Both alprazolam (Xanax) and lorazepam (Ativan) are considered short-acting benzodiazepines—and when used for the right reasons—they’re quite effective for anxiety. These medications have some serious risks, which we’ll discuss below, so they are typically prescribed only after other anxiety medications like SSRI and SNRI antidepressants, Buspar, or pregabalin have been considered.
If you’re at the point of considering Xanax or Ativan, you may be wondering if they’re the same, which works better, and which works faster for anxiety. Let’s take a look.
- What are they used for?
- Which one works better for anxiety?
- What are the forms and dosages?
- How fast do they work and how long do they last?
- What are their side effects?
- The big downside: Psychological dependence
- Which one is cheaper?
- How Long Does Ativan Withdrawal Last?
- Ativan Withdrawal
- Factors Affecting Withdrawal
- Medications to Assist with Ativan Withdrawal
- Side effects
- Sex and fertility
- Pregnancy, post-natal and breastfeeding
- Driving and transport
- School and exams
- Friends and family
- Alcohol and street drugs
- Prescription medicines
- Other interactions
- References and further reading
- The Effects of Ativan Use
- Is Ativan Harmful?
- Short Term Effects of Ativan Use
- Ativan Long Term Effects
- Ativan Dependency
- Effects of Withdrawal
- Ativan Withdrawal and Addiction Treatment
- How Addictive Is Ativan (Lorazepam)?
- How Does Ativan Work?
- How Is Ativan Legally Classified?
- Is Ativan Addictive?
- Issues with Ativan
- Signs of Addiction to Ativan
- Common Ativan Side Effects
- Weight Gain & Weight Loss
- Ativan as a Benzodiazepine
- Ativan Help
- Side Effects of Ativan: Overdose, Weight Loss, Mixing with Alcohol
- Effects on the Body
- Effects on the Mind
- Signs of an Ativan Overdose
- Addiction and Withdrawal
- Seeking Help for Ativan Abuse
- Chris Cornell’s Family Thinks Ativan May Have Played Role in Suicide. How Safe Is the Drug?
What are they used for?
Xanax (alprazolam) is used for:
- Anxiety disorders
- Short-term relief of anxiety symptoms
- Anxiety associated with depression
- Panic disorder
Ativan (lorazepam) is used for:
- Anxiety disorders
- Short-term (4 months or less) relief of anxiety symptoms
- Anxiety associated with depression
- Anxiety- or stress-associated insomnia
Which one works better for anxiety?
Both Xanax (alprazolam) and Ativan (lorazepam) can work well for emotional and physical symptoms of generalized anxiety disorder (GAD). Numerous research studies have found that both are also effective for panic disorder.
Xanax and Ativan initiate anti-anxiety effects very quickly, within the first week of treatment. Compare that to other anxiety medications like Zoloft (sertraline) and Prozac (fluoxetine), which take a few weeks to work. That’s why Xanax and Ativan are so popular for acute anxiety symptoms, especially for people with severe symptoms who need rapid relief.
For this same reason, Xanax and Ativan might be prescribed when you first start taking an antidepressant like Zoloft and Prozac. These antidepressants are useful if you suffer from both depression and anxiety at the same time, but they take time to kick in. So Xanax or Ativan can be prescribed to help until the antidepressant starts working.
What are the forms and dosages?
There are some differences here.
Ativan is available as 0.5 mg, 1 mg, and 2 mg tablets, as is Ativan’s generic, lorazepam. For anxiety disorder, the typical dosage for lorazepam is 1 mg to 2 mg daily in 2 to 3 divided doses throughout the day.
Xanax is also available as a generic: alprazolam. Both the brand and generic are available in immediate- and extended-release (XR) forms. The immediate-release form comes in 0.25 mg to 2 mg tablets and is usually dosed at 0.25 mg to 0.5 mg every 8 hours, as needed. The extended-release form come in 0.5 mg to 3 mg tablets dosed at 0.5 to 1 mg twice a day.
Dosing for both Ativan and Xanax will vary based on the individual. Your healthcare provider will start with the lowest dose possible and then increase the dose depending on how you respond.
How fast do they work and how long do they last?
There are some subtle differences between Xanax and Ativan here, which might be important if you’re right about to do something that triggers anxiety—like getting on a plane, having a root canal, or getting into an MRI scanner.
With alprazolam (Xanax), both the immediate-release and extended-release formulations start working in an hour. Regular alprazolam will work for about 5 hours. Extended-release alprazolam will work for about 11 hours.
Lorazepam (Ativan) works even sooner at 30 to 60 minutes after taking it, with effects lasting up to 8 hours.
Both are broken down by the liver, so folks with liver disease will need to watch out for these drugs lasting longer than expected. Interestingly, Xanax has been shown in a small research study to last about 25% longer in Asians compared to Caucasians, and obesity and older age tend to make Xanax last longer, too.
What are their side effects?
Side effects of Xanax and Ativan are pretty much the same, with most coming from the fact that these drugs act on the nervous system. Side effects include cognitive dysfunction (difficulty with mental tasks), depression, dizziness, drowsiness, dysarthria (a motor speech disorder), fatigue, irritability, memory impairment, and sedation.
The big downside: Psychological dependence
Because they don’t work as long as long-acting benzodiazepines like clonazepam, Xanax and Ativan carry a higher risk of substance use disorder (previously referred to as dependence or addition). Essentially, you may feel the need to take more and more pills over time to function normally, and when you stop taking them, you may feel symptoms of withdrawal.
Long-term use of either Xanax or Ativan carries the risk of withdrawal symptoms like tremors, seizures, and psychosis when you stop taking them. That’s why neither should be used long term unless it’s really necessary. You and your healthcare provider should regularly check in to see if the medication is working and if you need to continue taking it. Studies show that when either drug is used for more than 1 month, dependence will occur in about half of those taking them.
Don’t stop taking Xanax or Ativan abruptly if you’ve been taking it for more than 2 weeks. Instead, your healthcare provider will assist you with lowering your daily dose by 0.5 mg every 3 days to slowly taper you off the medication.
Which one is cheaper?
Both Xanax and Ativan can be expensive, costing several hundred dollars for sixty 0.5 mg tablets if you pay the retail price. But remember, your generics will always be cheaper than your brand-name drugs. Currently, the lowest GoodRx price for sixty 0.5 mg tablets of either alprazolam or lorazepam is around $9.
