Lorazepam (A complete guide)

Lorazepam, which is sometimes referred to as its brand name Ativan, is a medication used to treat seizure disorders and anxiety. 

 What is lorazepam? 

Lorazepam is a medication from the benzodiazepine class. It can be used for the treatment of anxiety, insomnia, or sleep disturbances due to stress or anxiety. Lorazepam can also be prescribed to treat seizure disorders, to accompany anesthetics right before surgery, or to treat alcohol withdrawal. 

Lorazepam works by activating receptors for the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. GABA is the main inhibitory neurotransmitter in the brain, which means that it reduces the firing of neurons. When receptors for GABA are activated by alprazolam, neurons are “quieter” and thus elicit a calming and sedative effect in the patient. The reduction of firing in neurons also helps prevent seizures from occurring. 

Lorazepam is usually taken as needed, such as when the patient feels a panic attack coming on. It should not be used as a recreational drug or in combination with alcohol. 

Lorazepam (A complete guide)

Who should take lorazepam? 

Lorazepam is usually prescribed to people who have been diagnosed with a seizure disorder or an anxiety disorder. 

Be sure not to confuse normal every day anxiety with an anxiety disorder. If you are experiencing a problem at work, a big exam coming up, or an important decision, you are probably having a normal anxious reaction to life stressors. Anxiety disorders, however, are chronic and usually center around irrational fears and worry. 

There are many different types of anxiety disorders such as generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder, tdo name a few.   

Symptoms of GAD usually include: 

·      Feelings of restlessness or on edge

·      Difficulty concentrating and racing thoughts

·      Muscle tension

·      Irritability

·      Trouble sleeping

·      Difficulty controlling feelings of worry

·      Easily fatigued 

Lorazepam is commonly prescribed to people suffering from panic disorder because the calming effects help subside panic attacks. Symptoms of panic attacks include:

·      Heart palpitations or accelerated heart rate 

·      Sweating, trembling, shaking

·      Shortness of breath 

·      Feelings of impending doom 

Phobia-related disorders are another set of anxiety disorders that are characterized by an intense fear or aversion to specific situations or objects. This fear is usually out of proportion to the actual danger imposed by the situation or object. 

Symptoms of phobia-related disorders include: 

·      Irrational or excessive worry about encountering the feared object or situation 

·      Intentional avoidance of feared object or situation 

·      Intense and immediate anxiety upon exposure to the object or situation 

Specific phobias can be related to situations such as flying or heights, or related to animals such as spiders. Some people also have phobias of receiving injections or blood.

Agoraphobia is another type of anxiety disorder where people have an intense fear of two or more of the following situations: 

·      Being in open or enclosed spaces

·      Standing in lines

·      Crowded areas

·      Using public transportation

·      Being outside of their home 

People with agoraphobia often avoid these situations out of fear that they will not be able to escape. Some have an intense fear that they will panic or have other embarrassing symptoms. In severe cases, people may avoid leaving their house altogether. 

If you suspect you have an anxiety disorder, do NOT start taking lorazepam from a non-reputable source such as a friend, consult a psychiatrist immediately. 

Lorazepam should be taken in combination with the right kind of psychotherapy, such as talk therapy or cognitive behavioral therapy (CBT). These therapies teach the patient active coping mechanisms to manage anxiety symptoms. 

Lorazepam (A complete guide)

 What are the side effects of lorazepam? 

The most common side effects of lorazepam include the following:

  • Dizziness
  • Drowsiness
  • Fatigue
  • Lightheadedness 
  • Impaired coordination 
  • Difficulty concentrating 

These side effects are usually present at the beginning of the treatment course but should subside within a few weeks. If you are taking lorazepam and the side effects listed above do not go away or are worsening, contact your doctor. 

Lorazepam (A complete guide)

More serious side effects of lorazepam include the following: 

  • Shortness of breath, dizziness, trouble speaking, or fainting 
  • Extreme fatigue
  • Increased heart rate, headache, difficulty remembering things, irritability, restlessness
  • Severe allergic reaction (swelling of the face) 
  • Very rarely, people who are taking benzodiazepines such as lorazepam to help them sleep experience behaviors akin to sleepwalking. This can include sleep driving, making phone calls, preparing or eating food. When they awaken, they have no memory of these events occurring. 
  • Depression, low mood, loss of interest in life, thoughts of suicide. 

What is some important information I should know before I start taking lorazepam? 

You should not drive or operate heavy machinery until you know how lorazepam affects you, because it may cause you to feel tired or dizzy. 

Lorazepam, like other benzodiazepines, has addictive potential. This means that your body will become physically and psychologically dependent on the drug. For this reason, lorazepam is usually only prescribed for short periods of time. Talk to your doctor to figure out the length of the treatment plan that is right for you. 

If you are taking lorazepam and want to wean off the medication, do not stop taking the pills without talking to your doctor first. Withdrawal from lorazepam can cause unpleasant side effects such as irritability, nausea, dizziness, tachycardia (fast heartbeat), seizures, and changes in blood pressure. 

If you are taking any type of opioid medication such as morphine or oxycodone, notify your doctor immediately. Taking lorazepam with opioid medications has led to serious and sometimes fatal side effects including respiratory depression. If you feel dizzy or tired after taking lorazepam with an opioid medication, seek emergency medical attention immediately.  

It is also imperative to avoid alcohol while taking lorazepam. 

