Lorazepam (Ativan®)

Key takeaways:

• Lorazepam is a benzodiazepine that works on GABA receptors in the brain to slow cellular communication that may lead to increased anxiety. Therefore, this medication is chiefly prescribed for anxiety disorders, insomnia stemming from anxiety, and the short-term management of stress, along with some off-label uses
• Lorazepam can be habit-forming and should be used with caution in individuals who have a history of substance use disorder. This medication acts as a central nervous system depressant that can slow breathing, which makes it unsafe for use with individuals who have respiratory or cardiac conditions.
• Lorazepam is most beneficial when paired with integrated psychotherapy based on a person’s condition. Cognitive behavioral therapy can be helpful to manage anxiety, while relaxation techniques and sleep hygiene training can assist with insomnia.

Understanding lorazepam

Lorazepam is a type of medication called a benzodiazepine. Lorazepam regulates a person’s brain activity to offer short-term relief from anxiety and insomnia. This medication may be recommended for those with anxiety disorders, sleep disturbances attributed to anxiety, and pre-operative anxiety. Some physicians may also prescribe lorazepam for the management of short-term stress.^[1][2]

In some cases, lorazepam is prescribed alongside other mental health medications to maximize their effect. There are a range of uses for this medication, though it comes with several side effects, so it should be used with caution in certain populations.^[1][2]

How it works

Lorazepam acts on gamma-aminobutyric acid (GABA) receptors in the brain. GABA slows nerve activity, which can create a calming effect. Lorazepam enhances the effects of GABA, making it easier for the chloride ions in these cells to move, which inhibits communication between neurons. Less nerve signal transmission leads to less nervous system activity, especially in the amygdala and parts of the cerebral cortex responsible for emotion regulation.^[1][6]

Brand names

Lorazepam capsules are sold under the brand name Ativan®.^[3][4] The oral concentrate of this medication is sold as Lorazepam Intensol. The extended-release lorazepam capsule is marketed as Loreev XR. Lorazepam is also available as an injection, which is sold as Lorazepam Novaplus. ^[5]

Conditions treated with lorazepam

FDA-approved uses

The Food and Drug Administration (FDA) has approved lorazepam for the treatment of several conditions:

• Short-term management of anxiety disorders.
• Physicians should prescribe oral lorazepam for no longer than 4 months when used to manage anxiety disorders.^[1]
• Treatment of status epilepticus.
• Lorazepam is considered a first-line treatment for active seizures and should be given intravenously for the most rapid response.^[1]
• Preoperative anxiety.
• A low dose of lorazepam can be given intramuscularly 2 hours before surgery to assist with temporary anxiety and supplement the effects of anesthesia.^[1]
• Insomnia due to temporary stress or anxiety.
• Individuals under the age of 65 may take oral lorazepam at bedtime to assist with stress-related insomnia temporarily.^[1]

Off-label uses

There are several off-label uses for lorazepam. While none of these uses have been specifically approved by the FDA, they are appropriate as long as there is scientific evidence supporting their effectiveness and safety, and they have been recommended by a medical professional. ^[1][3]

• Cancer-related nausea and vomiting.
• Lorazepam is often used alongside antiemetics to manage nausea and vomiting caused by chemotherapy.
• Agitation due to alcohol withdrawal.
• Physicians may prescribe small doses to be repeated as needed.
• Catatonia.
• Lorazepam doses (not given for more than 5 days) may help manage abnormal behaviors, movements, and social withdrawal due to mood or psychotic disorders.
• Vertigo.
• Lorazepam may be prescribed to manage vertigo in individuals with an inner ear disorder called Meniere's disease. However, physicians must use caution, as benzodiazepines are not recommended for vertigo due to other conditions.
• Stabilization of a highly agitated patient.
• Emergency physicians may use lorazepam (with or without atypical antipsychotics) to rapidly manage agitation.
• Schizophrenia.
• The American Psychiatric Association says benzodiazepines may help manage akathisia related to antipsychotic therapy.

Lorazepam side effects

You may experience several common side effects after taking lorazepam. While these are not necessarily a cause for concern, they can be difficult to manage. It is important to note that older adults may experience these side effects longer than others do, which occurs due to their slowed metabolism.^[3] You should contact your doctor if any of these common side effects persist or become severe: ^[2]

• Unsteadiness
• Muscle weakness
• Drowsiness
• Diarrhea
• Nausea
• Appetite changes
• Constipation
• Changes in libido/sexual dysfunction
• Fatigue

There are several potentially serious side effects associated with lorazepam. These include: ^[3][2]

• Sleep disturbances
• Vision changes
• Hallucinations
• Aggression
• Disorientation
• Depression
• Shuffling gait
• Hand tremors
• Difficulty talking
• Swelling of the face, eyes, or mouth
• Rash
• Hives
• Difficulty concentrating
• Restlessness
• Dark urine

It is important to contact your doctor or emergency medical services in the event you experience any of these concerns.^[2]

Dangerous and rare side effects

Like other benzodiazepines, lorazepam slows central nervous system function. This may lead to some dangerous side effects. These adverse effects are rare and are more likely to occur with higher doses, though you should still be aware of the signs. Rarer side effects include: ^[1]

• Seizures.
• Low blood pressure.
• Shortness of breath.
• Suicidal thoughts.
• Syncope (fainting).
• Disorders of the blood or bone marrow, also called blood dyscrasias.
• An irregular heartbeat.
• Paradoxical reactions, or aggressive and hyperactive behaviors.
• Intra-arterial gangrene.
• Memory impairments.
• Propylene glycol toxicity may occur when taking high doses parenterally.
• Yellowing of the skin or eyes, also known as jaundice.