Another option for lowering the price of these medications may be pill splitting. Xanax and Ativan tablets are both scored, so pill splitting is an option. However, extended-release tablets should never be broken or split.
– – –
Put drug prices & coupons in your pocket! We’ll text you a link to download our free Android or iPhone app Get GoodRx Mobile App Your link is on the way!
We’ve sent a link to download the GoodRx mobile app to your phone.
Something went wrong
We were unable to send a link to your phone.
How Long Does Ativan Withdrawal Last?
How long do withdrawals last? (Lorazepam) Ativan withdrawal symptoms start quickly after the last dose due its half-life. Most acute side effects hit 3-4 days out.
Ativan (lorazepam) is a member of the benzodiazepine class of drugs.
Benzodiazepines are used primarily in the treatment of anxiety, seizure disorders, and as muscle relaxants. These drugs work on the major inhibitory neurotransmitter system in the brain, gamma-aminobutyric acid (GABA). Their action results in a decrease of excitation in the brain and spinal cord due to a suppression of neuronal firing.
Ativan is also classified as a Schedule IV drug by the United States Drug Enforcement Administration, indicating that it has a moderate potential for abuse and for the development of physical dependence. It is the potential for physical dependence that makes it a drug that will inevitably produce a withdrawal syndrome in chronic users and abusers who attempt to stop using it.
Physical dependence occurs as a result of an individual taking certain types of drugs over rather lengthy periods of time. When an individual chronically uses or abuses certain classes of drugs, the individual’s system becomes acclimated to having the drug present and learns to function at a steady level only when the drug is present in the individual’s tissues. The system automatically adjusts its own release of chemical substances, such as neurotransmitters, hormones, and so forth, to account for the presence of the drug. Once the individual abruptly stops taking the particular drug, the system is thrown off balance, and this produces a number of physical symptoms known as withdrawal symptoms.
Withdrawal from a benzodiazepine like Ativan can be potentially dangerous and even fatal due to the potential to develop seizures during the withdrawal process. Ativan withdrawal usually occurs in two stages: an acute stage and a prolonged stage.
Ativan has a half-life of 10-12 hours on average, so withdrawal symptoms can start relatively quickly (within 24 hours) following the last dose. The average onset of withdrawal symptoms is 3-4 days. Acute withdrawal may begin with a rebound effects that consist of a rush of anxiety, increased blood pressure, increased heart rate, and difficulty sleeping. Acute withdrawal phase symptoms may include:
- Headache, sweating, tremors (especially in the hands), difficulty concentrating, and/or confusion
- Increased blood pressure, heart palpitations, and a rapid heart rate
- Nausea, abdominal cramps, vomiting, and/or weight loss
- Irritability, feelings of anxiety, mood swings, and/or even panic attacks
- Seizures can occur in rare cases
A protracted withdrawal syndrome (in some sources, this is just referred to as a withdrawal syndrome) occurs after the acute phase and typically lasts 10-14 days; however, in individuals who use very high doses of Ativan, it could last even longer. In this stage, individuals will continue to experience symptoms of anxiety, drug cravings, nausea, vomiting, headache, general malaise, and may even to begin to develop depression.
Some individuals who have a co-occurring anxiety or panic disorder may also experience a return of anxiety symptoms that may persist until treatment is put into place.
Certain individuals may continue to experience mood swings, depression, general malaise, and lack of motivation for months to years following discontinuation of Ativan. Some sources refer to this as a post-acute withdrawal syndrome (PAWS).
Factors Affecting Withdrawal
The duration and intensity of withdrawal symptoms individuals experience depend on a couple of different factors. Most often, these include:
The dose and frequency of Ativan: Chronic users or abusers of Ativan develop tolerance relatively quickly. Individuals who become physically dependent on Ativan and have been taking it for some time typically take doses that are far higher than the daily recommended maximum dose and take them relatively frequently to avoid withdrawal symptoms. The higher the dose one takes and the more often one takes Ativan, the more intense and lengthy the withdrawal syndrome will be.
How long the individual was taking Ativan: This will determine in part the intensity and duration of the withdrawal symptoms.
Individual differences in physical, emotional, and psychological makeup: Personal factors – such as body composition, history of addiction, and co-occurring mental health issues – can play a role in the intensity and length of the withdrawal syndrome associated with Ativan.
Benzodiazepines are commonly abused in combination with other drugs, such as alcohol, narcotic pain medications, other benzodiazepines, and even sedatives. Withdrawal from benzodiazepines becomes even more complicated when an individual also stops using other drugs that involve physical dependence and withdrawal symptoms, such as alcohol.
Medications to Assist with Ativan Withdrawal
Ativan withdrawal symptoms can be eased via medical detox. The program should be supervised by a physician who can slowly taper down the dosage of Ativan for the individual, minimizing withdrawal symptoms. At the same time, the physician and other medical professionals can supervise the client and prescribe medications as needed to facilitate the process.
Certain drugs or substances can be given to assist in the process of withdrawal. Melatonin, a hormone that induces sleep, is sometimes used during Ativan detox. There is research to indicate that it can be useful in addressing insomnia in individuals withdrawing from Ativan and other benzodiazepines; however, the research is mixed.
The antidepressant Paxil (paroxetine) has some research evidence to indicate that it can help ease some of the withdrawal symptoms associated with Ativan detox. It may be associated with increased success rates during withdrawal.
Individuals who develop seizures or seizure-like activity during Ativan detox are generally prescribed anticonvulsants.
While physicians may use a number of medications to address certain symptoms during the withdrawal process, there are no medications specifically dedicated to treating benzodiazepine withdrawal. In addition, a 2006 meta-analysis indicated that the most effective method of addressing withdrawal did not include the use of medication, but instead included the use of a tapering approach during the withdrawal process from benzodiazepines like Ativan.
Please do not be worried by the side effects listed on this page. Many people take lorazepam without any side effects or only a few mild side effects. If you think you might be getting a side effect from lorazepam, then you should discuss this with your doctor, nurse, or pharmacist.
Common side effects of lorazepam include:
- daytime drowsiness, tiredness, sleep problems
- dizziness, feeling less alert, headache
- poor muscle control, muscle weakness
- feeling that you are becoming reliant on lorazepam and finding it difficult to stop
- a feeling of wellbeing for no reason
- appetite changes
- changes in sex drive, difficulty reaching orgasm (coming), difficulty getting an erection (getting hard)
- slurred speech
- memory loss or forgetfulness
- trembling or shaking
- problems with vision, including double vision or blurred vision
- stomach upsets, feeling sick, constipation (finding it hard to poo)
- changes in the amount of saliva in the mouth
Do not stop taking the tablets until you talk to your doctor, or you may get withdrawal symptoms as well.
