What is Ativan (Lorazepam) Used For?
Benzodiazepine drugs such as Ativan are used as a potent short term tranquilizer for a variety of purposes. The drug is fast-acting and produces a drowsy, calming, and mildly euphoric effect as a result of depression of the central nervous system.
One of the considering factors regarding Ativan is that it is short-acting. If someone takes Ativan at night, it can be that by morning they are no longer feeling the sedating effects. Especially for people who experience daytime anxiety, this can create a rollercoastering effect of inter-dosing withdrawal manifestations. Should this be occurring, the tendency may be for the practitioner to include daytime dosing. It is for this reason that Ativan is a poor choice for long-standing pre-existing anxiety. The person with pre-existing anxiety could quickly find themselves in a spot where they are taking the medication 3 or 4 times a day, and no clear way out of this situation.
Uses for the drug include the treatment of anxiety, in depressed persons with anxiety, to avoid seizures during alcohol detox, to reduce discomfort during opiate withdrawal, for panic disorders, as a muscle relaxant, and to treat insomnia.
Ativan is used for pre-surgical anesthesia or pre-dental anesthesia.
Lorazepam is sometimes prescribed to help with nausea, a common side effect of cancer-related chemotherapy.
Ativan is sometimes abused by opiate users because combining these two drugs augments the euphoric effects, although the practice is dangerous and often leads to overdose, coma, or death.
Another form of abuse is using Ativan on a victim of “date rape” or even robbery, due to the drug’s ability to induce a trance-like state of non-resistance, and amnesia.
Ativan (Lorazepam) Alternative Names and Slang
Ativan is often referred to in street slang where the drug is used in non-clinical settings for getting high or for medicating symptoms of addiction or withdrawal. Here are some of the nick-names for Ativan:
Ativan (Lorazepam) Side Effects
The tranquilizing effects of Ativan (lorazepam) taken orally in pill form come on quickly, within approximately 30 minutes and peaking at about the two-hour mark. The drug also comes in an injectable form, producing effects within 15 to 20 minutes, which effects last from 6 to 8 hours.
Side effects include:
- Mild euphoria
- Skin rash
- Slurring of speech
- Loss of balance
- Artificial sense of well-being
Less common side effects include:
- Tachycardia (racing heartbeat)
- Altered perceptions
- Mood swings, i.e., angry, irritable, euphoric, aggressive, sad, etc.
- Increased salivation
- Dry mouth
- Appetite changes
- Blurred vision
- Muscle weakness
- Muscle spasms
- Gastrointestinal issues, i.e., constipation, diarrhea
Ativan is a CNS depressant, and should never be mixed with alcohol, or other depressants such as opiates or barbiturates. When two or more depressants are taken together, the effects become more potent, and can become life-threatening, leading to coma, stopped breathing, stopped heartbeat and death.
The number of ER visits for adverse events involving benzodiazepines tripled from 1998 to 2008, which demonstrates clearly the dangers that can be linked with benzodiazepines.
Ativan (Lorazepam) Withdrawal Symptoms
Ativan is recommended for short-term use only. Medical regulators in the US, UK, and other countries have reduced the recommended window for Ativan prescription to last no longer than one month. This is due to the risk of becoming drug-dependent after one month. (1)
Withdrawal symptoms from Ativan include the following:
- Seizures, convulsions
- Increased breathing rate
- Delusions or hallucinations
- Tremors, shaking
- Profuse sweating
- Muscle cramping
- Increased anxiety
- Increased depression
In general, the shorter the drug was used, the milder the withdrawal symptoms will likely be. However, cases have occurred where severe withdrawals presented after only a few days or weeks of using Ativan or similar drugs.
Unless medically as directed by a hospital, never abruptly stop benzodiazepines that have been in regular use, but do a gentle taper off of the drug under medical supervision. Abruptly stopping benzodiazepines may result in seizure or death, especially if they have acclimated to using it over a longer duration.
Benzodiazepines are also known to have a number of PAWS or post-acute withdrawal symptoms that can linger long after the drug has been stopped, including:
- Return of anxiety and/or depression
- Return of sleep difficulties – also called rebound insomnia
- Mood swings, crying spells, irritability, etc
- Restlessness, agitation, dysphoria
- Lack of focus or ability to concentrate
- Tremors, shakiness
- Cravings may become problematic, often leading to continuing drug-seeking behavior.
Discontinuing/Quitting Ativan (Lorazepam)
Withdrawal from Ativan is safest when done slowly; giving the body a chance to stabilize and adjust to incrementally reduced presence of the drug in the system.
As mentioned earlier, benzodiazepines should not be prescribed for more than one month.
When the time comes to begin the detox or tapering process, a clinic or setting that can provide close and careful medical monitoring is recommended.
Ativan tapering may manifest a certain complication; due to the short half-life. This means a person can go into withdrawal quite rapidly. A pragmatic approach might be to spread the dosing out so that it is being administered three or four times over a day, to limit withdrawal effects between dosing. Then, using a stair-step down dosing strategy, attempting to maintain a somewhat consistent level. An example of this approach might be:
- A person takes 1mg daily, split into 4x.25mg dosings throughout the day. Dropping one of the doses to .125 would be a reasonable approach to discuss with your doctor.
- Then, dropping each of the dosings to .125mg, one step at a time.
- Over the course of four tapers, the person would be at .5mg total daily.
- Then consider dropping the mid-day dose.
- For the next taper, pick another dose to eliminate until medication free.
In some cases, temporary bridge drugs like Trileptal or gabapentin may be used to soften the tapering process.
Another much different approach may be switching to Valium, as it is longer acting. Not everyone reacts to these two drugs equally, and there may be a crossover reaction.
These are all options to discuss with your treating physician. This is not intended to represent what you should do in your case, but merely talking points for your doctor and you to discuss. Each person’s situation is highly specific to them and truly needs the guidance of an experienced and trusted medical professional to determine the correct strategy.
This process might additionally be challenging for your family. Consider residential treatment as it may significantly ease what you and your family may go through during this delicate time.