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Understanding the Abuse Potential and Side Effects of Ativan

While prescription drugs have legitimate medical uses, they can be dangerous if misused or abused. One such drug, Ativan, is a powerful treatment for anxiety that carries significant potential for addiction. The Food and Drug Administration has classified it as a Schedule IV controlled substance because of the risk of abuse. If you or a loved one has been taking Ativan, it’s important to understand the hazardous side effects of this medication.

What Is Ativan?

Ativan is the brand name for the generic drug lorazepam. It has been available as a treatment for anxiety in the United States since 1977, and was prescribed to more than 10 million Americans in 2019 alone according to data from ClinCalc.

Benzodiazepines such as Ativan depress the central nervous system, which can soothe the signals that create irritability, fear, tension, restlessness and other anxiety symptoms. Although scientists aren’t exactly sure how this class of drugs works in the brain, they theorize that medications like Ativan enhance the impact of a brain chemical called GABA. This in turn reduces the brain activity that causes these uncomfortable symptoms.

Your doctor may recommend Ativan if you have panic attacks or anxiety symptoms that interfere with your everyday life. It can also help with sleep issues and severe but temporary stress. However, it’s not meant for long-term use and can lead to physical and mental dependence. How long does it stay in your system? Depending on weight and other factors, 1 mg of Ativan will remain in our body for 6 to 8 hours.

The nervous system quickly adjusts to the dosage of Ativan, which means it won’t work as well over time (an effect known as tolerance). When this occurs, many people begin to take more of the drug to achieve the desired calming effect, which increases the risk of addiction and overdose.

Why Is Ativan Used?

What is it used for? Anxiety treatment is the most common reason that doctors prescribe Ativan, but it can also treat seizure disorders, muscle spasms and insomnia.

This drug is also used off-label, which means doctors sometimes prescribe it for conditions beyond the approved FDA uses. Off-label uses of Ativan may include treatment for depression, nausea caused by vertigo or chemotherapy, migraine headaches, chronic pain, alcohol withdrawal symptoms and fear of flying.

Your doctor may recommend Ativan if you show symptoms of generalized anxiety disorder. This condition is characterized by an unusual level of worry or anxiety that lasts for six months or longer. People with GAD may also experience fatigue, sleep problems, restlessness, muscle tension, mood changes and difficulty concentrating.

GAD affects an estimated 2% of the adult population of the U.S. according to WebMD. This condition is more common among women than men and often begins during the childhood or teen years. People who have another mental health problem, such as depression, substance use disorder, or panic disorder, have a higher risk of developing GAD.

What Is the Correct Ativan Dosage?

Your doctor will recommend the right amount of Ativan for your needs. The drug comes in 0.5 mg, 1 mg and 2 mg tablets. The generic version, lorazepam, is available in either a tablet or a liquid version. Intravenous Ativan, used for surgical sedation, is also available.

Most people with this prescription take 2 to 6 mg a day at different intervals, although some may be prescribed as little as 1 mg or as much as 10 mg of daily Ativan. The Food and Drug Administration recommends that doctors prescribe the lowest possible dose for the shortest possible time interval.

Your health care provider considers your overall health, age and reason for taking Ativan when setting the initial dose, but may increase the amount you take over time if necessary. If your doctor recommends Ativan “as needed” for anxiety, you must stay below a maximum daily dose.

You should always adhere to the Ativan dose prescribed by your health care provider. Continuing to take the drug after your prescription ends or taking more than your prescribed amount significantly increases the risk of becoming addicted to this medication. If you miss a dose of Ativan, just wait for your next dose. Taking a double dose can be dangerous.

Unfortunately, you can develop a dependence on the drug even when taken as directed, so it’s important to be vigilant if your doctor prescribes Ativan. Dependence means that you need to take more and more of the medication to obtain the same effect.

Most providers only put patients on this drug for short-term use. In fact, the FDA has only approved Ativan for four months of use and has not reported on the effects of longer periods of use. Scientists do know that long-term use of a benzodiazepine such as Ativan can affect your ability to think and remember (cognition), although this side effect sometimes improves with time when you stop taking the medication.

Make sure to safely store your Ativan prescription in your home so that others cannot access the drug. You should never take someone else’s Ativan or share your prescription with someone else. Doing so creates a serious, potentially fatal health hazard. For this reason, it is illegal to give or sell this drug to anyone.

Who Should Not Use Ativan?

The FDA has not approved Ativan for use in children younger than 12. In addition, many doctors use caution when prescribing this drug to older adults, since they are more likely to experience dizziness and fatigue that can result in fall-related injuries.

You should also avoid Ativan if you have a serious chronic illness or a disease that affects breathing, such as chronic obstructive pulmonary disorder or sleep apnea. Pregnant women should not take Ativan as it can result in birth defects and drug dependence for the newborn at birth. The medication is not safe for people who are breastfeeding, have glaucoma or have had an allergic reaction to another benzodiazepine.

Even if your doctor says it is safe for you to take Ativan, call for medical help right away if you experience any of the following while taking the drug:

  • Suicidal thoughts
  • Seizures
  • Hallucinations
  • Confusion
  • Severe behavior or mood changes
  • Increase in activity 
  • Tremors or muscle spasms

How Does Ativan Compare to Xanax?