Lorazepam has not been shown to affect weight in most people.
It can affect the appetite, but this is rare (happens in up to one in 10,000 people).
Talk to your doctor about this if it worries you.
Lorazepam is used to help people who cannot sleep, so you would expect it to make you feel sleepy.
Lorazepam can, however, make people feel sleepy during the day which can become a problem.
If lorazepam makes it more difficult for you to get to sleep, or gives you strange nightmares, you should go back to your doctor as soon as possible.
Sex and fertility
Lorazepam can have side effects that affect your sex life. These might include:
- losing interest in sex, or sometimes feeling more like having sex
- feeling ‘numb’ to your normal emotions
- feeling less inhibited about sex
- finding it difficult to reach orgasm (cum)
- finding it difficult to get an erection (get hard)
These effects should pass after the first couple of weeks on the medication. If they don’t and this is a problem for you, go back to your doctor.
The good effects of lorazepam may have a positive impact on your sex life as your symptoms settle, you sleep better, and you can concentrate on your relationships.
There is no evidence that lorazepam affects fertility.
Pregnancy, post-natal and breastfeeding
Lorazepam can affect the developing baby, and cause symptoms in a newborn baby. For this reason, it is usually recommended to avoid taking lorazepam during pregnancy.
However, the risks to the developing baby from taking lorazepam will need to be weighed up against the risks of not taking lorazepam to your mental health.
Some studies suggest a low risk of possible mouth defects, but other studies didn’t find this.
If you and your doctor decide that you need to take lorazepam during the pregnancy, then this will be at the lowest dose that works for you and for the shortest period that is necessary. This is to minimise the amount of lorazepam that the developing baby is exposed to.
If you are taking lorazepam in the last few weeks of pregnancy, you should tell your midwife and doctor so that they can look out for symptoms in the newborn baby.
Your baby may be less active than other babies, have a low body temperature, be floppy, or have breathing or feeding difficulties for a while.
Your baby’s response to the cold might be affected for a while.
Your baby may develop withdrawal symptoms after birth.
Lorazepam is passed to the baby in breast milk in small amounts. It is not usually seen as a problem unless your baby was born early or has other health problems.
Breastfeeding can reduce any withdrawal symptoms the baby may have from lorazepam.
If your baby becomes restless, very sleepy or develops feeding problems, stop breastfeeding and quickly seek medical advice.
It is important that you remain well while you are bonding with your newborn baby. For this reason, you may need to keep taking some medicines on your doctor’s advice.
Driving and transport
Do not drive a car or ride a bike just after you start taking lorazepam.
Taking lorazepam may make you feel dizzy, sleepy or forgetful, and you may find it difficult to concentrate.
It may also cause blurred vision and muscle weakness.
This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus.
If you are not sleeping well, this could also make driving dangerous for yourself and other people.
It might be best to stop doing these things for the first few days, until you know how it affects you.
Under new ‘drug driving’ laws introduced in 2015, you could be arrested if driving dangerously while taking lorazepam. However, the limit for the medication is higher than what a doctor would normally prescribe.
It is important to stick to the dose on the prescription, and to check that you can drive safely while taking it.
School and exams
Try not to take lorazepam for the first time just before your exams.
You may feel forgetful, very sleepy, and find it difficult to concentrate when you start taking lorazepam.
You should talk to your doctor about any future exams if you are starting lorazepam. You might decide together to delay starting it until you have done them.
If they are more than a few days away, however, you might find that it is better to start lorazepam to improve your sleep and your ability to study.
Try not to drink caffeine drinks to stay awake for exam revision – they stop the lorazepam working.
Lorazepam might make you forgetful and make it difficult to concentrate.
After the first few days you will know how it affects you.
Friends and family
You may want to let your family and friends know you are taking lorazepam so they can support you and help you look out for side effects.
For guidance on this, check out our page on getting support with your medication.
Lorazepam is not a banned substance in sport.
However, lorazepam has many side effects that might make you less able to take part in sports that need a lot of focus.
These side effects include feeling sleepy, blurred eyesight, being forgetful, muscle weakness and finding it difficult to concentrate.
The good effects of lorazepam may have a positive impact on your sporting performance as your symptoms settle, and you start to feel the benefits of the medication.
Alcohol and street drugs
You can drink a small amount of alcohol while taking lorazepam, but having the two together is likely to make you very sleepy. This will be most noticeable during the early part of your treatment
Taking large amounts of alcohol and lorazepam together could affect your breathing especially if you have an existing lung problem.
If you need to drive a car, ride a bike, or use machines at work, taking alcohol and lorazepam together could be dangerous to yourself and other people.
It is very easy, and serious, to overdose with any combination of lorazepam and drugs.
Using cannabis with lorazepam will make sedative effects worse. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up.
Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis. For more information, have a look at our drugs and alcohol page.
Using heroin or methadone with lorazepam will increase their combined sedative effects. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up.
Using cocaine or other stimulants (like ecstasy, amphetamine, MDA, 6-APB) with lorazepam can lead to uncertain and dangerous effects.
Lorazepam does not mix well with some other medicines and drugs and may affect the way in which they work. Tell your doctor if you are taking any other medications including over-the-counter medicines for common illnesses and things you put on your skin.
Caffeine interferes with the way lorazepam works on your body, as it has the opposite effect to the medicine.
Try not to drink caffeine drinks (like coffee, cola or energy drinks) while you are taking lorazepam.
Caffeine can cause anxiety and sleep loss – stopping these drinks might help to improve your symptoms.
References and further reading
For more helpful links and information, have a look at our references and further reading page.
The Effects of Ativan Use
Table of Contents Authored By American Addiction Centers Editorial Staff Reviewed By Eric Patterson, MSCP, NCC, LPC
Is Ativan Harmful?
When misused or taken recreationally, Ativan can be addictive and dangerous.
Ativan (generic name: lorazepam) is classified as a benzodiazepine medication used primarily for short-term treatment of anxiety and seizure activity. It is sometimes used to manage intractable insomnia, and as a sedative for hospitalized or aggressive patients. The drug works to slow down the central nervous system of the person using it by boosting the effects of a neurotransmitter called GABA–lowering signs of physical tension and psychological anxiety.