What should I do if I miss a dose of lorazepam?

If you miss a dose of lorazepam, take it as soon as you remember, unless it is already time for the next dose. Do not take a double dose or more than you are prescribed. 

What happens if I overdose on lorazepam? 

If you think you or someone you know has overdosed on lorazepam, seek emergency medical help immediately. Symptoms of overdose include feeling dizzy or lightheaded, drowsy, extremely fatigued, decreased ability to concentrate, and loss of coordination. 

Lorazepam (A complete guide)

Frequently asked questions (FAQs) about lorazepam:

1.   Is lorazepam as strong as Xanax?

Lorazepam and Xanax are part of the same class of drugs known as benzodiazepines. They are both equally effective for the treatment of anxiety, but Xanax has a quicker onset and offset and a shorter duration of action of 4 to 6 hours. Lorazepam, on the other hand, has its effects for 8 hours. 

2.   Is lorazepam the same as Xanax?

Lorazepam and Xanax are part of the same class of drugs known as benzodiazepines and are prescribed for the treatment of anxiety.

3.   When should you take lorazepam?

Adults and children 12 years of age or older who are prescribed lorazepam for anxiety or transient situational stress should take a single dose at bedtime. 

4.   What are the most common side effects of lorazepam?

The most common side effects of lorazepam are dizziness, drowsiness, loss of coordination, headache, nausea, blurred vision, changes in sex drive, constipation, heartburn, or changes in appetite. 

5.   How long does it take for lorazepam to start working?

Extended-release lorazepam will start working within about 30 to 60 minutes after taking it and the effect should last for around 11 hours. 

Want to learn more about lorazepam? Try these recommended readings!

Panic Attacks and You-Methodology for recovery from anxiety and panic attacks disorder

Justin Burns writes all about how to deal with the long- and short-term issues that come with having panic attacks in this extremely powerful self-help book. He identifies the causes of panic attacks and details how to prevent them. This book also lists major symptoms of panic attacks, the differences between anxiety attacks and panic attacks, and effective treatments for panic attacks. 

LORAZEPAM Tablet: Treats Anxiety Disorders, or for the Short-Term Relief of the Symptoms of Anxiety Associated with Depressive Symptoms

This book by James Lee Anderson provides information about lorazepam in paperback form. It discusses what lorazepam is prescribed for, how it works, and how it should be taken.  

The Neurotic Paradox, Volume 1: Progress in Understanding and Treating Anxiety and Related Disorders (World Library of Mental Health)

This is a collection of papers written by Dr David Barlow, where he discusses years of research on the treatment of anxiety disorders. His research has resulted in new classifications of anxiety disorders as well as new treatments that have proven very useful to clinical psychologists. 

Medications for Anxiety & Depression – A no-nonsense, comprehensive guide to the most common (and not so common) antidepressants and anti-anxiety drugs available

If you are suffering from major depressive disorder (MDD), including treatment resistant depression and dysthymia, generalized anxiety disorder (GAD), panic disorder, phobic disorder, obsessive compulsive disorder (OCD), or any mood disorder on the depressive or anxious spectrum, this book is for you. It is important to understand which medications might be prescribed to you and how they work, as well as common side effects. Benjamin Kramer provides extensive details on common and non-common antidepressants and anti-anxiety medications (anxiolytics) includingSSRIs (selective serotonin re-uptake inhibitors, such as Zoloft, Paxil, Prozac and Lexapro), SNRIs (Serotonin and Norepinephrine re-uptake inhibitors uch as Effexor and Cymbalta), atypical antidepressants (such as Remeron, Buspar and Wellbutrin), TCAs (Tricyclic antidepressants, such as Endep and Anafranil), Benzodiazepines (such as Xanax, Ativan and Klonopin), “Off-label” and experimental options including stimulants (amphetamine, methylphenidate), Lyrica, tramadol memantine and ketamine. This book also discusses upcoming drugs for depression and anxiety that are supposed to become available soon. 

The Mindfulness Journal: Daily Practices, Writing Prompts, and Reflections for Living in the Present Moment

As described above, journaling is a great way to give yourself a stress release. Whether you are dealing with mental health issues, heartbreak, a problem at work, or any other life stressor, this journal is for you. This Mindfulness Journal can easily be added into your daily routine and can serve as an outlet for stress-reduction that will help you appreciate every single day and moment. It includes 365 daily writing prompts divided into 52 weekly mindfulness topics. The prompts are extremely unique, fun, and engaging, so you will never get bored while journaling. Additionally, each prompt is on its own separate page so you will have more than enough room for reflection and to write down all of your thoughts, big or small. Although it is suggested to journal once a day, you can spend as much or as little time as you want on each prompt. 

I am not in recovery. I am in discovery: Journaling my mental illness

Journaling is a great way to help process and keep track of your experiences and feelings while you are going through depression or seasonal affective disorder (SAD). This journal contains 94 daily templates to aid in your discovery process. 

References

Anxiety Disorders.National Institute of Mental Health. July 2018. 

Lorazepam (Ativan). National Alliance on Mental Illness. January 2019. 

Lorazepam (A complete guide)

Aura Des los Santos

Aura Des los Santos is a Clinical Psychologist with two masters degree in Education. One focused in Higher Educacion and the other in the research of Psychology of Education. Her experience is focused on working depression, anxiety and personal development. She frequently writes articles in the area of psychology, education, travel and general culture.