Clinically Reviewed by: Charee Marquez, LMFT
Today, we’ll be discussing a critical topic that concerns the misuse of a commonly prescribed medication: Ativan. If you or someone you know is taking Ativan, it’s crucial to be aware of the dangers of an overdose.
What is Ativan?
Ativan is a brand name for lorazepam, a medication classified as a benzodiazepine. Benzodiazepines are central nervous system depressants that are commonly prescribed for anxiety, insomnia, seizures, and other conditions. They work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which has a calming effect on the brain and nervous system.
The different types of Ativan formulations include:
- These are oral tablets available in different strengths, typically ranging from 0.5 mg to 2 mg. The tablets are taken orally and are often prescribed for anxiety disorders.
Ativan Oral Solution:
- Ativan is also available in liquid form as an oral solution. This form can be useful for individuals who may have difficulty swallowing tablets. The liquid is typically measured with a dropper.
- Ativan is available in injectable form for intramuscular or intravenous administration. This form is often used in hospital or emergency settings for the rapid treatment of acute anxiety or seizures.
For Ativan (lorazepam) tablets, some common imprints include:
- 0.5 mg Ativan: White, round tablets with “WYETH” on one side and “27” on the other.
- 1 mg Ativan: White, round tablets with “WYETH” on one side and “274” on the other.
- 2 mg Ativan: White, round tablets with “WYETH” on one side and “275” on the other.
Mechanism of Action
Lorazepam, sold under the brand name Ativan, belongs to a class of medications known as benzodiazepines. Its mechanism of action involves enhancing the effects of a neurotransmitter in the brain called gamma-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter, meaning it helps reduce the activity of nerve cells in the brain.
Here’s a more detailed explanation of how Ativan works:
GABA Receptor Modulation:
- Ativan binds to specific sites on the GABA-A (gamma-aminobutyric acid type A) receptors, which are ionotropic receptors in the central nervous system.
Increased GABAergic Activity:
- When Ativan binds to the GABA-A receptors, it enhances the inhibitory effects of GABA. This results in increased chloride ion influx into the neurons, leading to hyperpolarization of the cell membrane.
- The hyperpolarization caused by increased chloride ion influx makes it more difficult for nerve cells to become excited. This neuronal hyperpolarization contributes to the calming and sedative effects of Ativan.
Central Nervous System Depression:
- Overall, the increased activity of GABA and the inhibitory effects on nerve cells lead to a generalized central nervous system depression. This can result in calming effects, muscle relaxation, anti-anxiety properties, and sedation.
Onset and Duration
The onset and duration of action for Ativan (lorazepam) can vary depending on several factors, including the individual’s metabolism, the dosage administered, and the method of administration. Here are general guidelines:
Onset of Action:
- Oral (Tablets): The onset of action for oral administration typically ranges from 15 to 30 minutes, with peak effects occurring within 1 to 1.5 hours.
- Intramuscular (IM) Injection: When administered via intramuscular injection, the onset of action is usually quicker, with effects often observed within 15 to 30 minutes.
Duration of Action:
- The duration of action for Ativan is typically around 6 to 8 hours. This means that the calming and sedative effects of the medication are likely to last for this duration.
Here are some common uses of Ativan:
- Ativan is frequently prescribed to manage symptoms of generalized anxiety disorder (GAD), social anxiety disorder, and other anxiety conditions. It helps by producing a calming effect on the central nervous system.
- In some cases, Ativan may be prescribed on a short-term basis to help with insomnia. It can promote sleep by inducing a sedative effect.
- Ativan is used as an anticonvulsant to control and prevent seizures, especially in emergency situations.
Sedation Before Surgery:
- Ativan may be administered before certain medical procedures or surgeries to induce sedation and reduce anxiety.
- Benzodiazepines, including Ativan, are sometimes used to manage symptoms of alcohol withdrawal, such as agitation and seizures.
- Ativan may be prescribed to alleviate muscle spasms and discomfort associated with certain medical conditions.
Chemotherapy-Induced Nausea and Vomiting (CINV):
- Ativan may be used as part of an antiemetic
Here are short-term and long-term side effects:
Short-Term Side Effects:
Sedation and Drowsiness:
- One of the common short-term effects of Ativan is sedation, leading to drowsiness and a feeling of calmness.