Generally when used as directed by a physician, Ativan is safe and effective. However, when misused or taken recreationally, it can be addictive and dangerous.
Ativan is widely prescribed in the United States. According to the Drug Enforcement Administration, in 2011 there were more than 27.5 million prescriptions written for Ativan in the US alone.
Ativan Effects Quiz question 1
Ativan Effects Quiz question 2
Treatment Advisors Are On Call 24/7 Who Answers? Thinking About Getting Rehab?
Short Term Effects of Ativan Use
Ativan initially produces the following short-term effects:
- Reduced sense of physical and psychological anxiety, worry and tension.
- Increased feelings of euphoria.
- Heightened sense of well-being.
The ability to achieve these desirable effects are reduced as the user develops a tolerance to the drug. Over the course of months, the drug is no longer as effective due to the user’s increasing tolerance level.
Ativan Effects Quiz question 3
- Feeling sleepy.
- Poor motor coordination.
- Depressed mood.
- Decreased seizure threshold in those with epileptic conditions.
Like many benzodiazepines, Ativan can elicit confusion, depression, and memory loss in those taking it. These dose-dependent effects can be quite debilitating. This means that the effects will occur more markedly as the dosage amount of Ativan is increased.
The side effects of Ativan use are more common in elderly patients taking the drug. Taking Ativan may also cause difficulty in maintaining body balance, resulting in falls and other accidents–with varying degrees of resultant bodily injury.
Many people choose to abuse this substance concurrently with other drugs – including alcohol – to strengthen the pleasurable effects. Mixing substances also adds to the danger connected with Ativan.
Ativan Effects Quiz question 4
Ativan Long Term Effects
Exaggerated Side Effects
Taking Ativan for an extended period may result in certain long-term effects. Generally, these effects will present as extreme or exaggerated versions of the side effects listed above.
For example, rather than mild sedation, someone may find themselves sleeping most of the day with no energy or motivation when awake. Or, rather than occasional misunderstandings, people will find themselves frequently and profoundly confused, or even begin to experience a delirium.
Long-term use of Ativan may cause other problems with cognition or thinking impairments in the patient.
For the most part, the issue will resolve with cessation of the drug. However, some level of cognitive impairment may remain, even after treatment. This is especially true for an elderly population, who may already be experiencing a decline in the cognition associated with aging. Additionally, the cognitive impact of substance abuse can accelerate the rate of mental decline associated with an existing dementia.
A common long-term effect of Ativan use is the development of a tolerance to the drug. Tolerance to Ativan is the body’s response to the persistent physical presence of the drug. As the drug becomes a common component of the user’s “everyday” body chemistry, that individual’s system begins to adjust to its presence and chemical influence.
This adjustment serves to lowers the perceived efficacy of the drug, causing the person to need higher doses of the drug to achieve the same high on Ativan as before. Eventually, the user becomes dependent on the drug–further advancing them down a path towards addiction.
Ativan is a relatively fast-acting, highly addictive form of benzodiazepine. Extended use of the drug or use in high dosages can lead to both psychological and physical dependence.
Dependence can develop in as little as one to two months, with withdrawal occurring if drug use is stopped or severely curtailed after the dependency begins. Drug seeking behaviors – such as illicit purchasing or doctor shopping – may be seen in those that dependency has become an issue.
Recreational use of Ativan frequently occurs in the setting of polysubstance abuse, including the mixing benzodiazepines with alcohol, illicit opiates or prescription opioids. For instance, according to the National Institute on Drug Abuse, 15% of heroin users were users of a benzodiazepine on a daily basis, with 73% using weekly. Ativan itself is normally abused by prescription users increasing their dosage for an experience in what the Ativan high is like. For more information on how to help someone addicted to Ativan, give us a call.
Whereas the arrival of physiologic dependence can somewhat be gauged by the onset of the withdrawal syndrome that will occur when stopping the drug, Ativan addiction is sometimes reflected in a change in behavior of the person abusing the drug.
Someone addicted to Ativan may:
- Often take the substance in ways other than prescribed by increasing the dosage or frequency of administration.
- Obtain the medication through fraudulent or illegal means such as receiving multiple prescriptions, forging prescriptions, or buying/trading Ativan with others.
- Neglect other factors in life like relationships, career commitments, or education.
- Experience legal repercussions from buying, selling, or possessing the substance illegally.
- Find themselves in financial distress due to spending beyond their means to obtain more Ativan.
Effects of Withdrawal
Withdrawal from Ativan occurs soon after the last dose is taken, and places an individual at risk of unwanted, possibly dangerous symptoms. The benzodiazepine withdrawal syndrome can include a rebound of many of the physical and psychological symptoms that Ativan is intended to reduce or eliminate, with symptoms such as:
- Heightened anxiety.
- Increased heart rate and blood pressure.
- Worsening insomnia.
- Sensory hypersensitivity.
- Seizures and convulsions.
The above symptoms are short-term and may resolve after some length of time. However, in some cases, some short-term symptoms may not improve and intensify over time to become long-term symptoms—becoming part of a post-acute withdrawal syndrome. Some of these longer-term withdrawal symptoms may continue for several months after last use. These signs and symptoms may include:
- Worsening anxiety.
- Worsening depression.
- Continued insomnia.
Withdrawal symptoms vary in severity, with stronger symptoms occurring in users who have taken the drug for longer periods, have taken high drug doses, or have used the substance concurrently with other drugs of abuse–especially alcohol and/or other sedatives.
Because the drug reduces anxiety, users may be reluctant to discontinue its use due to fear of the anxiety’s return. Adding to this fear is the rebound effect correlated to ending Ativan use. This is when anxious symptoms return with increased severity following last use. With this being true, many will continue the pattern of abuse, addiction, and dependence to avoid the perceived risk.
The unwanted and uncomfortable withdrawal symptoms associated with dependency can be reduced or eliminated with appropriate, professional treatment options.
Ativan Withdrawal and Addiction Treatment
Treatment of Ativan frequently begins in a detoxification center. The treatment is done commonly on an inpatient basis and consists of a controlled detoxification by tapering the level of Ativan. The tapering process involves the slow reduction of the drug dosage amounts without bringing on withdrawal symptoms. At times, temporary administration of a longer-acting sedative – such as Valium – can be beneficial to managing seizure activity, if present. When the dosage of sedative has been tapered down low enough to quit the drug use without withdrawal occurring, then the drug use is discontinued. This is accomplished with observation of a medical team tracking vitals to ensure their health and safety.
