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Lorazepam, also sold under the brand name Ativan, is a benzodiazepine medication commonly prescribed for anxiety, seizures, and insomnia. While it can be an effective treatment for these conditions, it also carries a number of potential side effects. In this article, we will explore the various lorazepam side effects in detail.
1. Drowsiness and Sedation – One of the most common side effects of lorazepam is drowsiness or sedation. This effect can be particularly pronounced in the first few days of treatment, and it may take some time for the body to adjust to the medication. Individuals taking lorazepam may experience difficulty with attention and concentration, as well as impaired motor function. Patients should not operate heavy machinery or drive until they know how the medication affects them
2. Impaired Memory and Cognitive Function – Ativan – Lorazepam can also have an impact on cognitive function, including memory and concentration. This is particularly true in the elderly or in patients taking higher doses of the medication. Some studies have suggested that long-term use of benzodiazepines like lorazepam can increase the risk of developing dementia.
3. Confusion and Disorientation In addition to cognitive impairment, lorazepam can also cause confusion and disorientation. This can be particularly concerning for elderly patients, who may already be experiencing cognitive decline. Patients taking lorazepam should be monitored for signs of confusion, as it may indicate a need to adjust the dosage or discontinue the medication.
4. Respiratory Depression Ativan can also have an impact on the respiratory system, potentially causing respiratory depression. This effect is more pronounced in individuals taking higher doses of the medication or those who are already experiencing respiratory issues. Patients should be monitored for signs of respiratory distress, including shortness of breath, shallow breathing, and wheezing.
5. Addiction and Dependence Ativan – Lorazepam is a habit-forming medication, and long-term use can lead to addiction and dependence. Patients taking the medication for an extended period of time may develop tolerance to the drug, requiring higher doses to achieve the same effect. Abruptly discontinuing the medication can lead to withdrawal symptoms, including seizures and hallucinations.
6. Mood Changes Ativan – Lorazepam can also cause changes in mood, including depression and anxiety. This effect is particularly pronounced in individuals taking higher doses of the medication or those with a history of mental health issues. Patients should be monitored for signs of depression or anxiety, and the medication should be discontinued if these symptoms become severe.
7. Nausea and Vomiting Ativan – Lorazepam can cause gastrointestinal distress, including nausea and vomiting. This effect is typically mild and can be managed with over-the-counter medications, but patients should be monitored for signs of dehydration or other complications.
8. Headache and Dizziness Headache and dizziness are common side effects of lorazepam, particularly in the first few days of treatment. These symptoms may be related to the sedative effects of the medication, and they should resolve as the body adjusts to the drug.
9. Muscle Weakness Ativan can also cause muscle weakness, particularly in individuals taking higher doses of the medication. Patients should be monitored for signs of weakness or difficulty with motor function, and the medication should be discontinued if these symptoms become severe.
10. Skin Rash Ativan – Lorazepam can cause skin rash or hives, particularly in individuals with a history of allergies or sensitivity to benzodiazepines. Patients should be monitored for signs of rash or itching, and the medication should be discontinued if these symptoms become severe.
11. Hypotension Ativan – Lorazepam can cause a drop in blood pressure, leading to hypotension. This effect is more pronounced in individuals taking Lorazepam.
12. Sexual Dysfunction Lorazepam can also cause sexual dysfunction, including decreased libido and erectile dysfunction in men. This effect is more pronounced in individuals taking higher doses of the medication or those with a history of sexual dysfunction. Patients should be monitored for signs of sexual dysfunction, and the medication should be discontinued if these symptoms become severe.
13. Liver Damage Lorazepam can cause liver damage in some patients, particularly those taking higher doses of the medication or those with preexisting liver disease. Patients should be monitored for signs of liver damage, including yellowing of the skin or eyes, dark urine, and abdominal pain.
14. Seizures While lorazepam is often used to treat seizures, it can also cause seizures in some patients. This effect is more pronounced in individuals taking higher doses of the medication or those with a history of seizures. Patients should be monitored for signs of seizure activity, including convulsions or loss of consciousness.
15. Allergic Reactions Lorazepam can cause allergic reactions in some patients, particularly those with a history of allergies or sensitivity to benzodiazepines. Patients should be monitored for signs of allergic reaction, including swelling of the face or throat, difficulty breathing, and hives.