Ativan is very similar in comparison to Xanax. Xanax and Ativan are both categorized as benzodiazepines. Doctors primarily prescribe Ativan for short-term anxiety symptoms, while Xanax is approved by the FDA to treat panic disorder and generalized anxiety disorder. The effects of Xanax peak about an hour or two after the first dose, while Ativan takes two or three hours to take effect.

While the drugs have similar uses, risks and side effects, Xanax stays in your system longer. Unlike Ativan, it also comes in an extended release version. As a result, it’s associated with a higher incidence of unwanted symptoms and potential overdose.

Xanax is also more likely to interfere unfavorably with other substances such as alcohol, though it’s dangerous to mix either medication with other drugs. It may cause side effects that are not associated with Ativan, such as irregular menstrual periods, weight gain and weight loss.

What Is the Abuse Potential of Ativan?

This drug has a boxed warning from the FDA, which is the strongest alert for patients and health care providers about a substance’s potential hazards. It’s important for people who take Ativan to understand the abuse potential & side effects of this medication.  It only takes about two weeks to develop a physical dependence on Ativan. The drug takes effect within minutes after your dose, which increases the potential to develop a tolerance.

Often, people who become addicted to Ativan go to multiple doctors to find a provider who will prescribe the medication. They also tend to continue using the drug even when it affects work, relationships and other aspects of life. However, few of these individuals intend to get high when they start taking prescription drugs such as Ativan. In fact, most begin abusing benzodiazepines simply because they have trouble sleeping, often because of the underlying anxiety they experience.

According to the National Center for Drug Abuse Statistics, nearly 5 million Americans ages 12 and older abuse benzodiazepines such as Ativan each year, most after receiving a legitimate prescription. Talk to your doctor if you experience cravings or find yourself increasing your dose of Ativan above the prescribed amount. These signs of dependence require medical attention, since it can be dangerous to stop taking the drug abruptly.

Does Ativan Use Cause Side Effects?

Some of the side effects of Ativan use include loss of physical coordination, slurred speech, and difficulty communicating or understanding. When a friend or family member has developed an addiction to Ativan, you may notice symptoms such as:

  • Sleeping too much
  • Hallucinations
  • Confusion
  • Fatigue
  • Depression and other mood changes
  • Shaking
  • Sweating
  • Headaches 
  • Jaundice
  • Vision changes
  • Appetite changes
  • Nausea and vomiting
  • Loss of interest in favorite activities
  • Loss of consciousness
  • Deceptive behavior, such as lying about drug use
  • Isolation from friends and family
  • Constipation
  • Vertigo
  • Borrowing or stealing money to obtain more Ativan
  • Decreased performance at school and work
  • Lack of personal hygiene
  • Sexual dysfunction

Using Ativan to treat insomnia or anxiety for a long time can result in a “rebound” of these symptoms. That means the drug makes your condition worse over time rather than improving your health.

RX List cited a study of 3,500 people taking Ativan for anxiety to review the drug’s side effects. Sedation, experienced by about 16% of patients who participated in the research, was the most common side effect. Other common side effects included feeling dizzy (about 7%), weak (about 4%) or shaky (about 3%). Older adults are more likely to experience these issues with Ativan.

Can Ativan Abuse Be Fatal?

As a depressant drug, Ativan slows breathing and lower blood pressure. In addition to the side effects described above, severe medical issues can occur with an overdose. Your risk increases if you mix your prescription with other depressants such as opioids or alcohol.

Overdose can result in loss of consciousness, memory problems, tremors, seizures, coma and respiratory depression, which can be life-threatening without immediate medical attention. People who take Ativan and have untreated depression also have an elevated risk of suicide.

If you or a loved one shows symptoms of Ativan overdose, call 911 or Poison Control. The drug can be fatal when taken with other drugs that result in respiratory depression. Danger signs include shallow or weak breathing, weak pulse, lightheadedness, dizziness, weak muscles, slurred speech, confusion and coma.

What Happens During Withdrawal From Ativan?

People who discontinue the drug after dependence develops will experience physical and mental symptoms of withdrawal. These side effects, typically associated with stopping the drug “cold turkey,” can include muscle spasms, seizures, intense anxiety, tremors, nausea, vomiting, insomnia, restlessness and stomach pain.

Without treatment, the most intense phase of Ativan withdrawal lasts about 10 days. However, some symptoms of withdrawal can last up to a year. You can reduce or avoid the withdrawal symptoms of Ativan by slowly tapering your dose under a doctor’s care.

How Can I Get Help for Ativan Abuse?

If you have concerns about your Ativan use, talk to your health care provider about medically supervised withdrawal. In addition to the symptoms described above, stopping the drug abruptly after extended use can cause fatal seizures. Your doctor will recommend a tapering schedule so you can slowly stop using Ativan and completely detoxify from the drug.

At Clean Recovery Centers, we work to help our clients become free from addiction to drugs such as benzodiazepines, addressing both the underlying sources of substance use and its effects on the person’s physical and emotional health. Our three-phase approach starts with three to four weeks of medically supervised residential drug detox, followed by either inpatient or outpatient mental health and substance use treatment. Finally, the maintenance phase sets the stage for a sustainable sober lifestyle.

Clean Recovery Centers are located in Tampa, New Port Richey and Sarasota, Fla. Contact us today if you or a loved one is struggling with dependence on Ativan or any other controlled substance.

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