Following successful detoxification, formal substance abuse treatment may occur in a rehab center or outpatient program. Rehab tends to occur in various types of residential settings where someone will live for a period of weeks or months with the purpose of focusing primarily on addiction recovery. Mental health counseling approaches—including cognitive-behavioral therapy—will assist with uncovering the triggers of addiction as well as looking forward to measures that will limit or eliminate unhealthy coping skills in the future.
The progress made during inpatient or residential treatment will be carried on post-rehab, when various aftercare approaches are implemented. Aftercare typically entails some form of outpatient drug and alcohol counseling or ongoing mental health treatment. Whether therapy occurs on an individual or group basis, it will focus on returning to life free from the influence of Ativan. Aftercare counselors will work with the recovering addict to establish a relapse prevention plan that outlines a series of behaviors to engage in and supports to contact so that the substance is not obtained or used.
- Drug Enforcmeent Administration. Fact Sheet. (2013). Benzodiazepines.
- National Institute on Drug Abuse. (n.d.). Monitoring the Future Study: Trends in Prevalence of Various Drugs.
- National Institute on Drug Abuse. (2016). Treatment Approaches for Drug Addiction.
Last updated on June 11, 2019 2019-06-11T11:00:21+00:00 Finding the perfect treatment is only one phone call away!
How Addictive Is Ativan (Lorazepam)?
Ativan (lorazepam) belongs to a class of drugs known as benzodiazepines. Benzodiazepines are some of the most commonly prescribed drugs in America, with over 15 different drugs in the class, including Valium and Xanax.
Benzodiazepines like Ativan are primarily used in the treatment of anxiety disorders; however, they are often used for the treatment of other conditions. Taking the drug Ativan will produce several possible effects that include:
- A reduction in feelings of nervousness or anxiety
- An increase in feelings of relaxation that may be accompanied by fewer behavioral inhibitions
- A reduction in the potential to experience seizures
The major therapeutic uses of Ativan include the treatment of anxiety disorders, as an aid for sleep, as a muscle relaxant, as an anticonvulsant medication, and as a pre-anesthetic drug used in surgical procedures.
Anxiety disorders include psychological disorders, such as phobias (severe fears); panic disorder (where a person experiences repetitive panic attacks); agoraphobia (where people have a severe fear or anxiety associated with being in open places and may not be able to leave their homes); and social anxiety disorder (where individuals have severe anxiety associated with situations where they have to interact with others). As a pre-anesthetic, Ativan helps relax individuals before they are given general anesthesia prior to surgery.
Ativan may also be used in conjunction with other medications for individuals who experience depression (especially individuals who experience depression with accompanying irritability, restlessness, and insomnia), to help relax individuals who may be experiencing pain from some other medical condition, and in the treatment of certain neurological disorders such as tremor. Thus, Ativan has a variety of potential therapeutic uses.
How Does Ativan Work?
Benzodiazepines like Ativan are classified as positive allosteric modulators that affect neurons in the brain that use a neurotransmitter called gamma-aminobutyric acid (GABA). GABA is the primary inhibitory neurotransmitter found throughout all areas of the brain and spinal cord (the central nervous system, or CNS). These factors influence how Ativan works in the brain:
- A positive allosteric modulator indirectly acts on a neurotransmitter in the brain.
- An inhibitory neurotransmitter reduces the activity of other neurons in the brain when it is released and results in the brain working more slowly.
- Ativan is a GABA agonist, meaning that it binds to the neurons in the brain that have receptors for GABA, and this binding stimulates the release of GABA from other neurons in the CNS (this is the indirect action).
- The release of GABA in the brain decreases the firing of all the other neurons in the brain, producing an overall reduction in activity in the CNS (this is the CNS depressant action).
- This action results in one feeling less anxious, more relaxed, and may also increase feelings of sedation (this is the anti-anxiety action).
- Moreover, the particular GABA receptor that is affected by benzodiazepines like Ativan is found in high concentrations throughout the brain, so the effects are all-encompassing.
- All functions become affected in the same manner, including other cognitive functions (e.g., attention, memory, etc.) and physical functions (e.g., reaction time).
Because of its chemical properties, relatively smaller doses of Ativan have the same effect as higher doses of other benzodiazepines such as Xanax. Moreover, Ativan tends to stay in the system longer than Xanax. While an individual may feel the maximum effects of Xanax quicker than with Ativan, the effects of Xanax do not last as long, and the individual may feel the need to take Xanax more frequently than they do with Ativan. Thus, Xanax may be used to treat panic attacks that appear to come out of the blue or insomnia because these require more immediate attention, whereas Ativan can be used for situations that require longer-term attention.
How Is Ativan Legally Classified?
Ativan can only be purchased legally with a prescription from a physician. Ativan is listed by the United States Drug Enforcement Agency as a Schedule IV drug. This means that it is believed to have a low potential for abuse or physical addiction relative to drugs such as heroin or cocaine. However, just because Ativan is not considered to be as physically addictive as heroin, this does not mean it is not a drug that carries potential for abuse and/or addiction.
Is Ativan Addictive?
All benzodiazepines have a high potential for physical dependence, abuse, and addiction. Because of Ativan’s chemical structure, it has specific therapeutic uses; however, its chemical structure also makes it a high-risk drug for both physical dependence and addiction.
Like with all benzodiazepines, when one takes the drug, there are feelings of mild euphoria and a pleasant sense of wellbeing. Ativan has a higher potency than many other benzodiazepines, and this higher potency can result in an individual developing tolerance to Ativan much faster than with other lower-potency benzodiazepines.
Because Ativan has a high potency, it can result in more extreme cravings when it is discontinued than other benzodiazepines. These extreme cravings may result in individuals using more Ativan than prescribed, using Ativan for longer periods than needed, and attempting to obtain Ativan from other doctors (doctor shopping) or other individuals. This can result in severe abuse and addiction.
Issues with Ativan
Using Ativan to treat psychological disorders, such as anxiety, depression, or issues with sleep, should not be a long-term strategy. Despite its therapeutic usefulness, there are several downsides to the use of Ativan.
