitane); it is unclear if there is a drug interaction, but caution should be used if Ativan and loxapine are used together.
Is lorazepam safe to take if I am pregnant or breastfeeding?
Ativan and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester. Ativan is best avoided if at all possible in the first trimester and probably throughout pregnancy.
Ativan is excreted in human milk and should be avoided during pregnancy.
What else should I know about lorazepam?
Preparations available for lorazepam are:
- Tablets: 0.5, 1, and 2 mg.
- Oral solution: 0.5 mg/5 ml, 2 mg/ml.
- Injection: 1 mg/0.5 ml, 2 mg/ml and 4 mg/ml
How to store lorazepam:
- Tablets should be kept at room temperature 15 C to 30 C (59 F to 86 F).
- Oral solutions should be refrigerated at 2 C to 8 C (36 F to 46 F).
- Injectable solutions should be refrigerated.
Ativan is the brand name available in the US for lorazepam. Loraz, another brand name for lorazepam has been discontinued in the US.
Ativan is avialable in generic form; however you need a prescription from your doctor.