- Some individuals may experience dizziness or lightheadedness, especially when changing positions.
- Ativan can cause muscle weakness or a feeling of heaviness in the limbs.
- Coordination and motor skills may be temporarily impaired, leading to a lack of precision in movements.
- Ativan can affect cognitive function, leading to difficulties with concentration and memory.
- Short-term use may result in gastrointestinal effects such as nausea or constipation.
- At higher doses, there is a risk of respiratory depression, which is a slowing of breathing.
Long-Term Side Effects:
- With prolonged use, individuals may develop tolerance, requiring higher doses to achieve the same therapeutic effects.
- Long-term use of Ativan can lead to physical and psychological dependence. Abrupt discontinuation may result in withdrawal symptoms.
- Discontinuing Ativan after prolonged use can lead to withdrawal symptoms, including anxiety, insomnia, irritability, and rebound symptoms.
- Extended use may contribute to long-term cognitive impairment, especially in older adults.
Increased Fall Risk:
- Older adults using Ativan may be at an increased risk of falls, fractures, and injuries due to sedation and impaired coordination.
Potential for Misuse and Addiction:
- Long-term use increases the risk of misuse, and there is a potential for the development of addiction, particularly in individuals with a history of substance abuse.
Is Ativan Addictive?
Yes, Ativan (lorazepam) has the potential for addiction, especially when used for an extended period or in higher-than-prescribed doses. Ativan belongs to a class of drugs known as benzodiazepines, which are central nervous system depressants. These medications are prescribed to treat anxiety, insomnia, and certain seizure disorders.
Key points regarding the addictive potential of Ativan include:
Physical Dependence: With regular use, the body may develop a tolerance to Ativan, requiring higher doses to achieve the same effects. Physical dependence can also occur, leading to withdrawal symptoms if the medication is abruptly stopped.
Psychological Dependence: Individuals may become psychologically dependent on the calming effects of Ativan, leading to a reliance on the medication to cope with stress or anxiety.
Risk of Abuse: Some individuals may misuse Ativan by taking larger doses than prescribed, seeking the drug for its sedative effects, or using it without a prescription.
Withdrawal Symptoms: Abruptly stopping Ativan can result in withdrawal symptoms, including increased anxiety, insomnia, irritability, and, in severe cases, seizures. Tapering the medication under the guidance of a healthcare professional is essential to minimize withdrawal effects.
It’s crucial for individuals prescribed Ativan to follow their healthcare provider’s instructions closely and to communicate openly about their experiences, including any concerns about dependence or addiction.
Alcohol Use and Ativan
Combining Ativan (lorazepam) with alcohol is generally not recommended due to the potential for increased sedation and central nervous system depression. Both Ativan and alcohol act as central nervous system depressants, and their combined use can enhance each other’s effects, leading to:
- Combining Ativan and alcohol can result in excessive sedation, making individuals feel extremely drowsy or sleepy.
Impaired Coordination and Judgment:
- Both substances can impair coordination and cognitive function. Combining them may increase the risk of accidents or injuries due to impaired motor skills and decision-making.
- Both Ativan and alcohol can depress the respiratory system. Combining them may lead to slowed breathing, which can be dangerous, especially at higher doses.
Memory and Cognitive Impairment:
- The combination may result in significant memory impairment and cognitive difficulties.
Increased Risk of Overdose:
- Combining Ativan and alcohol increases the risk of overdose, especially if taken in large amounts. Overdose symptoms can include severe respiratory depression, loss of consciousness, and, in extreme cases, coma or death.
Potential for Additive Effects:
- The effects of Ativan and alcohol are additive, meaning the combined impact is greater than the sum of their individual effects.
It’s crucial to follow healthcare provider instructions and warnings on medication labels regarding alcohol consumption while taking Ativan.
Controlled Substance Classification
Ativan (lorazepam) is classified as a Schedule IV controlled substance in the United States. This classification indicates that it has a lower potential for abuse compared to substances in Schedule III. Schedule IV substances have an accepted medical use but may lead to physical or psychological dependence if abused. The scheduling is part of the Controlled Substances Act, a system that categorizes drugs based on their potential for abuse, medical utility, and overall safety.
