The Dangers of Lorazepam (Ativan)
Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: February 5, 2026
Fact checked
Quick Summary
  • The Anxiety and Depression Association of America estimates that around forty million American adults or 18% of the US population live with anxiety.
  • Most of these patients are treated with anxiety-reducing drugs like lorazepam, a short-acting tranquilizer marketed under the brand name Ativan.
  • Ativan (lorazepam) is a benzodiazepine, a class of drugs often referred to as CNS (central nervous system) depressants.
Reading time: 13 min

The Anxiety and Depression Association of America estimates that around forty million American adults or 18% of the US population live with anxiety.

Most of these patients are treated with anxiety-reducing drugs like lorazepam, a short-acting tranquilizer marketed under the brand name Ativan. Ativan (lorazepam) is a benzodiazepine, a class of drugs often referred to as CNS (central nervous system) depressants. Other benzodiazepines are Klonopin (clonazepam), Valium (diazepam), Librium (chlordiazepoxide), and Xanax (alprazolam).

Ativan is prescribed for the treatment of anxiety, short-term sleeplessness, and seizures. Ativan is used off-label to manage alcohol withdrawal, vomiting, and nausea related to chemotherapy, agitation, catatonia, irritable bowel syndrome, and numerous other conditions. It can be given to aid in relaxation prior to surgery or other dental or medical procedures. This is referred to as pre-med.

Due to their potential for lorazepam abuse and other benzodiazepine drugs, they are designated “controlled substances” in the US and are subject to government regulation. It is crucial to be aware of the possible side effects of Ativan in the event that you experience any. Immediately visit your doctor if this occurs.

Lorazepam is only available with a valid prescription. It is available in tablet and liquid form for swallowing. It can also be administered intravenously in a hospital setting for seizures and fits. It is also sold under the trade name Ativan.

Despite the fact that prescription drugs are subjected to rigorous testing processes to assure their general safety, medicines may affect individuals differently based on their weight, age, unique body composition, and other health concerns they must manage. Therefore, the majority of prescription medications, such as Ativan, have a comprehensive list of potential side effects and warnings.

Consult your physician or pharmacist instantly if you develop any of the following symptoms while taking lorazepam:

  • Persistent headaches
  • Disorientation or dizziness
  • Nausea
  • Impaired vision
  • Mood swings
  • Constipation
  • Changes in sexual desire or hunger

Ativan Side Effects In Elderly

Ativan is particularly used in older adults, hence the incidence and prevalence of most of the side effects have been studied in the vulnerable older population. The anti-anxiety drug sold under the brand name Ativan is lorazepam. This drug belongs to the benzodiazepine family, which consists of sedatives that influence the brain and neurological system. Lorazepam addiction risk is always a concern, despite the fact that it has benefited many people with panic and anxiety problems. It may also have undesirable side effects for the elderly, which may cause you or your loved one some form of concern.

As Ativan is a depressant of the central nervous system, users may suffer drowsiness, loss of coordination, and unsteadiness. The elderly may be particularly susceptible to these consequences. In addition, Ativan may not alleviate anxiety in certain older individuals. Instead, it can lead to agitation, disorientation, and an increased likelihood of falling which are the main cause of accidents among those aged 65 and older.

Some users acquire a psychological or physical dependence on Ativan since they appreciate the way the drug affects them and grow to equate its usage with positive outcomes. Adults over the age of 65 may be particularly likely to develop an addiction to Ativan if they misunderstand the instructions, use the improper dosage, or use other drugs that may intensify the effects of benzodiazepines. However, as Ativan dependence develops, it can exacerbate anxiety to the point where the two symptoms amplify each other.

Alternatives to Ativan

If your doctor gives you a medication, you have the absolute right to inquire about its potential side effects in order to become a more educated patient. For example, it may not be in your better interest to take Lorazepam if you have a family background of substance abuse and mental illness. In addition, some drugs may provide a risk of harmful side effects or drug interactions with other drugs you regularly use.

If you have any concerns about using Ativan, your healthcare professional should be more than prepared to provide alternatives, especially drug-free alternatives. For instance, you can control anxiety without the use of benzodiazepines by adopting strategies such as exercise, mindfulness meditation, and self-care. A skilled therapist can also enable you to practice appropriate coping strategies and assist you in identifying different anxious thought patterns.

It is essential to use Ativan under the supervision of a physician and to avoid operating heavy machinery or driving until you understand how the medication affects you.

Because Ativan works by lowering the neurological system, frequent adverse effects include sedation, drowsiness, low blood pressure, vertigo, and instability.

What Does Lorazepam Do To Your Brain

Ativan has potent impacts on the nervous system and the brain. Many users, though, experience “rebound” adverse effects or an exacerbation of the symptoms that the medication is intended to treat. Specifically, Ativan can result in sleep problems, rebound anxiety, agitation, and abnormal movements of the body.