Tolerance develops rapidly. What this means is that individuals who take Ativan for any significant period of time will inevitably need a higher dosage of the drug to achieve the same effects initially experienced. As a person takes more and more of the drug, the body becomes physically dependent on it. With continued use, it becomes more likely that withdrawal symptoms will occur when use is stopped or the dosage is lowered. These withdrawal symptoms may include:
- Nausea and vomiting
- Tachycardia (faster than normal heart rate)
- Loss of appetite
- Flulike symptoms
- Numbness and tingling of hands, feet, fingers, or toes
- Insomnia, irritability, and restlessness
- Increased feelings of anxiety
- Increased feelings of depression
These symptoms mimic many of the same symptoms individuals with anxiety disorders experience, and such symptoms may be misinterpreted as a return of anxiety. Individuals who take Ativan for anxiety-related issues or depression may end up believing that their psychological disorder is returning once they stop using the drug. In fact, they may actually be experiencing withdrawal symptoms, and they may often simply attempt to renew the prescription or take more of the drug. This can result in the beginning of Ativan abuse for individuals who initially took the drug for therapeutic reasons.
Other individuals may get access to Ativan illegally, such as from a friend who has a prescription, or they may buy it on the street. These individuals may use it to self-medicate their own issues with anxiety or for the euphoric effects it produces.
Individuals who abuse benzodiazepines like Ativan tend to use them with other drugs, such as alcohol or narcotic pain medications. When people do this, the effects of all substances are enhanced, and this increases the likelihood of addiction and overdose.
Government statistics indicate that between 2000 and 2010, referrals for substance abuse treatment for benzodiazepines in conjunction with abuse of other medication increased substantially compared to other types of referrals. Thus, benzodiazepine abuse and addiction have become major health issues in United States
Signs of Addiction to Ativan
There are several signs that may indicate someone may be abusing Ativan.
First, individuals who use or abuse Ativan may some other comorbid (co-occurring) disorder that could include:
- Depression or an anxiety disorder, such as panic disorder, phobias, or other anxiety disorder
- A sleep disorder, such as insomnia
- Some other issue with substance use or abuse, such as alcohol abuse, narcotic pain medication abuse, stimulant abuse, or other illicit drug abuse
- A seizure disorder
- Post-traumatic stress disorder
An individual with one of these disorders who is prescribed Ativan and uses it for lengthy period of time may be at risk for abuse. It is important that the individual’s physician monitor use of the drug, as Ativan should not be used for long periods in most cases. Individuals who use other drugs or substances in addition to taking Ativan are at a particularly high risk of abusing the drug. Other signs and symptoms of Ativan abuse include:
- The person begins to neglect responsibilities.
- The person demonstrates declining performance at school or work.
- The person begins to use more Ativan than prescribed or take it more often than prescribed.
- The individual takes Ativan in ways that are not prescribed.
- The individual begins doctor shopping to get more Ativan.
- The individual is obtaining Ativan from illegal sources.
Because Ativan abuse or addiction results in significant physical dependence, individuals who attempt to stop using Ativan will likely experience withdrawal symptoms. These withdrawal symptoms can be relatively severe, depending on the level of abuse or addiction. Thus, individuals who are attempting to recover from Ativan abuse or addiction will need to do so under the supervision of a physician who will oversee the withdrawal process. Treatment for Ativan abuse or addiction will typically consist of the following components:
- Medical detox, where the symptoms of withdrawal from Ativan are supervised and managed, is required.
- During the detox process, the person will begin a program of therapy to address underlying issues that led to Ativan abuse.
- Following detox, the individual will continue in therapy to develop coping skills and strategies to prevent relapse.
- Most individuals with substance abuse issues or addiction will need long-term aftercare to allow them to continue to grow, develop social support, and reduce the risk for relapse.
- Individuals with co-occurring mental health issues will need to get simultaneous treatment for these issues.
All treatment must be catered to each individual client. There is no one-size-fits-all solution to addiction treatment.
- Ativan is a benzodiazepine that has useful therapeutic properties; however, it is also a drug that carries a definite risk for abuse and addiction.
- In the majority of cases, Ativan should only be prescribed for temporary use due to its high potential for the development of tolerance and subsequent abuse.
- There are some specific indicators that may suggest that an individual is either abusing or addicted to Ativan.
- A person who has developed an addiction to Ativan will initially need treatment that is supervised by a physician (medical detox) and need to undergo intensive treatment.
- Individuals who abuse Ativan often have co-occurring mental health issues that need to be assessed and addressed.
- Individuals can successfully recover from Ativan abuse or addiction and go on to lead fulfilling lives in recovery.
Ativan is a benzodiazepine, prescription narcotic that is primarily used to treat short- and long-term anxiety disorders and seizure disorders. The drug depresses the central nervous system, causing several neurological side effects such as drowsiness, apathy, and mood swings, but the use and abuse of this drug also has many physical side effects.
Many people are unaware of the significant impact medications can have on their metabolism, appetite and weight gain/loss.
Common Ativan Side Effects
More common side effects of Ativan use include:
- Dry mouth
- Appetite changes
Weight Gain & Weight Loss
Studies on Ativan use have documented that the drug can cause both weight gain and weight loss. The effects of Ativan, like any other medication, are dependent on a dozen factors like other medications being used, genetics, pre-existing health conditions, and more.
A decrease in appetite and weight loss are more common side effects of Ativan when the drug is taken short-term, whereas long-term Ativan use is more likely to result in weight gain.
Any central nervous system depressant works by slowing down brain activity and as a result the rest of the body’s organs function slower than usual while the drug is present. This can slow down the digestive system and affect one’s metabolism and perhaps lead to weight gain.
Ativan as a Benzodiazepine
Another possible reason the drug could lead to weight gain is due to the general side effects of using a benzodiazepine. Benzodiazepine’s cause tiredness, drowsiness or apathy and this can impact how active a person is, ultimately affecting weight gain. The motivation to exercise may be depleted by the drug’s sedating and calming effects. Furthermore, Ativan is addictive, and this can also have a significant impact on appetite, eating habits and weight fluctuations.
When people become physically dependent and psychologically addicted to a substance, they lose control over their behavior.
Feeding the addiction becomes a necessity and things like nutrition, exercise, and other responsibilities fall to the wayside. This can result in overeating, under-eating, eating to fend off withdrawal symptoms, having no energy to workout, or having little to concern about eating. When addicts become so consumed with their addiction, they place all their time, focus and energy into maintaining a life that supports their addiction, or allows it to continue. This is one reason why several drug addicts experience a change in their diet, eating habits, weight and physical appearance.