16. Withdrawal Symptoms Abruptly discontinuing lorazepam can lead to withdrawal symptoms, including seizures, hallucinations, and insomnia. Patients should be weaned off the medication slowly to avoid these symptoms.
17. Interactions with Other Medications Lorazepam can interact with other medications, particularly those that affect the central nervous system, such as opioids or other benzodiazepines. Patients should inform their healthcare provider of all medications they are taking to avoid potentially dangerous interactions.
18. Tolerance and Dependence As mentioned earlier, long-term use of lorazepam can lead to tolerance and dependence, requiring higher doses of the medication to achieve the same effect. Patients should be monitored for signs of tolerance and dependence, and the medication should be discontinued if these symptoms become severe.
19. Suicidal Thoughts Lorazepam can cause suicidal thoughts or behavior in some patients, particularly those with a history of depression or anxiety. Patients should be monitored for signs of suicidal ideation, and the medication should be discontinued if these symptoms become severe.
20. Pregnancy and Breastfeeding Lorazepam can be harmful to a developing fetus or nursing infant, and should be avoided during pregnancy and breastfeeding unless the potential benefits outweigh the risks. Patients should consult with their healthcare provider before taking lorazepam if they are pregnant or breastfeeding.
21. Falls and Fractures Lorazepam can increase the risk of falls and fractures, particularly in elderly patients or those with a history of falls. Patients taking lorazepam should be monitored for signs of dizziness or impaired balance, and steps should be taken to minimize the risk of falls, such as using assistive devices or modifying the home environment.
22. Respiratory Infections Lorazepam can increase the risk of respiratory infections, particularly in patients with preexisting respiratory issues. Patients taking lorazepam should be monitored for signs of respiratory infections, such as coughing or shortness of breath.
23. Gastrointestinal Bleeding Lorazepam can increase the risk of gastrointestinal bleeding, particularly in patients taking higher doses of the medication or those with a history of gastrointestinal issues. Patients should be monitored for signs of bleeding, including black or tarry stools or vomiting blood.
24. Cardiovascular Effects Lorazepam can have an impact on the cardiovascular system, potentially causing changes in heart rate or blood pressure. Patients with preexisting cardiovascular issues should be closely monitored while taking lorazepam.
25. Vision Changes Lorazepam can cause vision changes, including blurred vision or difficulty focusing. Patients should be monitored for signs of vision changes and should not operate heavy machinery or drive until these symptoms resolve.
26. Weight Changes Lorazepam can cause weight changes, including weight gain or weight loss. Patients should be monitored for changes in weight and should discuss any concerns with their healthcare provider.
27. Interference with Laboratory Tests Lorazepam can interfere with certain laboratory tests, particularly those measuring liver function or drug levels in the blood. Patients should inform their healthcare provider if they are taking lorazepam to ensure that accurate test results are obtained.
28. Impact on Immune Function Lorazepam can have an impact on immune function, potentially increasing the risk of infections or other immune-related issues. Patients with preexisting immune system issues should be closely monitored while taking lorazepam.
29. Impact on Endocrine System Lorazepam can have an impact on the endocrine system, potentially causing changes in hormone levels or function. Patients with preexisting endocrine issues should be closely monitored while taking lorazepam.
30. Impact on Renal Function Lorazepam can have an impact on renal function, potentially causing changes in kidney function or urine output. Patients with preexisting renal issues should be closely monitored while taking lorazepam.
31. Behavioral Changes Lorazepam can cause behavioral changes, including irritability, agitation, and aggression. These symptoms may be more pronounced in patients taking higher doses of the medication or those with a history of behavioral issues. Patients should be monitored for signs of behavioral changes, and the medication should be discontinued if these symptoms become severe.
32. Anaphylaxis Lorazepam can cause anaphylaxis, a severe and potentially life-threatening allergic reaction. Patients should be monitored for signs of anaphylaxis, including swelling of the face or throat, difficulty breathing, and hives, and should seek immediate medical attention if these symptoms occur.
33. Respiratory Failure In rare cases, lorazepam can cause respiratory failure, a serious condition in which the lungs fail to function properly. Patients should be monitored for signs of respiratory failure, including difficulty breathing, cyanosis (bluish discoloration of the skin), and confusion.