  • Rebound anxiety
  • Loss of interest in daily activities
  • Restlessness
  • Memory issues
  • Depression
  • Learning problems

The chemical composition of lorazepam is designed to lessen the excitation or stimulation of the nerves and brain while calming the emotional responses that cause restlessness and anxiety. On the downside, Ativan might dull the emotional responses and worldly experiences of its users. Individuals taking Ativan may start to lose interest in their daily activities and duties. They may continually feel sluggish and exhausted and have a confused, sleepy demeanor.

Ativan Effects on the Body

Ativan alters biological functions and responses by lowering the activity of nerves and the brain. As a tranquilizer, Ativan can provide feelings of calm and physical relaxation. When administered correctly, Ativan can also halt painful muscular spasms and avoid life-threatening seizures. This drug is usually safe and beneficial for patients taking it as prescribed and for valid reasons. Nevertheless, all users must be aware of potential adverse medication responses, such as: (source: SAMHSA, 2023)

  • Daytime somnolence or sleepiness
  • Reduced levels of energy
  • Confusion
  • Inadequate muscular coordination
  • Distorted vision
  • Loss of equilibrium or balance 
  • Blood in the feces or urine
  • Stomach ache
  • Weight reduction
  • Chills
  • Cold, pale skin
  • Involuntary actions (shaking, tremors)

Due to its ability to induce drowsiness, clumsiness, and disorientation, Ativan increases the risk of accidental injury. The National Highway Traffic and Safety Administration warns that a benzodiazepine group of medications, like Ativan, can cause symptoms similar to alcohol intoxication, including loss of motor balance, slurred speech, visual abnormalities, and blurred vision. Driving while under the influence of Ativan or engaging in other tasks requiring hand-eye coordination and fast reflexes can be exceedingly hazardous, particularly if the user has also taken drugs, alcohol, or other sedatives.

In extreme situations, Ativan can induce significant respiratory depression, sedation, coma, and, in the worst cases, death, because it inhibits the neural signals from the brain to the body to breathe. These serious adverse effects may occur if:

Ativan is used in large doses

Ativan is used with other medications that suppress the nervous system, like other benzodiazepines, opioid painkillers, alcohol, and barbiturates.

Ativan is administered to patients with sleep apnea, chronic obstructive pulmonary disease (COPD), and other conditions that impact breathing.

Children and Elderly People

Ativan can have a “paradoxical effect” on certain populations, including youngsters and the elderly. It may induce agitation and disorientation rather than a relaxing effect. Patients aged 65 and older who use Ativan have an increased risk of falling.

Pregnancy, Infants, and Breastfeeding

Ativan can have adverse effects on breastfeeding and pregnant women and their infants. In fact, Ativan can pass through the placenta and also enter breast milk. In these instances, it is crucial to discuss the risks and advantages of using this medicine with your healthcare professional.

Tolerance and Physical Dependence

Long-term usage of benzodiazepines like Ativan may result in physical dependence. This indicates that your body has developed a tolerance to the drug. You may require increasing doses of the medicine over time to achieve the same impact.

In other terms, if you take the same medication dosage over an extended length of time, the efficacy of that dose is less compared to when you used a smaller dose.

Long-term benzodiazepine users may develop physical dependence, however, this does not essentially indicate that they are dependent on or misusing these drugs.

Withdrawal

Some individuals who abruptly discontinue Ativan may have withdrawal symptoms.

Among the most frequent symptoms of withdrawal are anxiety, depression, sleeplessness, and tremor. In extreme circumstances, withdrawal symptoms may include hallucinations, confusion, convulsions, and even death.

Before discontinuing a benzodiazepine, it is crucial to consult with a healthcare professional. To avoid withdrawal, a health professional can help you gradually reduce or taper your Ativan dosage over time.

Substance Abuse and Addiction

The risk of lorazepam addiction and abuse is a matter of concern for doctors and healthcare practitioners. If you have a background of addiction or a propensity to addiction in your family, you should use these medications with extreme caution and be constantly watched by your healthcare professional. A substance use disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as a troublesome pattern of substance use resulting in significant clinical distress or impairment that includes two or more of the following criteria during a 12-month period:

  • The substance is frequently used in higher quantities or for longer durations than planned.
  • There is an ongoing desire or failed attempts to reduce or manage substance use.
  • The activities required to procure the substance, use the substance, and recuperate from its effects consume a substantial amount of time.
  • Strong desire or compulsion to take the substance.
  • Chronic substance abuse leads to the inability to fulfill major role responsibilities at school, work, or home.
  • Persistent substance usage despite ongoing or frequent interpersonal or social problems brought on by or aggravated by the substance’s effects.
  • Significant occupational, social, or recreational activities are abandoned or scaled back due to substance abuse.
  • Recurrent substance abuse in situations where it poses a bodily risk.
  • Persistent substance use despite awareness of having a chronic or recurrent bodily or psychological issue that was likely triggered or worsened by the substance.
  • Tolerance is described as a requirement for significantly larger doses of the drug or substance to achieve the desired effect or intoxication, or a significantly lessened effect with continuing usage of the same dose.
  • Withdrawal is exhibited either by the symptoms of withdrawal of the substance or by the use of the substance to alleviate or prevent symptoms of withdrawal.