If unwanted side effects do arise from Ativan use, patients should talk to their doctor or pharmacist immediately to avoid any serious damage.
If you’re concerned with your Ativan use and would like to learn more from a recovery professional, you can call our toll-free number, 24 hours a day, 7 days a week at 706-914-2327. Our recovery professionals are happy to assist you with all of your questions, concerns and needed information regarding Ativan.
For those of you seeking drug abuse, dependence or addiction treatment, we have connections to a wide-array of quality treatment services all across the globe and can help you find the options that are right for you and your unique needs. Only you can make the decision to better your health; if you’re ready, people are ready to help you the rest of the way. So call and ask for help today.
Side Effects of Ativan: Overdose, Weight Loss, Mixing with Alcohol
What are the side effects of Ativan?
Major side effects associated with Ativan use and/or abuse include:
- Lack of muscle control
- Blood in urine or stool
- Stomach pain
- Weight loss
- Tolerance to the impact of Ativan
- Rebound anxiety
- Memory loss
- Learning difficulties
- Emotional blunting
About 40 million American adults ” 18 percent of the US population ” suffer from some form of anxiety, according to the Anxiety and Depression Association of America.
Many of these individuals are treated with anti-anxiety medications like lorazepam, a short-acting tranquilizer sold under the trade name Ativan. Ativan acts quickly on the central nervous system by increasing the availability of gamma-aminobutyric acid (GABA) to the brain. GABA is a brain chemical that calms the central nervous system, exerting a tranquilizing effect on the mind and body. When taken appropriately under a doctor’s supervision, Ativan can help reduce many of the common symptoms of anxiety, including panic attacks, unjustified fears, sleeplessness, agitation, and restlessness. In addition to treating anxiety, Ativan is prescribed for seizure, spasms, alcohol withdrawal, or insomnia. Ativan can causes side effects, especially when it is taken in excessively high doses or used for recreational reasons.
Effects on the Body
By slowing the activity of the brain and nerves, Ativan also affects physical functions and responses. As a tranquilizer, Ativan can make the user feel calm and physically relaxed. Ativan can also stop painful spasms in muscles, or prevent life-threatening seizures when taken correctly. For patients who take Ativan as directed for legitimate reasons, this medication is generally safe and effective. However, all users must watch out for potential adverse reactions to the drug, such as:
- Daytime sleepiness
- Low energy levels
- Poor muscle coordination
- Blurry vision
- Loss of balance
- Blood in stool or urine
- Stomach pain
- Weight loss
- Pale, cool skin
- Involuntary movements (tremors, shaking)
Because it can cause clumsiness, drowsiness, and disorientation, Ativan poses an increased risk of accidental injuries. The National Highway Traffic and Safety Administration cautions that drugs in the benzodiazepine family, like Ativan, can cause symptoms resemble alcohol intoxication, such as loss of motor coordination, slurred speech, visual disturbances, and blurred vision. Driving under the influence of Ativan, or performing other activities that require hand-eye coordination and quick reflexes, can be extremely dangerous, especially if the user has also consumed alcohol or other sedatives.
Effects on the Mind
Ativan can have powerful effects on the brain and nerves. However, many users experience “rebound”side effects, or a worsening of the same symptoms that the drug is designed to treat. In particular, Ativan can cause rebound anxiety, sleep disturbances, abnormal body movements, and agitation.
- Rebound anxiety
- Loss of pleasure in day-to-day experiences
- Memory problem
- Learning difficulties
The chemical structure of lorazepam is intended to reduce the excitability of the brain and nerves, while soothing emotional responses that create anxiety and restlessness. On the negative side, Ativan can flatten users’ emotional responses and blunt their experiences of the world. Individuals who take Ativan may begin to feel a loss of interest in their everyday experiences or responsibilities. They may feel constantly sluggish and tired, and have a dazed, drowsy appearance.
Signs of an Ativan Overdose
Ativan is a safe drug when taken in the prescribed doses, at the recommended times. But taking large doses of this medication puts the user at risk of an overdose, which may end in coma or even death. The number of overdose-related deaths associated with prescription benzodiazepines like Ativan has increased fourfold since 2001, according to the National Institute on Drug Abuse. In 2013, there were nearly 7,000 fatalities attributed to benzodiazepine overdose in the US. As a central nervous system depressant, Ativan slows down activity in the brain and nerves. When taken alone and used correctly, Ativan rarely causes unconsciousness, coma, or death. However, high doses of Ativan can have fatal consequences, especially when lorazepam is combined with other drugs that also suppress the activity of the brain and vital organs. Many overdoses, either accidental or deliberate, have been linked to the use of Ativan with alcohol, prescription pain medications, other anti-anxiety drugs, and hypnotic medications used for insomnia.
Learning to recognize the signs of a lorazepam overdose could literally save a life:
- Pale, cool, bluish skin or lips
- Shallow, slow breathing
- Over-sedation or drowsiness
- Stumbling and loss of coordination
- Slurred speech
- Memory loss
- Loss of consciousness
An Ativan overdose is an emergency that may end in death if the individual doesn’t receive immediate medical attention.
People who have overdosed on Ativan should never be left alone to recover from the effects of the drugs, especially if there are other drugs involved.
Addiction and Withdrawal
One of the most serious side effects of Ativan use is the possibility of developing an addiction to this medication. Ativan addiction is most common in users who take too much of the drug, who use it for nonmedical reasons, or who take Ativan with other tranquilizing drugs, like alcohol, prescription pain relievers, and sleep aids.
After taking Ativan for more than 2-3 weeks, the nervous system becomes accustomed to the effects of the drug.
Many patients require higher doses of the drug to relieve their symptoms, a phenomenon called tolerance. Tolerance may lead to dependence ” a physical or psychological reliance on the drug in order to feel normal. If the user continues to misuse Ativan, or the dose is not reduced, tolerance can lead to addiction. Addiction is a progressive disease that causes a compulsive need to seek and use a drug. The red flags of an Ativan addiction include:
- Restlessness, irritability, or depression when the user can’t get the drug
- An obsessive interest in getting and using more of the drug, in spite of the harmful effects on personal health or relationships
- A loss of control over how much Ativan the user takes at any given time
- Isolation from friends, family, or social events as a result of drug use
- A deterioration in the quality of one’s work on the job or at school
- A decline in physical appearance and grooming
- Physical and psychological withdrawal symptoms when the drug is discontinued or the dose is lowered
Benzodiazepine withdrawal can have dangerous side effects, including seizures, severe agitation, and hallucinations. When individuals are suddenly deprived of the drug, they may also have headaches, nausea and vomiting, sleeping problems, sweating, and episodes of restlessness. In order to minimize withdrawal symptoms, a drug taper is advised for most Ativan users. In a drug taper, a doctor gradually lowers the dose of Ativan over a certain period of time, until the drug can be safely stopped without compromising the patient’s health or wellbeing.
