Chemically, Ativan (lorazepam) is a short-acting anxiolytic belonging to a group of drugs known as benzodiazepines. It is usually prescribed to treat anxiety associated with mental health conditions such as depression and insomnia, panic, muscle spasm pain, and seizures. In some cases, it has also been used to manage symptoms associated with the acute phase of schizophrenia.
Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter—meaning it does not cause excitement in the brain—produced in the central nervous system. It can help the body calm the nervous system and promote balanced activity within a person’s brain. To put it very simply, Ativan acts on GABA receptors and causes a release and enhancement of the GABA neurotransmitter, which promotes a relaxing, calming effect throughout the body.
The possible side effects of Ativan include drowsiness and lightheadedness the day after administration. Depending on dose, it may also cause an anterograde amnesic effect, which leads to difficulty forming new memories. For elderly individuals, confusion and ataxia (loss of muscle coordination) are common due to the sedative properties of anxiolytics. The sedative effect of Ativan can also lead to hypotension, headache, vertigo, and muscle weakness. Changes in libido and urinary retention are also reported in some cases.
Ativan can interact with various drugs and can lead to various effects. Some of the drug interactions of this medication include:
Antihistamines (drugs commonly used for hay fever and different allergies/hypersensitivities): An interaction occurs because most antihistamines have sedative properties too. This can cause an increased level of sedation.
Sedatives and hypnotics: When taking with other sedatives, caution must be taken as it may cause an increased level of sedation.
Antifungals and antibacterials: Antifungals and antibacterials can decrease or increase the hepatic (liver) metabolism of drugs, which can alter the effects of Ativan.
Antidepressants and antipsychotics: These drugs may cause increased sedation when taken together with Ativan.
Beta blockers and other antihypertensives: These drugs may cause a decrease in blood pressure when administered with Ativan.
Calcium channel blockers: These drugs can alter the metabolism of Ativan.
Muscle relaxants: These drugs may cause an increased level of sedation when co-administered.
Ulcer healing drugs: Proton pump inhibitors can increase plasma concentration of Ativan due to decreased metabolism, leading to increased or prolonged sedation.
Ativan is both a sedative that reduces anxiety and a hypnotic that produces drowsiness. After administration of this medication, activities requiring motor coordination should be avoided, such as driving, operating heavy machinery, or climbing.
In doses greater than the recommended dose, it can cause excessive sedation and partial airway obstruction.
During IV administration, the monitoring of respiratory and cardiac function is required. For individuals experiencing hepatic (liver) and renal (kidney) failure, this drug is not recommended as it is metabolized by the liver.
Do not consume grapefruit or products containing grapefruit as they may increase the plasma concentration of benzodiazepines.
Most benzodiazepines are meant to be used short term. Long-term use increases the occurrence and severity of withdrawal symptoms when the treatment must be stopped. In order to avoid the uncomfortable, sometimes debilitating symptoms associated with withdrawal, make a safe plan to taper your dosage down with your doctor.
Page content reviewed by James Pendleton, ND
Last Update: 04-23-2015
Articles about Ativan (Lorazepam)