Talk to your doctor if you encounter any of these symptoms while taking Ativan to avoid developing a strong dependence or addiction.

Lorazepam is a commonly prescribe drug in the US. Based on the Drug Enforcement Administration, more than 27.5 million medical prescriptions for Lorazepam were issued in the United States alone in 2011. Some of the Ativan side effects (long-term) are as follows: (source: FindTreatment.gov, n.d.)

Extreme Adverse Effects

Long-term use of Lorazepam may have specific long-term consequences. In general, these consequences will manifest as exaggerated or extreme versions of the aforementioned adverse effects.

For instance, rather than having mild drowsiness, a person may spend most of the day asleep, with no motivation or drive when awake. Or, instead of occasional misunderstandings, individuals will feel constant and intense confusion, or they may even develop delirium.

Cognitive Impairment

A patient’s use of Lorazepam for an extended period of time may result in cognitive or mental deficits.

The majority of the problem will be resolved by discontinuing the medicine. Despite treatment, cognitive decline may persist to some degree. This is especially true for the elderly, who might already be experiencing a cognitive impairment as a result of aging. In addition, the cognitive effects of substance addiction might hasten the degree of cognitive deterioration associated with dementia.

Tolerance

Tolerance development is a frequent consequence of long-term Ativan use. The body’s response to Ativan’s constant physical presence is tolerance. As Ativan becomes an integral part of the user’s “daily” body chemistry, the user’s system adapts to its availability and biochemical influence.

This modification reduces the perceived efficacy of the medicine, causing the person to require higher dosages of Ativan to obtain the same effect as previously. Ultimately, the user develops a dependence on the substance, which reinforces them down the road to addiction.

Ativan is a safe medication when used at the recommended doses and intervals. High quantities of this medication, however, pose a danger of overdose, which may result in coma or death. Based on the National Institute on Drug Abuse, the number of fatalities attributable to benzodiazepine prescriptions such as Ativan has quadrupled since 2001. In 2013, there were over 7,000 benzodiazepine overdose deaths in the United States.

As a nervous system depressant, Ativan reduces nerve and brain activity. Ativan seldom induces coma, unconsciousness, or death when taken alone and appropriately. However, large doses of Ativan can be lethal, particularly when lorazepam is coupled with other medicines that likewise decrease brain and essential organ activity. Numerous accidental or intentional overdoses have been attributed to the combination of Ativan with prescription pain medications, alcohol, other anti-anxiety meds, and insomnia medications.

Learning to identify the symptoms of an Ativan overdose could save a life:

  • Blue-tinged, pale lips or skin
  • Sluggish and shallow respiration
  • Excessive sedation or sleepiness
  • Loss of balance and coordination
  • Fluency problems or slurring of speech
  • Memory impairment
  • Cognitive dissonance
  • Weakness
  • Loss of consciousness

An Ativan overdose is a real emergency that can result in death if quick medical assistance is not provided.

Individuals who have overdosed on Lorazepam should not be left alone to recuperate from the drug’s effects, particularly if additional medications are involved.

While the development of physiologic dependency can be approximated by the start of the withdrawal state when the medication is discontinued, Ativan addiction can sometimes be represented by a shift in the behavior of the abuser of this drug.

A person dependent on Ativan may:

  • Frequently take the medication in methods different than prescribed by raising dosage or frequency.
  • By acquiring numerous prescriptions, falsifying prescriptions, or trading/buying Ativan, obtain the drug through fraudulent or unlawful ways.
  • Neglect other aspects of life, such as relationships, work obligations, and education.
  • Illegally selling, purchasing, or possessing the material will result in legal consequences.
  • Spending over their means to gain additional Ativan resulted in financial difficulty.

FAQs

Can You Take Ativan Everyday

Lorazepam may be used daily at regular intervals or as directed (“PRN”). Usually, your healthcare professional will prescribe a maximum amount of dosage each day. Your health care practitioner will decide the appropriate dosage and administration technique for you premised on your response.

Is Lorazepam Addictive

Benzodiazepines are the 3rd most abused substance in the US, after marijuana and prescription opioids. The combined processes of dependence and tolerance may develop rapidly in lorazepam abusers and lead to increasing, compulsive drug usage and addiction.

Can Ativan Cause Muscle Twitching

Yes. Ativan can elicit a variety of extrapyramidal and movement-related symptoms in specific individuals or when used over and above the prescribed doses. These symptoms include muscular twitches, aberrant or atypical jerky movements, and tremor-like muscle movements.

Is Ativan A Narcotic

Lorazepam is not a narcotic drug. In principle, benzodiazepines produce sedative effects, while narcotics diminish the sense of pain. Narcotics refer to a variety of illegal drugs including Schedule II opioids, including:
Methadone
Hydrocodone
Meperidine
Morphine
Fentanyl

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