Anxiety disorder treatment drug – Ativan

What is Ativan?

Ativan is a brand name used by Biovail Pharmaceuticals for lorazepam. This is one of the longest-acting benzodiazepines and is used orally as an anxiolytic and by injection to treat nervous tension and seizures. Ativan is highly addictive and so, if used for sleep induction, should be only used in the short term. It is useful in the sedation of hospital patients and aggressive individuals. Because of its strong amnesic properties it has been widely exploited for criminal purposes, particularly sexual assault.

ativanHow does Ativan work?

Like all benzodiazepines, Ativan works by enhancing the effects of GABA. It is a classic benzodiazepine which acts at benzodiazepine sites on GABA receptors throughout the central nervous system. Ativan has strong affinity for GABA receptors which is believed to be the reason for its potent amnesic effect.

What does Ativan look like?

Ativan is presented as white pentagonal pills with strengths from 0.5 to 2 mg. It is also sold in injectable and oral liquid forms. It may be taken with or without food.

Ativan dosing and administration

When Ativan is used for its anxiolytic effect the recommended initial dosage is 1 mg two to three times daily. The standard starting dose for insomnia is between 2 and 4 mg at bedtime. Because elderly patients tend to more sensitive to Ativan, the starting dose should be halved in these patients.

Common adverse effects from Ativan

Because it is effective at a low dosage, the side effects of Ativan are generally not as problematic as those of other diazepines. Most common are sedation, vertigo, weakness, lethargy, coordination problems, fatigue, memory problems, problems with balance, confusion, disorientation, vision disturbances, slurring of speech, nausea, constipation, changes in libido, erectile dysfunction, delayed orgasm, alopecia and mild hypotension. Less frequent but more serious side effects may include depression, suicidal thoughts, dyspnea, epilepsy, anxiety or rage, insomnia, hallucinations and allergic reactions. You should inform your doctor if you experience any of these more serious side effects.

Ativan warnings and precautions

Ativan has strong addictive potential and the long term effects included tolerance and dependence, withdrawal syndrome and partially irreversible cognitive impairment. Because of these problematic side effects, it should be used short term and at the lowest dosage needed to achieve the desired effect. When ceasing Ativan therapy, particularly from a high dose or after a longer period, the dosage should be tapered gradually over a number of weeks in order to avoid withdrawal symptoms. Ativan should never be taken with alcohol or other central nervous system depressants because of the danger of dangerously lowered respiratory function. Ativan should never be used for more than 2-4 weeks continually because of the risk of withdrawal.

Interactions with Ativan

Other drugs which may interact with Ativan include alcohol, anesthetics, all antidepressants, antipsychotics such as arpriazole, asenapine, chlorpromazine, clozapine, fluphenazine, haloperidol, iloperidone, loxapine, lurasidone, molindone, olanzapine, paliperidone, perphenazine, pimozide, prochlorperazine, quetiapine, risperidone, thioridazine, thiothixene, trifluoperazine and ziprasidone, all barbiturates and narcotics, divalproex sodium, any other benzodiazepines, probenecid, seizure medications and sleep medications.