Can You Overdose on Ativan (Lorazepam)?

Ativan (lorazepam) is a benzodiazepine drug commonly prescribed for anxiety disorders. Although the drug can be helpful when taken exactly as prescribed, it is also a controlled substance that carries the risk of dependence, abuse, addiction and overdose. If you or a loved one take Ativan, ensuring you are using the drug appropriately is important to avoid complications, including overdose.

What Are the Side Effects of Ativan?

When taken as prescribed, Ativan’s side effects are generally mild to moderate and tend to diminish as the body adjusts. Nonetheless, everyone’s response to Ativan can be different. Common side effects include:

• Drowsiness and Sedation: Because Ativan enhances GABA’s effect in the central nervous system, it can cause drowsiness and a sense of relaxation or fatigue.
• Dizziness: A feeling of dizziness or lightheadedness may arise, especially after starting the medication.
• Blurred Vision: Some people experience slight changes in vision.
• Headache: Headaches can accompany dizziness or fatigue.
• Nausea: Gastrointestinal upset may occur when first taking Ativan.
• Changes in Appetite: Some may notice an increase or decrease in appetite.

Less common side effects of Ativan may include memory problems, confusion, changes in mood or changes in libido. If these symptoms worsen or become difficult to manage, it is important to consult a healthcare provider.

Even though these side effects can be uncomfortable, they are generally not dangerous on their own. However, the real concern arises when Ativan is used incorrectly, used for an extended period or mixed with other substances like opioids or alcohol — situations that can heighten its risks significantly.

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Ativan Effects on the Body

Ativan primarily affects the central nervous system (CNS). By binding to GABA receptors, it amplifies GABA’s inhibitory action, slowing down nerve activity. This decrease in neural excitation can have several effects on the body:

• Muscle Relaxation: The medication’s sedative nature often results in relaxed muscles, which can be beneficial for certain conditions like tension headaches or muscle spasms.
• Reduced Blood Pressure: Since it calms overall physiological activity, it may lead to a modest drop in blood pressure.
• Slowed Breathing: The drug’s sedative properties may lead to a decrease in respiratory rate, which is a key concern during an overdose.
• Decreased Coordination and Reaction Time: Because CNS depression slows down responses, it can impair coordination and reflexes. This increases the risk of accidents and injuries, such as falls or car accidents, particularly in older adults.

Over the long term, the body can develop a tolerance to Ativan. Tolerance means that the original prescribed dose may no longer provide the same effect, prompting some individuals to take higher doses to achieve the desired level of sedation or relief from anxiety. This escalation can precipitate dependency and elevate the risk of an overdose.

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Ativan Effects on the Mind

Ativan is well-known for its sedative and anxiolytic properties, meaning it can:

• Reduce Anxiety: By enhancing GABA activity, Ativan can be effective at calming racing thoughts and easing anxiety symptoms.
• Promote Relaxation: Many people report a sense of tranquil well-being, especially when first using the medication.
• Cause Memory Impairment: When used in higher doses or over long periods, Ativan can cause short-term memory issues, including difficulty forming new memories (anterograde amnesia).
• Induce Confusion or Disorientation: In some individuals, especially older adults, Ativan may lead to confusion, disorientation or paradoxical reactions like agitation.

If misused, the psychological effects of Ativan can intensify, potentially exacerbating mental health struggles. Prolonged misuse can contribute to changes in mood and cognition, creating a cycle in which a person relies on higher doses of Ativan to function normally or cope with stress.

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Can You Overdose on Ativan?

Yes, it is possible to overdose on Ativan. As a potent benzodiazepine, Ativan can significantly depress the central nervous system if taken in large amounts or combined with other CNS depressants. While benzodiazepines alone are less likely to be fatal in overdose compared to other drugs, a large dose of Ativan can be dangerous and may lead to severe complications, including respiratory failure.

A major risk factor for overdose arises when Ativan is combined with other substances such as alcohol, opioids or certain medications. Both alcohol and opioids also depress the central nervous system, making the cumulative effect far greater than each substance alone. This combined effect can lead to life-threatening respiratory depression and coma.

