If you’re one of the 40 million people in the United States who have experienced an anxiety disorder, you likely know there are several medications available to ease symptoms. Ativan, or lorazepam, is one of the medications used to treat anxiety disorders. It can also be used by people experiencing withdrawal from alcohol abuse, nausea from cancer therapy, and sleep disorders. We’ve put together this guide to help you understand Avitan—what it is, why it’s prescribed, common side effects, and how it compares to other drugs on the market.
What is Ativan?
Avitan is the brand name for lorazepam. It’s most commonly used to treat anxiety disorders, but can also be used for people experiencing nausea, muscle spasms, and difficulty sleeping.
Ativan belongs to the drug class known as benzodiazepines, which create a calming effect by slowing brain activity.
Note: Ativan is not a narcotic. In general, benzodiazepines cause sedative effects, whereas narcotics reduce the perception of pain. They do, however, have similar side effects, including addictive qualities if taken irresponsibly or for long-term use. It is a controlled substance due to its addiction potential.
Ativan is a prescription drug and is available in its generic form (lorazepam) at a lower cost. It is not available for purchase over the counter without a prescription.
What is Ativan used for?
Ativan is primarily used to treat anxiety disorders, but it works for other medical conditions and symptoms including:
- Nausea from cancer treatment or alcohol withdrawal
- Muscle spasms
- Insomnia and sleeping difficulties, usually related to stress and anxiety
- Status epilepticus (severe seizures)
- Sedation before surgery or a procedure
When someone is experiencing general anxiety disorder (GAD), anxiety symptoms can include:
- Muscle tension
- Poor sleep
- Difficulty concentrating
- Panic attacks
What does Ativan do for anxiety?
Ativan is a central nervous system depressant. Its active ingredient, lorazepam, reduces the activity of nerves in the brain responsible for anxiety, tensions, seizures, and other symptoms. To do so, it enhances the effects of a neurotransmitter in the brain called gamma-aminobutyric acid (GABA), which in turn decreases the activity of specific brain nerves that may cause anxiety.
Does Ativan help you sleep?
Ativan is a prescription sleep aid, too, due to its calming effects. However, some doctors may be hesitant to prescribe benzodiazepines purely for sleep and insomnia. They can reduce the time spent in deep sleep—an essential sleep stage for feeling rested the next morning. Additionally, abruptly stopping a benzodiazepine may cause a patient to rebound into a sleeping problem that’s potentially worse than it was before taking the medication.
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If your healthcare provider decides you’re the right candidate for Ativan, they may prescribe it in the form of an oral tablet or an injectable solution. A doctor or nurse must administer the injectable form of Ativan.
As with many anxiety medications, your physician will likely start you on a lower dosage and increase it as needed. It’s important to take benzodiazepines only as prescribed. Never take higher doses of Ativan without the guidance of your healthcare provider.
Ativan commonly comes in the following dosages, both of which are available as generic lorazepam:
- 0.5 mg, 1 mg, or 2 mg tablet
- 2 mg per mL or 4 mg per mL injectable solution
Often, your full dosage is divided and taken between two to three times daily. However, if you’re taking it for insomnia, the full dose is often taken at once in the evening before bed.
Your doctor will determine which dosage and form are best for you based on many factors, including:
- Your medical history
- The condition you’re trying to treat and its severity
- Your age and lifestyle
- If you take any other medications to avoid drug interactions
Ativan immediately starts working, with its effects peaking at around two hours. This fast-acting quality classifies it as a rapid onset medication. It often lasts from six to eight hours; however, the duration of its effects varies from person to person.
Xanax (alprazolam) is another benzodiazepine used to treat anxiety. It works similarly to Ativan, but by comparison is metabolized and eliminated from the body faster.
Here is a quick comparison between Ativan and other benzodiazepines:
||Oral or injection
||0.5, 1, or 2 mg tablet
||0.25, 0.5, 1, or 2 mg tablet
||5 hours (immediate-release) or 11 hours (extended-release)
||2, 5, or 10 mg tablet
||0.5, 1, or 2 mg tablet
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Is anyone restricted from using Ativan?
It’s not uncommon for medication restrictions to apply to some patients due to potentially negative side effects. The following groups should be wary of taking Ativan and discuss alternative treatment options with their doctor.
- Pregnant women: Avoid Ativan during pregnancy, as it can harm a fetus. It may pass to breast milk at low levels, causing no adverse effects in breastfed infants. However, it’s best to consult your doctor for professional medical advice before taking Ativan while breastfeeding.