Along with a physician-supervised drug taper, individuals who are addicted to Ativan need therapeutic treatment for addiction, as well as psychosocial resources to rebuild their lives. In a randomized, controlled trial of benzodiazepine users published in the Canadian Journal of Psychiatry, 180 patients were followed after completing a benzodiazepine discontinuation program. Patients who went through a drug taper were able to stop using the medication for longer periods of time. Heavier benzodiazepine users and those who were also addicted to alcohol or other drugs had more difficulty staying sober. Comprehensive recovery services include individual therapy, access to support groups, behavioral modification therapies, case management, and other research-based interventions.
Seeking Help for Ativan Abuse
Many people mistakenly believe that prescription medications like Ativan are less harmful or habit-forming than illegal drugs like meth, cocaine, or marijuana. But prescription drug addiction ” including the addiction to tranquilizers like Ativan ” has become a major threat to public health in the US. If individuals continue to abuse Ativan in spite of harmful side effects and negative health consequences, they may be addicted to this medication. While talking to loved ones about Ativan abuse may feel awkward or uncomfortable, this expression of concern could be the first step in helping them recover physical and psychological health.
Chris Cornell’s Family Thinks Ativan May Have Played Role in Suicide. How Safe Is the Drug?
Jason Merritt/Getty Images
After Chris Cornell’s death on Wednesday night was ruled a suicide by hanging, the musician’s lawyer and family are suggesting that an anti-anxiety medication he was taking may have influenced his final moments.
“Without the results of toxicology tests, we do not know what was going on with Chris—or if any substances contributed to his demise,” the family’s attorney said in a statement, reported by People. “Chris, a recovering addict, had a prescription for Ativan and may have taken more Ativan than recommended dosages. The family believes that if Chris took his life, he did not know what he was doing, and that drugs or other substances may have affected his actions.”
Cornell’s wife Vicky also released a statement, calling his suicide “inexplicable” and noting that, hours earlier, the couple had discussed upcoming plans for Memorial Day weekend. “I know that he loved our children and he would not hurt them by intentionally taking his own life,” she said.
Vicky’s statement also describes how Cornell was slurring his words when he spoke with her by phone on Wednesday night after his performance with Soundgarden in Detroit. “When he told me he may have taken an extra Ativan or two, I contacted security and asked that they check on him,” she said.
RELATED: 12 Signs of Depression in Men
Ativan (and its generic version, lorazepam) is an extremely common drug, prescribed to millions of people every year, says Asher Simon, MD, assistant professor of psychiatry at The Mount Sinai Hospital in New York City. (Dr. Simon did not treat Cornell.) And overall, he says, “it can be an incredibly effective and very safe medication.”
It’s in a class of drugs called benzodiazepines, which work by slowing down the central nervous system and enhancing certain chemicals in the brain to produce a calming effect. (Other well-known benzodiazepines include Valium and Xanax.) The drug is usually prescribed on a short-term basis for the treatment of anxiety, and is often helpful for people with depression.
“It lasts about four to six hours, and a lot of times it’s prescribed on an as-needed basis,” says Dr. Simon. “We might say, ‘Take one or two pills three times a day, as needed.’” The drug starts working right away, he says; that’s why they’re sometimes recommended for people who are anxious about flying on airplanes or visiting the dentist, for example.
Ativan might also be prescribed for short-term use alongside antidepressant medications. “A lot of times when someone comes in with anxiety and you start them on an antidepressant, their anxiety can get worse before it gets better,” says Dr. Simon. “So sometimes they need a couple weeks of an anti-anxiety medication to provide immediate relief, until the antidepressant kicks in.”
Because it’s a sedative, Ativan can make people dizzy and tired when they first start taking it. It can increase the risk of falls, especially in older people, and patients are warned about driving or operating heavy machinery until they know how the drug will affect them.
But Dr. Simon says that taking an extra Ativan or two would not cause slurring or serious impairment, especially for people who have been on the drug long-term and developed a tolerance to its sedating side effects. “Yes, of course you should never take more than prescribed,” he says. “But one or two additional pills is usually not a huge deal.”
Taking higher doses, or combining Ativan with alcohol or other drugs, is much more dangerous, he says—mostly because of the potential for impaired judgment and slowed breathing and heart rate. And overdoses of anti-anxiety medications do occur: A 2016 report found that, as more people are prescribed these drugs, more people are also dying from them.
There’s less of a chance that Ativan would cause a non-suicidal person to take their own life, says Dr. Simon. “A lot of suicide comes at a time of acute anxiety, and if it treats the anxiety it can actually prevent those suicides,” he says. “It is extremely unlikely to cause suicidal thinking in and of itself.”
RELATED: 19 Natural Remedies for Anxiety
But, he adds, the drug’s effects can work in either direction. “In someone who is already depressed and suicidal, it can impair their judgment—and if someone is intent on killing themselves, it can lower their inhibition and make them more likely to act on their impulses.”
This is a common risk with most anti-anxiety and antidepressant medications, and these drugs carry warnings about the potential for worsening depression or suicide. That’s why doctors should evaluate patients carefully and make sure they’re being treated for their underlying mood disorder, says Dr. Simon, and not just their short-term symptoms.
Benzodiazepines like Ativan can also be habit-forming, he says, and doctors should be extremely careful about prescribing them to people with a history of drug use.
To get more news you need to know delivered to your inbox, sign up for the Healthy Living newsletter
Until more is known about Cornell’s suicide, the public can only speculate what role his prescription medication played in his death. But for others who have been prescribed Ativan or similar medications, Dr. Simon says there’s little reason to worry.
It’s important to know the risks of any medication, and to report any worsening of depression or suicidal thoughts to your doctor. But when used as directed, says Dr. Simon, people can rest assured that Ativan is safe—and can be extremely beneficial—for millions of Americans.