What is Ativan?
Ativan is the brand name of the generic drug lorazepam. Ativan is a benzodiazepine that may be prescribed to treat anxiety, insomnia, and status epilepticus (continuous seizures).
Benzodiazepines (such as Ativan, Klonopin, Xanax, and others) work by slowing down selected areas of your brain’s activity, leaving you feeling calm and/or drowsy. They do this by attaching to gamma-aminobutyric (GABA—a type of neurotransmitter, or small molecule in your brain that relays messages between nerves) neuroreceptors.
Something to keep in mind when considering Ativan and other benzodiazepines is that they are typically prescribed for short-term use (usually several weeks or months). You may have heard that taking these kinds of medications could come with a risk of physical or psychological dependence, or addiction, to them. The Drug Enforcement Agency (DEA) has classified benzodiazepines as controlled substances. And there is an increased risk of abuse or dependence in people who have a history of substance use disorder.
Ativan tablets are available in:
- 0.5 mg
- 1 mg
- 2 mg
The Ativan dosage you take—as well as how often you take it—will depend on many factors, such as your age and the reason you are taking it. Typical doses range from 0.5 to 6 mg daily, sometimes taken as divided doses, with the highest dose usually taken before bedtime. The maximum recommended dose is usually considered to be 10 mg per day. Your prescribing doctor, nurse practitioner, or Minded psychiatry provider will work with you to determine the right dose for your needs.
A typical starting dose for adults taking Ativan for anxiety is 0.5 to 3 mg per day (taken in divided doses 2 to 3 times per day).
For insomnia, Ativan is usually taken once daily—typically at or before bedtime—at a dose between 0.5 and 4 mg.
Elderly people may be more prone to the sedative effects of Ativan. Therefore, the starting dose for elderly people is generally 0.5 to 2 mg daily, taken in divided doses.
Ativan may be taken either daily at regularly scheduled times or on an “as-needed” basis. Your prescribing healthcare professional will provide you with instructions on when and how often to take this medication, as well as the maximum amount that can be taken in a day.
You can take Ativan with or without food—however; if you have an upset stomach after taking it without food, you may want to take it with food going forward.
If you accidentally miss a dose of Ativan, you will want to either take your missed dose as soon as you remember to or—if it is closer to the time when you would take the next dose, just go ahead and take the next dose.
Ativan side effects, warnings, and interactions
Ativan side effects
Common side effects of Ativan include:
These side effects typically improve during the first few weeks of taking Ativan.
Talk to your prescribing doctor, nurse practitioner, or Minded psychiatry provider if you experience any of these (or other) side effects.
Rare or serious side effects of Ativan include:
- Difficulty speaking
- Extreme tiredness or dizziness
- Feelings of depression or decreased interest in day-to-day life
- Impaired memory
- Increased heart rate
- Passing out (fainting)
- Severe allergic reaction and facial swelling, which can occur even on the first dose
- Shortness of breath
- Thoughts of self-harm or suicide
Ativan side effects in elderly people are not thought to be different from those in younger adults. However, they are more likely to experience more severe side effects, which is why monitoring them and finding the right dosage is very important.
Some people (regardless of age) who take benzodiazepines to help with sleep problems may perform activities—such as eating, driving, or making phone calls—while they are either asleep or not fully awake. They do not remember having done these activities once they are awake.
Always seek immediate medical attention if you experience these or any other serious or worsening side effects.
Ativan comes with an FDA “Black Box” warning, which means that the FDA has identified certain serious safety risks that may arise from taking this medication. “Black Box” warnings are meant to alert patients and prescribers to these potentially serious safety risks. However, these risks may be low, or even rare.
The Black Box warning for Ativan states that:
- Taking benzodiazepines (such as Ativan) in addition to opioids may lead to serious—potentially fatal—interactions
- Using benzodiazepines comes with a risk of abuse, misuse, and/or addiction
- Continuing to use benzodiazepines may lead to physical dependence on them and/or cause withdrawal if these medications are discontinued abruptly
Ativan and pregnancy
If you are currently pregnant or planning to become pregnant and/or breastfeed, discuss your treatment plan with your prescribing doctor, nurse practitioner, or Minded psychiatry provider. Taking Ativan while you are pregnant may harm your baby. Ativan can also be passed to your baby through your breast milk.
Ativan withdrawal symptoms
Work with your prescribing doctor, nurse practitioner, or Minded psychiatry provider if you need to stop taking Ativan for any reason. Together, you can come up with a plan to safely taper off of the medication in order to avoid Ativan withdrawal symptoms, which may include:
- Changes in blood pressure
- Rapid heart rate
Always let your prescribing doctor, nurse practitioner, or Minded psychiatry provider know about all other medications and supplements you are taking so that they can see if Ativan may have any negative interactions with them.
Ativan may interact with:
- Antihistamines, such as Benadryl (diphenhydramine)
- Antipsychotic medications
- Narcotic pain medications, such as Lortab (hydrocodone), morphine, OxyContin (oxycodone), or Vicodin (hydrocodone)
- Opioid cough medications, such as codeine cough syrup
- Other anti-anxiety medications
- Sleep medications, such as Ambien (zolpidem)
- Some anticonvulsant medications
- Tricyclic antidepressant medications, such as Elavil (amitriptyline)
Ativan and alcohol
You should not drink alcohol while you are taking Ativan. Not only can alcohol increase the negative side effects of medications like Ativan, but it can also decrease their benefits. Because alcohol can impair both judgment and memory, drinking alcohol may also increase your risk of unintentionally overdosing on Ativan.
Symptoms of an Ativan overdose include:
- Decreased coordination
- Slowed reflexes
Because an Ativan overdose can be fatal, you should seek immediate medical attention if you are experiencing these or any other overdose symptoms.