If you are taking lorazepam to assist with insomnia, you may enter a partially asleep state during which you go about your usual activities, such as eating, driving, talking to others, and engaging in sexual activities. Although this is rare, contact your doctor if it occurs, as it can lead to injury or other bodily harm.^[5]

Misuse, dependence, and addiction

Benzodiazepines can be habit-forming and lead to physical dependence. You should only take the recommended dose as prescribed by your healthcare professional, as misuse can lead to overdose, dependence, and possibly even death. A healthcare professional should monitor dosage and use to avoid the risk of misuse or addiction to lorazepam. Psychiatrists, medical doctors, nurse practitioners, pharmacists, and other healthcare professionals involved in your care should watch for signs of adverse effects or misuse.^[1]

You should not stop taking lorazepam without consulting your doctor. If you suddenly stop taking this medication, you can experience dangerous withdrawal symptoms, especially if you have been using it long-term or taking a high dose.^[3]

Precautions

Lorazepam should be used with caution in individuals who have a history of addiction, as this medication is habit-forming. If this medication is the best option for someone with past substance use disorder (SUD), it is important to limit lorazepam to short-term use and monitor individuals for any signs of dependence. Your doctor should also know if you have a history of depression, psychosis, or suicidal thoughts, as this may warrant additional monitoring.

Since lorazepam affects heart rate and blood pressure, it should be used with caution in individuals who have cardiovascular conditions.^[2] While lorazepam can be used as a rescue medication for someone having a seizure, this medication is not intended to replace traditional seizure medications. Let your doctor know if you have epilepsy before taking this medication.^[3]

Considerations and risks

Individuals who are allergic to benzodiazepines should not take lorazepam. You should not take lorazepam if you are pregnant or breastfeeding, as this can lead to birth defects or life-threatening withdrawal symptoms after birth.^[1][2]

Individuals with narrow-angle glaucoma should not take this medication, as lorazepam can increase intraocular pressure and significantly worsen someone’s vision.^[2][3] Since benzodiazepines cause central nervous system depression and can slow breathing, anyone with severe respiratory insufficiency, sleep apnea, asthma, chronic obstructive pulmonary disease (COPD), or other respiratory disorders should avoid this medication.

In addition, do not take lorazepam if you have myasthenia gravis, as muscle weakness is a common side effect that can cause further decline in motor function for these individuals.^[3] You should not take lorazepam extended-release capsules if you are allergic to aspirin or yellow dye.^[2]

Drug interactions

Do not combine lorazepam with other benzodiazepines, like alprazolam, clonazepam, diazepam, and others, as this can lead to severe respiratory depression, coma, and potential death.^[1] You should not take lorazepam if you are taking other drugs that slow your breathing. These include kratom, sleeping pills, antihistamines, muscle relaxers, opioid medications, cough and cold medications, anxiolytics, and epilepsy medication.^[3] Lorazepam may also interact with some antidepressants as well as phenothiazines (first-generation antipsychotics).^[4]

Other interactions

You should not combine lorazepam with alcohol, as this can make you excessively drowsy.^[1] Lorazepam may interact with dietary supplements, vitamins, herbs, and over-the-counter medications, so it’s important to tell your doctor about all of the medications you are taking.^[3]

Lorazepam dosage

Lorazepam oral capsules and extended-release capsules come in 1 mg, 1.5 mg, 2 mg, and 3 mg doses. The oral concentrate of this medication is 2 mg/mL. Oral lorazepam tablets come in 0.5 mg, 1 mg, and 2 mg.^[3]

When prescribed to adults for anxiety, it is common for initial doses of oral lorazepam to be between 2 and 3 mg taken 2 to 3 times per day. Maintenance doses may be between 1 and 2 mg taken 2 to 3 times daily. If taking lorazepam orally for insomnia, it is recommended to take between 2 and 4 mg once daily at bedtime. Depending on the other uses for lorazepam, daily doses may vary from 1 to 10 mg per day. Your doctor will determine the dose that is best for you.^[3]

Lorazepam and integrated therapy

It is recommended to participate in psychotherapy while taking benzodiazepines for optimal results. The exact type of psychotherapy you receive will vary depending on your diagnosis. For example, a therapist may use Cognitive Behavioral Therapy to address negative thought patterns with someone who has an anxiety disorder. A counselor may work with someone who has insomnia to develop sleep hygiene and relaxation techniques that assist them in falling and staying asleep.

Lorazepam FAQs

Can lorazepam be dangerous?

While lorazepam is a safe medication, it can cause dangerous side effects, especially if taken long-term or otherwise misused. Your doctor should monitor your dosage and use to decrease the risk of adverse side effects.

Is lorazepam a controlled substance?

Yes, lorazepam is a Schedule IV controlled substance in the United States. This means it has recognized medical uses and carries the potential for dependence and abuse.

How long does lorazepam last?

The effects of lorazepam can last between 6 and 8 hours, depending on your age and the dose you take.

Author

Brittany Ferri

Brittany Ferri holds a PhD in Integrative Mental Health and is an occupational therapist, health writer, medical reviewer, and book author.

Activity History - Last updated: March 19, 2026, Published date: March 19, 2026

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Reviewer

Geralyn DexterPhD, LMHC

Geralyn Dexter, PhD, LMHC (she/her), is a psychology faculty member, researcher, writer, and licensed therapist with 15 years of experience providing evidence-based care.

Activity History - Medically reviewed on March 23, 2026 and last checked on March 19, 2026