34. Jaundice Lorazepam can cause jaundice, a condition in which the skin and whites of the eyes become yellow due to increased levels of bilirubin in the blood. Patients should be monitored for signs of jaundice, including yellowing of the skin or eyes, dark urine, and pale stools.
35. Stevens-Johnson Syndrome Lorazepam can cause Stevens-Johnson Syndrome, a rare and potentially life-threatening skin condition that can cause blistering and peeling of the skin, as well as mucous membranes such as the mouth and eyes. Patients should be monitored for signs of Stevens-Johnson Syndrome, including rash, blisters, and skin peeling, and should seek immediate medical attention if these symptoms occur.
36. Thrombocytopenia Lorazepam can cause thrombocytopenia, a condition in which there is a low level of platelets in the blood, leading to an increased risk of bleeding. Patients should be monitored for signs of thrombocytopenia, including bruising, bleeding gums, and petechiae (small red or purple spots on the skin).
37. Pancreatitis Lorazepam can cause pancreatitis, a condition in which the pancreas becomes inflamed and swollen, leading to severe abdominal pain, nausea, and vomiting. Patients should be monitored for signs of pancreatitis, and the medication should be discontinued if these symptoms occur.
38. Hypersensitivity Syndrome Lorazepam can cause hypersensitivity syndrome, a rare but potentially life-threatening condition that can cause fever, rash, and multiple organ failure. Patients should be monitored for signs of hypersensitivity syndrome, and the medication should be discontinued if these symptoms occur.
39. Interference with Psychomotor Testing Lorazepam can interfere with psychomotor testing, such as driving tests or other tests of coordination and reaction time. Patients should not participate in these tests until the sedative effects of the medication have worn off.
40. Disinhibition Lorazepam can cause disinhibition, a condition in which patients exhibit impulsive or inappropriate behavior, such as making inappropriate comments or engaging in risky behaviors. Patients should be monitored for signs of disinhibition, and the medication should be discontinued if these symptoms occur.
41. Withdrawal Seizures in Neonates Lorazepam can cause withdrawal seizures in neonates born to mothers who used benzodiazepines during pregnancy. These seizures can be life-threatening and require prompt medical attention.
42. Paradoxical Reactions Lorazepam can cause paradoxical reactions, a rare but potentially serious condition in which patients exhibit the opposite of the desired effect of the medication. For example, instead of feeling sedated, patients may become agitated or hyperactive. Patients should be monitored for signs of paradoxical reactions, and the medication should be discontinued if these symptoms occur.
43. Respiratory Arrest In rare cases, lorazepam can cause respiratory arrest, a serious condition in which breathing stops completely. Patients should be monitored for signs of respiratory distress, and emergency medical attention should be sought if respiratory arrest occurs.
44. Serotonin Syndrome Lorazepam can cause serotonin syndrome, a rare but potentially life-threatening condition in which there is an excessive accumulation of serotonin in the body. Symptoms can include fever, agitation, confusion, tremors, and muscle rigidity. Patients should be monitored for signs of serotonin syndrome, and emergency medical attention should be sought if these symptoms occur.
45. Hyponatremia Lorazepam can cause hyponatremia, a condition in which there is a low level of sodium in the blood. Symptoms can include headache, nausea, vomiting, confusion, and seizures. Patients should be monitored for signs of hyponatremia, and the medication should be discontinued if these symptoms occur.
46. Drug-Induced Psychosis Lorazepam can cause drug-induced psychosis, a condition in which patients experience hallucinations, delusions, and other psychotic symptoms. This effect is more pronounced in individuals taking higher doses of the medication or those with a history of mental health issues. Patients should be monitored for signs of drug-induced psychosis, and the medication should be discontinued if these symptoms become severe.
47. Acute Narrow-Angle Glaucoma Lorazepam can cause acute narrow-angle glaucoma, a serious condition in which there is a sudden increase in pressure inside the eye. Symptoms can include severe eye pain, headache, nausea, and blurred vision. Patients should be monitored for signs of acute narrow-angle glaucoma, and emergency medical attention should be sought if these symptoms occur.