Storage and Disposal
Here are brief guidelines for the storage and disposal of Ativan (lorazepam):
- Store Ativan at room temperature, away from light and moisture.
- Keep it in its original packaging and out of reach of children and pets.
- Avoid storing it in the bathroom or other areas with high humidity or temperature fluctuations.
- Dispose of unused or expired Ativan by following local regulations or drug take-back programs.
- If a take-back program is not available, mix the medication with an undesirable substance (such as coffee grounds or kitty litter) and place it in a sealed bag before throwing it in the trash.
- Do not flush Ativan down the toilet unless explicitly instructed to do so by the medication’s label or healthcare professional.
Always follow specific disposal instructions provided by your healthcare provider or local authorities to ensure proper and safe disposal.
What Causes an Ativan Overdose?
An overdose occurs when an individual takes more of a substance than the body can metabolize or handle safely. The causes of an overdose can vary depending on the specific substance involved. In the case of Ativan (lorazepam), an overdose can be caused by:
Taking Excessive Amounts: Taking a larger dose of Ativan than prescribed or recommended by a healthcare professional can lead to an overdose.
Combining with Other Substances: Taking Ativan in combination with other substances, especially central nervous system depressants like alcohol or opioids, can increase the risk of overdose.
Accidental Overdose: Accidentally taking more Ativan than intended, such as taking a double dose or mistakenly ingesting someone else’s medication, can result in an overdose.
Tolerance Changes: Individuals who have developed a tolerance to Ativan may be tempted to increase their dosage to achieve the desired effects, which can lead to an overdose.
Health Conditions: Certain health conditions or interactions with other medications can affect how the body processes Ativan, increasing the risk of overdose.
Signs and Symptoms of Ativan Overdose
Immediate Steps in Case of Suspected Overdose
If someone is experiencing an Ativan overdose, take the following steps:
Call 911: Immediately dial emergency services to seek professional medical assistance.
Stay with the Person: Do not leave the individual alone; provide reassurance and monitor their condition.
Provide Information: Share details about the suspected Ativan overdose, including the dosage taken and any other substances involved, when possible.
Administer First Aid if Trained: If you have first aid training, administer appropriate measures while waiting for medical help.
Keep Airway Open: Ensure the person’s airway is open and unobstructed to facilitate breathing.
Monitor Vital Signs: Watch for signs of respiratory distress, such as difficulty breathing, and monitor vital signs until medical help arrives.
Avoid Home Remedies: Refrain from attempting home remedies, and wait for professional medical assistance for proper intervention.
Remember, in cases of overdose, prompt medical attention is crucial. Always prioritize the safety and well-being of the individual by seeking professional help as soon as possible.
Long-term Effects of Ativan Overdose
A serious overdose can lead to lasting damage to the body and brain. Additionally, misuse of Ativan can worsen existing mental health conditions and contribute to addiction.
Risk Factors for Ativan Overdose
Certain factors can increase the risk of an overdose, such as taking higher doses than prescribed, combining Ativan with other substances like alcohol, or having a history of substance abuse.
Preventing Ativan Overdose
To prevent an overdose, it’s essential to take Ativan exactly as prescribed by a healthcare professional. Avoid using Ativan for recreational purposes, as this significantly increases the risk of an overdose.
The Importance of Seeking Professional Help
If you or someone you know is struggling with Ativan misuse or addiction, don’t hesitate to reach out for professional help. California Prime Recovery offers compassionate and comprehensive addiction treatment to help individuals find a path to recovery.
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If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390
It’s crucial to seek medical advice before making any changes to your medication regimen. Abruptly stopping Ativan can lead to withdrawal symptoms and other health issues.
When taken as prescribed and monitored by a healthcare professional, Ativan can be safe and effective for managing anxiety and related conditions.
Yes, Ativan can be habit-forming, especially when misused or taken for extended periods.
California Prime Recovery provides personalized treatment plans, a supportive environment, and a comprehensive approach to addiction recovery.
Yes, California Prime Recovery works with various insurance providers to make treatment accessible to those in need.