Another scenario that increases overdose risk is when someone tries to stop using Ativan but relapses, taking the same high dose they used before. Their tolerance may have decreased during withdrawal, and the previously “tolerable” amount can now overwhelm the body’s systems.

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Signs of Ativan Overdose

Recognizing the symptoms of an Ativan overdose can be crucial in seeking timely medical help. Common signs include:

• Extreme Drowsiness or Unresponsiveness: Someone overdosing on Ativan may appear lethargic or even slip into a comatose state.
• Confusion: This can range from mild disorientation to a profound inability to recognize people or surroundings.
• Slurred Speech: Because the drug slows neurological activity, speech may become incoherent.
• Impaired Coordination: Over-sedation can cause stumbling, an unsteady gait or general clumsiness.
• Slow or Shallow Breathing: Respiratory depression is a critical sign of an overdose. If a person’s breathing rate drops too low, it can lead to organ damage from lack of oxygen.
• Low Blood Pressure and Weak Pulse: In severe cases, blood pressure and heart rate may drop dangerously.

If you suspect someone is overdosing on Ativan, call emergency services immediately. While waiting for help, keep the individual awake and upright if possible, monitor their breathing and be prepared to provide any information about what substances and doses were taken.

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Ativan Withdrawal Symptoms

Because Ativan can be habit-forming, stopping its use suddenly or drastically reducing the dose can lead to withdrawal symptoms. These symptoms may include:

• Rebound Anxiety: A return or escalation of anxiety symptoms, often more intense than before starting the medication.
• Insomnia: Difficulty falling or staying asleep.
• Irritability: Changes in mood, anger or heightened agitation.
• Sweating: Night sweats or profuse sweating during the day.
• Tremors: Shaking hands or other uncontrollable muscle movements.
• Nausea or Vomiting: Gastrointestinal distress is common.
• Seizures: In severe cases, abrupt withdrawal from high doses of Ativan can trigger seizures, a medical emergency.

Tapering off Ativan under the supervision of a healthcare provider can help mitigate withdrawal symptoms. Stopping “cold turkey” can be dangerous and may lead to serious complications, highlighting the importance of medical guidance during any discontinuation process.

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Ativan Addiction Diagnostic Criteria

Benzodiazepine use disorder, including Ativan addiction, is usually diagnosed by a medical or mental health professional using criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Although only a professional can provide an official diagnosis, the DSM-5 criteria involve patterns such as:

• Taking More Than Intended: Persistent desire or unsuccessful efforts to cut down or control Ativan use.
• Excessive Time Spent: Spending a lot of time obtaining, using or recovering from Ativan’s effects.
• Cravings: Strong urges to use Ativan.
• Failure To Fulfill Obligations: Repeated neglect of home, work or school responsibilities because of Ativan use.
• Continued Use Despite Problems: Ongoing use despite social, occupational, physical or psychological issues caused or worsened by Ativan.
• Tolerance: Needing more Ativan to achieve the same effect or noticing less effect with continued use of the same amount.
• Withdrawal: Experiencing withdrawal symptoms or taking Ativan (or a similar substance) to avoid these symptoms.

Healthcare professionals may also consider the severity of these symptoms (mild, moderate or severe) when determining a treatment plan. If you suspect that you or a loved one has an Ativan addiction, seeking professional assessment and guidance is the best course of action.

Ativan Overdose Treatment

A person overdosing on Ativan is normally treated in the hospital with observation and supportive care. The medical team ensures the person’s breathing, heartbeat and circulation are normal and can intervene if there are problems. Although a benzodiazepine reversal agent, flumazenil, exists, it is rarely used due to severe toxicity concerns.

If you or a loved one is concerned about an Ativan addiction, help is here. Our Ativan experts at The Recovery Village Cherry Hill at Cooper can help you overcome your Ativan struggle. With a custom medical detox program to help you get off Ativan and rehab treatments to help keep you off the drug, we are with you every step of the way. Don’t wait: contact us today to see how we can help.