48. Severe Hypotension and Shock Lorazepam can cause severe hypotension and shock, particularly in patients with preexisting cardiovascular issues. Symptoms can include dizziness, lightheadedness, fainting, and rapid heartbeat. Patients should be monitored for signs of severe hypotension and shock, and emergency medical attention should be sought if these symptoms occur.
49. Adverse Effects on Fertility Lorazepam can have adverse effects on fertility in both men and women, including decreased libido, erectile dysfunction, and menstrual irregularities. Patients should discuss any concerns about fertility with their healthcare provider before taking lorazepam.
50. Adverse Effects on Hematopoiesis Lorazepam can have adverse effects on hematopoiesis, the process of blood cell formation. This can result in anemia, leukopenia, or thrombocytopenia, all of which can cause serious health problems. Patients should be monitored for signs of hematopoietic dysfunction, and the medication should be discontinued if these symptoms occur.
51. Increased Risk of Infection Lorazepam can increase the risk of infection, particularly in patients with preexisting immune system issues or those taking higher doses of the medication. Patients taking lorazepam should be monitored for signs of infection, such as fever, chills, or sore throat, and should seek medical attention if these symptoms occur.
52. Cognitive Impairment in the Elderly Lorazepam can cause cognitive impairment in the elderly, particularly in patients taking higher doses of the medication. This can lead to confusion, memory problems, and difficulty with attention and concentration. Elderly patients taking lorazepam should be closely monitored for signs of cognitive impairment.
References
1, Comparison of the actions of diazepam and lorazepam
Diazepam and lorazepam differ in potency and in the time-course of their action. As a sedative, diazepam 10 mg is equivalent to lorazepam 2-2.5 mg.
2, The effects of benzodiazepines on cognition
Initially thought to be virtually free of negative effects, benzodiazepines are now known to carry risks of dependence, withdrawal, and negative side effects. Among the most controversial of these side effects are cognitive effects.
3, Lorazepam-efficacy, side effects, and rebound phenomena
Lorazepam, 4 mg, was evaluated in an 18-night sleep-laboratory study involving five insomniac subjects. Hypnotic effectiveness and effects on sleep stages and related parameters were assessed.
4. Effects of lorazepam on prosaccades and saccadic adaptation
Background: Benzodiazepines have reliable adverse effects on saccadic eye movements, but the impact of sex as a potential modulator of these effects is less clear. A recent study reported stronger adverse effects on the spatial consistency of saccades in females, which may reflect sex differences in cerebellar mechanisms.
5. Effects of Intramuscular Midazolam and Lorazepam on Acute Agitation in Non-Elderly Subjects – A Systematic Review
Benzodiazepines are commonly used for the treatment of acute agitation in a psychiatric setting.We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant publications.
6. Lorazepam-induced diplopia
Diplopia – seeing double – is a symptom with many potential causes, both neurological and ophthalmological. Benzodiazepine induced ocular side-effects are rarely reported. Lorazepam is one of the commonly used benzodiazepine in psychiatric practice.
7. Acute lorazepam effects on neurocognitive performance
A double-blind, placebo-controlled, crossover design was employed to determine whether acute lorazepam (2 mg orally) cognitive side effects would emerge in a differential age-dependent fashion in 15 young (mean age=22 years) and 12 older (mean age=64 years) subjects. Acute use of lorazepam is frequently the initial treatment choice for convulsive status epilepticus or repetitive seizure clusters.
8. Efficacy and side effects of lorazepam, oxazepam, and temazepam as sleeping aids in psychogeriatric inpatients
The efficacy and side effects of 2 mg of lorazepam, 30 mg of oxazepam, and 20 mg of temazepam as sleeping aids were investigated in 20 psychogeriatric inpatients. The drugs were administered in a random order, double-blind, for 7 night each.
9. Effects of lorazepam on saccadic eye movements: the role of sex, task characteristics and baseline traits
Background: Saccadic eye movements are controlled by a network of parietal, frontal, striatal, cerebellar and brainstem regions. The saccadic peak velocity is an established biomarker of benzodiazepine effects, with benzodiazepines reliably reducing the peak velocity.
10. Subjective and behavioral effects of diphenhydramine, lorazepam and methocarbamol: evaluation of abuse liability
The effects of orally administered placebo, diphenhydramine, lorazepam, methocarbamol and placebo were studied in volunteers with histories of recreational substance abuse including sedative/hypnotics.