Medication and Treatment Reviews

Ativan

Generic Name: Lorazepam

Uses

Ativan, known as lorazepam in its generic form, is a benzodiazepine primarily used for short-term relief of symptoms of anxiety disorders in adolescents and adults. It may help relieve excessive worry, shortness of breath or heavy perspiration, feelings of edginess, and difficulty sleeping due to anxiety. The safety and effectiveness of taking lorazepam for more than four months in unknown.

Ativan is also used off-label to treat alcohol withdrawal, insomnia, and to prevent nausea from chemotherapy.

How to Use Ativan

Before starting or refilling an Ativan prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Ativan prescription instructions exactly. Lorazepam is taken orally with water or another liquid, with or without food. Tablets are available in 0.5mg, 1mg, and 2mg doses.

Do not drink alcohol while taking this medication.

The dosage varies by condition treated and by patient health. A typical schedule is 2 to 6 mg per day in divided doses. The highest dose is given before bed, when the potential reaction of sleepiness is less disruptive. Your doctor may increase your dosage gradually over time to decrease the potential for side effects.

Doctors may recommend starting with a lower dosage for the elderly patients or patients with advanced liver or other debilitating disease who may be particularly sensitive to benzodiazepines.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication. Stopping lorazepam suddenly can create withdrawal symptoms, and seizure can occur.

Some patients develop a tolerance to lorazepam. Do not increase your dosage without discussing it with your doctor. Your doctor should periodically reassess if the treatment is still useful. Long-term treatment with lorazepam increases the risk of dependence, and may cause difficulty when terminating treatment. After an extended period without symptoms, a patient may work with his or her doctor to taper off the medication gradually.

Side Effects

The most common side effects of lorazepam are similar to those associated with Alprazolam and other benzodiazepines, and are as follows: drowsiness, dizziness, weakness, unsteadiness, and symptoms of dependence/withdrawal with long-term usage.

Other serious side effects include constipation, depressive thoughts, loss of appetite, sexual problems, jaundice, memory impairment, headache, and blurred vision. If you stop taking lorazepam suddenly, a life-threatening seizure can occur.

In rare cases, lorazepam can have the opposite of the desired effect — called a paradoxical reaction —and increase anxiety, aggression, insomnia, or agitation. This effect is more common in children and the elderly.

Taking lorazepam may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects.

Disclose to your physician all mental health issues including any family history of suicide or depression. Lorazepam may create new or exacerbate existing behavior or mental problems. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or changes in mood.

Lorazepam can cause kidney or liver problems. Elderly or debilitated patients with impaired renal, hepatic, or pulmonary function should use caution and be observed closely when taking lorazepam. Seek medical help right away if you experience yellowing eyes or skin, seizures, or signs of an allergic reaction.

Benzodiazepines like lorazepam have a low potential for abuse and addiction among people who have anxiety. It is a “Schedule IV Stimulant,” a designation that the Drug Enforcement Agency uses for drugs with a low potential for abuse. Other Schedule IV drugs include Valium, Alprazolam, and Ambien. However, long-term treatment in higher dosages with lorazepam increases the risk of dependence, especially for people with a history of substance abuse. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions and Safety

Store Ativan in a secure place out of reach of children, and at room temperature.

You should not take lorazepam if you are sensitive to benzodiazepines, or have acute narrow angle glaucoma.

If you are thinking of becoming pregnant, you should not take lorazepam, because there is a high potential for fetal harm or withdrawal symptoms after delivery. Lorazepam is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

Interactions

Before taking lorazepam, discuss all other active prescription medications with your doctor.

You should not take lorazepam if you are taking:

  • Central nervous system depressants (e.g., alcohol, barbiturates, sedatives, etc.)
  • Clozapine
  • Valproate
  • Probenecid

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness. Let all doctors and physicians know you are taking lorazepam before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions

Sources:

http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/017794s034s035lbl.pdf
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ad2a0633-50fe-4180-b743-c1e49fc110c6

Tips for Good Medication and Treatment Reviews

  • Post reviews only for medications or treatments you have used or prescribed.
  • In your description, mention whether you're reviewing the medication or treatment for a child or for an adult (yourself or another adult), and as a patient or as a medical professional.
  • Mention what medical condition you were using the medication or treatment to address.
  • Mention the brand, dose, and period of time that you used the medication or treatment.
  • Please share your positive and negative experiences with the medication or treatment in detail. Note effectiveness, ease of use, side effects; and compare it with other treatments you have used.
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