- If you are taking opioids: Ativan and opioids, such as morphine, fentanyl, and oxycodone, can cause serious side effects, including a coma. They should only be prescribed together as a last-resort treatment.
- People taking antihistamines: Many antihistamines are sedative and can cause extreme drowsiness and potential breathing problems when combined with Ativan (also a sedative).
- Those taking other benzodiazepines: Taking more than one sedative medication is not advised as it can cause adverse effects such as excessive drowsiness.
- If you are taking other sedatives: Many drugs, including some antipsychotics and anticonvulsant medications, are sedatives and can lead to dangerously high levels of drowsiness when combined with Ativan.
- Drinking alcohol: Alcohol and Ativan combination can lead to breathing issues, severe drowsiness, coma, and death. Avoiding alcohol is strongly recommended, as both affect GABA receptors.
- Children under 12 years of age: Although sometimes prescribed off label for younger children, Ativan is not approved by the Food and Drug Administration (FDA) for use by children under 12 years old.
- Seniors: Seniors are more likely to experience side effects, so it should be used cautiously at lower doses and, if possible, avoided entirely.
What are the side effects of Ativan?
Whenever you start taking a new medication, it’s always important to be aware of any possible side effects. Your primary care physician will be able to provide you with an extensive list of possible side effects of Ativan. Common effects include:
- Fatigue and muscle weakness
- Trouble concentrating
As with most medications, Ativan should not be combined with alcohol, as it can lead to serious side effects, including respiratory failure and coma.
Serious side effects of Ativan
Contact a healthcare professional immediately if you think you’re experiencing any of the following severe reactions:
- Breathing problems, including respiratory depression and failure. Taking Ativan can cause a person’s breathing to slow down to a below-normal rate, resulting in dangerous levels of dizziness and fatigue. In extreme cases, breathing can slow to the point of respiratory failure, which is when your respiratory system stops working altogether. People at risk for respiratory failure when taking Ativan or generic lorazepam include seniors, anyone with a sleep condition such as sleep apnea, and those taking opioids or high doses of Ativan.
- Psychological and physical dependence. Long-term use of Ativan is not recommended, as it is a habit-forming drug. Physical and psychological dependence can lead to symptoms like depression, anxiety, vomiting, and body aches. Because of its addictive nature, it can also cause severe withdrawal symptoms if stopped abruptly. These include tremors, headaches, irritability, insomnia, and depression.
- Rebound effects. If taking Ativan for anxiety or insomnia, some people may experience a worsening of their original symptoms after taking the medication. By making the symptoms worse over time, “rebound insomnia” or “rebound anxiety” can cause patients to take more medication and become more dependent on the drug.
- Severe allergic reactions. In rare cases, patients may experience a severe allergic reaction to their medication. Go to the emergency room immediately if this happens. Signs of a severe allergic reaction include swelling of the throat, lips, tongue, eyes, and face, trouble swallowing and breathing, severe rash or hives, and rapid heartbeat.
- Suicidal thoughts. People with depression should not take Ativan, as it can increase the likelihood of suicidal thoughts.
Other rare and serious side effects to be mindful of when taking Ativan include:
- Memory problems, including memory loss
- Altered mental status
The FDA has not approved Ativan for use in children under 12 years of age. It is not a recommended treatment for seniors either. Both children and seniors are more likely to experience Ativan side effects.
Which is better: Ativan vs. Xanax
When prescribed any medication, it’s often helpful to know if there are any alternative drugs in the market, and how they compare. Ativan and Xanax are both classified as benzodiazepines and are most commonly used to treat anxiety disorders. However, they are not the same drug.
Similarities of Ativan and Xanax:
- Inhibit excess brain activity
- Potential for addiction and substance abuse
- Treat anxiety and psychiatric disorders
- Similar side effects of depression, confusion, fatigue, dizziness or unsteadiness, and slowed heartbeat
- Cannot be taken while pregnant
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Differences between Ativan and Xanax:
- Xanax works faster
- Xanax is metabolized and eliminated from the body more quickly
- Ativan has fewer dosage formulations
- Ativan is more affordable
Only your doctor will be able to determine and recommend which treatment option is best for you. A healthcare provider will take your medical history, lifestyle, and other medications into account before prescribing Ativan.
Both medications are FDA-approved and effective at treating anxiety when used correctly. However, they are considered second-choice options for anxiety and only recommended for short-term relief.