Ativan (lorazepam): uses, side effects, and what to expect

If you or your psychiatrist have mentioned Ativan as a possible option for anxiety, you probably have questions about how it works, what to expect, and whether it's the right fit. Ativan is the brand name for lorazepam, a benzodiazepine prescribed primarily for short-term relief of anxiety and panic. It works quickly, but because of the potential for dependence, psychiatrists tend to prescribe it carefully and for specific situations.

Key takeaways

• Ativan (lorazepam) is a benzodiazepine used to treat anxiety, panic disorder, and certain seizure conditions.
• It works by boosting the activity of GABA, a brain chemical that helps slow down overactive nerve signals.¹
• Many people notice its calming effects within 20 to 40 minutes of taking it.
• Lorazepam is usually prescribed for short-term use because benzodiazepines can lead to physical dependence.¹

What is Ativan?

Ativan is the brand name for lorazepam, a medication in the benzodiazepine class. It is an FDA-approved prescription medication used primarily for short-term management of anxiety disorders.² Lorazepam is also used for seizure-related conditions, including status epilepticus. As a controlled substance (Schedule IV), it requires a prescription and is monitored closely by your prescribing psychiatrist.

What does Ativan treat?

Ativan is FDA-approved for several conditions and is also used in other clinical situations. If you're exploring anxiety medication options, here's a breakdown of what lorazepam treats.

On-label uses

• Generalized anxiety disorder (GAD)
• Acute or short-term anxiety
• Status epilepticus and other seizure disorders

How does Ativan work?

Your brain has a natural braking system that keeps nerve activity in check. The main chemical behind that braking system is called GABA. Lorazepam strengthens GABA's ability to quiet overactive brain circuits, which is why it can reduce anxiety, ease panic, and help stop seizures.¹

• Enhances the calming effects of GABA. Lorazepam strengthens the activity of GABA, a neurotransmitter that slows down brain activity.¹
• Reduces overactive stress signals. By boosting GABA's calming effect, lorazepam quiets the brain circuits involved in anxiety and panic.
• Produces a calming effect. This can help with intense anxiety, panic attacks, or seizures.

3 things a Talkiatry psychiatrist wants you to know about Ativan

• It works quickly, and that's the point. Psychiatrists often choose lorazepam specifically for acute situations because its rapid onset can bring relief when anxiety or panic is at its worst.
• It's usually used short-term. Because benzodiazepines can lead to dependence, psychiatrists often prescribe them carefully and for limited situations.
• Don't stop suddenly. If you've been taking lorazepam regularly, it should be tapered gradually under medical supervision to avoid withdrawal symptoms.¹

Common side effects of Ativan

Like most medications, lorazepam can cause side effects. These are the ones reported most often:¹

• Drowsiness or feeling sleepy during the day
• Dizziness or lightheadedness
• Weakness or lack of energy
• Unsteadiness or difficulty with coordination

Talk to your psychiatrist if any of these feel persistent, severe, or get in the way of your day.

Serious side effects of Ativan and when to seek help

While serious side effects are less common, they can happen. Watch for the following:¹

• Tell your psychiatrist about all medications you take, as certain combinations can cause serious breathing problems, extreme drowsiness, or coma.
• Allergic reactions, including skin rash, hives, itching, swelling of the face, eyes, or mouth, wheezing, or difficulty breathing
• In rare cases, yellowing of the skin or eyes (jaundice)
• Lorazepam can be habit-forming. Do not take more than prescribed, take it more often, or use it longer than directed.
• Stopping lorazepam suddenly after regular use can cause serious withdrawal symptoms, including seizures, unusual movements, ringing in the ears, anxiety, memory problems, sleep difficulties, muscle twitching, shaking, depression, hallucinations, burning or prickling sensations in hands or feet, and thoughts of self-harm
• Signs of overdose include extreme drowsiness, confusion, severe tiredness, slowed breathing and heartbeat, coordination problems, or loss of consciousness. Call poison control (1-800-222-1222) or 911 immediately.

Call your psychiatrist right away or seek emergency care if you experience any of these symptoms.

What to watch for when starting Ativan

When you first start taking lorazepam, there are a few practical things to keep in mind:¹

• Lorazepam can cause drowsiness. Do not drive or operate machinery until you know how it affects you.
• Avoid alcohol during treatment, as it can worsen side effects.
• If you're taking lorazepam for insomnia, your psychiatrist may suggest taking it at bedtime.
• Some people feel dizzy or unsteady when standing up quickly. Rise slowly from a seated or lying position until you know how the medication affects you.

What to do if you miss a dose of Ativan

If you miss a dose of lorazepam, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.¹

Who should talk to a psychiatrist before taking Ativan

Some health conditions, medications, and life situations change how Ativan is prescribed. Tell your psychiatrist if any of the following apply to you:¹

• You use or have used substances such as alcohol, cannabis, opioids, hallucinogens, stimulants, prescription medication, or supplements
• Depression or other mental health conditions
• Acute angle glaucoma (your doctor may advise against taking lorazepam)
• Seizure disorders
• Sleep apnea
• Lung conditions such as asthma or COPD
• Heart or liver disease
• Pregnancy, plans to become pregnant, or breastfeeding
• Age 65 or older (specific risks and benefits should be discussed with your psychiatrist)
• Known allergies to lorazepam or any of its ingredients