When you need fast relief for severe anxiety, lorazepam can be effective. But it’s important to weigh the possible risks with the benefits.
Published April 28, 2021

Stress, worry, racing thoughts, restlessness. Living with these and other symptoms of anxiety is hard. But you’re not alone: According to the Anxiety & Depression Association of America, some 40 million American adults deal with anxiety disorders every year, making it the most common mental illness in the U.S.

Fortunately, anxiety is highly treatable. You and your healthcare provider can choose from several effective medications. Lorazepam (Ativan®), a type of benzodiazepine, is one of them.

Benzodiazepines were introduced in the early 1960s to treat both anxiety and insomnia. These medications work by enhancing the effect of a neurotransmitter called GABA, which sends calming messages to the body. Neurotransmitters are your brain’s chemical messengers. As a result, you feel calmer and better able to handle the stresses of day-to-day life.

“The major benefit of lorazepam is that it is quick-acting and effective at reducing anxiety,” says Amanda S. Brown, NP, a psychiatric nurse practitioner with Columbia University Irving Medical Center. But as with all medications, lorazepam comes with some side effects and risks. It’s not right for everyone. Here are 5 important things to know about lorazepam before you fill a prescription.

#1: Lorazepam is a short-term remedy, not a long-term solution

As Brown says, lorazepam works quickly. People notice a rapid improvement in symptoms within days or even hours of taking their first dose, according to the National Alliance on Mental Illness (NAMI).

But with that speed comes a high risk of emotional and physical addiction. Dependence can develop in as little as 2 weeks of daily use. In fact, the FDA requires that benzodiazepines carry the strongest warning possible for risk of addiction and withdrawal on their packaging inserts. For that reason, most experts suggest limiting your time on lorazepam. It’s often used to help bridge the gap between other slower-acting medications. (Do you think you could have an anxiety disorder? Learn more about the different types now.)

#2: Lorazepam can make you very drowsy

Feeling sleepy, dizzy and lightheaded are the most common side effects of lorazepam. Other symptoms include loss of focus and impaired coordination. “It’s very important to avoid driving and to be careful to avoid falling until you know how the drug will affect you,” says Jessica Nouhavandi, PharmD, a pharmacist based in Culver City, California.

According to the National Alliance on Mental Illness, other rare but serious side effects include:

  • Shortness of breath
  • Passing out
  • Increased heart rate
  • Headache
  • Strange sleep behaviors such as sleep eating or sleep driving
  • Depression
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#3: You shouldn’t quit taking lorazepam cold turkey

Stopping lorazepam abruptly can cause serious withdrawal symptoms. These can include increased anxiety, nausea, tremor, blood pressure changes and even seizures, according to NAMI. The symptoms can happen even if you’ve only been on lorazepam for a short while. If you decide you want to quit taking it, be sure to talk to your provider first. It’s important to set up a plan for slowly and gradually reducing your doses.

#4: Use lorazepam with caution if you’re on any other medications that cause drowsiness

This means working closely with your doctor to make sure you’re properly monitored. Also, never drink alcohol while taking lorazepam. “Using this medication in conjunction with certain other medications, such as opioids, can increase the risk of dangerous breathing problems, sedation and coma,” says Nouhavandi.

#5: Lorazepam is not recommended for people with addiction problems or suicidal tendencies

If you have a history of substance abuse, or even a family history of it, lorazepam may not be the safest option for you, the Anxiety & Depression Association of America warns.

If you struggle with either of these issues, your doctor will work with you to find a treatment that can ease your anxiety with less risk of complications.

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