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Ativan: Understanding the Short- and Long-Term Effects

Imagine having an anxiety or panic disorder and needing additional help. Ativan (lorazepam) can act as a miracle medication for those who deal with the stress of chronic anxiety.

Like all medications, Ativan comes with the risk of short-term and long-term effects. These effects are heightened when the drug is abused.

Ativan Overview

Ativan is a benzodiazepine, according to MedlinePlus. These types of drugs decrease brain activity and help people relax during a stressful event or when symptoms of anxiety surge.

The medication is sold as an oral solution (liquid) and a tablet. Doctors will typically explain how to take Ativan, and the prescription is usually ingested two to three times per day, as needed.

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People should not take Ativan for more than 16 weeks (four months). Those who take the drug may decide they want to quit, but no one should stop taking Ativan cold turkey. This is because Ativan works with neurotransmitters in the brain to control anxiety. It changes the brain and leads to physical dependence.

Some people may begin to feel the negative side effects of Ativan and decide they want to stop taking it.

Benzodiazepine withdrawal can be intense and even life-threatening. Generally, doctors will gradually wean their patients off benzodiazepines rather than stopping use suddenly.

Short-Term Effects 

Ativan should be prescribed for only a few weeks at a time, and it should not be taken for longer than four months.

Psychology Today mentions that doctors have been raising concerns about Ativan’s effects on the brain since at least the 1970s.

Short-term effects of Ativan come as a result of how it works to slow the body’s central nervous system to reduce the fight-or-flight mode that causes anxiety. Some side effects with short-term use include the following:

  • Changes in libido
  • Sleepiness
  • Dry mouth
  • Nausea
  • Dizziness
  • Loss of coordination
  • Headaches

Ativan can also have severe side effects.

  • Moodiness
  • Respiratory issues
  • Suicidal ideation
  • Difficulty walking

Psychology Today mentions that people also experience withdrawal if they try to quit benzodiazepines even after using them for a short time. Rapid physical dependence and dangerous withdrawal symptoms are some of the primary concerns with regular benzodiazepine use.

Long-Term Use 

Writer Harriet Brown published an article in 2017 for Tonic where she explained what it was like for her to get off Ativan after using it for eight years. Brown mentioned that after a while, she felt her memory was becoming fuzzy. She felt like she was losing her coordination and balance.

Brown described feeling anxiety when she would forget an Ativan dose and knew that quitting was going to be difficult. Per Psychology Today, various medical organizations have expressed concerns about loss of coordination brought on by long-term use of benzodiazepines since 1989.

A 2014 study published in Progress in Neuropharmacology & Biological Psychiatry mentioned concerns about long-term side effects of people over the age of 65.

  • Some side effects of benzodiazepines were seen after only one to three weeks of use.
  • The elderly are more likely to lose their coordination if they use benzodiazepines such as Ativan for a long time.
  • The elderly had problems recalling information within one to two hours of taking an oral dose of lorazepam.

Taking Ativan for a long time may also cause a person to experience withdrawal.

  • Interdose withdrawal: This can happen with any drug, and it means a patient is experiencing symptoms of withdrawal between doses of medication. A 2009 study published in Drug and Alcohol Dependence mentioned that the negative moods this can cause can have an effect on a person’s satisfaction levels during recovery
  • Risk of being diagnosed with Alzheimer’s disease: Harvard Medical School mentions that people who take benzodiazepines for a long time are at risk of being diagnosed with Alzheimer’s. Harvard Medical School warns that:
    • People who used benzodiazepines for 12 weeks (three months) or less displayed no more risk for Alzheimer’s than people who had never used the drugs.
    • Using benzodiazepines for three to six months increased the risk of being diagnosed with Alzheimer’s disease by about 32 percent
    • Using benzodiazepines for six months or longer increased the chances by up to 84 percent.

Harvard Medical School also mentioned that the type of benzodiazepine a patient uses plays a role in their diagnosis. Ativan is considered a short-acting benzodiazepine that poses fewer risks than long-acting medications, such as Valium.

Older adults should avoid using benzodiazepines because of their long-term effects. The loss of coordination they cause can also result in accidents or falls.

Ativan and the Brain

Though more research is needed to explain the brain damage potential of Ativan, there are a few things we do know today that could make clear why it causes harm.

The National Institute on Drug Abuse (NIDA) says that tolerance to a drug is dangerous to health because using drugs to provoke a reaction can make it harder for the brain to reward itself through natural means.

For example, if a person consistently uses Ativan to relax, it will become harder for them to rest on their own without the medication.

It can take between one to six weeks to get rid of Ativan in the body, depending on how much of it was taken and for how long. Harriet Brown mentioned in her account on Tonic that it took a full 10 months to stop using Ativan, and she felt some symptoms of withdrawal for six months after becoming sober.

Can Brain Damage Be Reversed?

Brain damage that results from Ativan and other benzodiazepines still need to be further studied. The National Institute on Drug Abuse explains a few things about general brain damage from all types of drugs.

  • The consistent use of any drug or medication can change the brain’s reward circuit, making it hard for people to feel pleasure the way they used to before using substances.
  • People who experience a seizure or stroke may encounter brain damage that cannot be reversed.

With time and treatment, less severe changes to the brain can be treated.

Tapering off Ativan with a doctor’s help can help people who feel they have become dependent on the drug.

Taking Ativan as directed, not combining it with other substances, and talking to your doctor about your concerns can prevent brain damage and other dangerous effects of long-term Ativan use.

Sources

(November 2018) How Does Ativan (Lorazepam) Work? Verywell Mind. from https://www.verywellmind.com/ativan-lorazepam-2584283

(April 2018) How Long Does Ativan Stay in Your System? Verywell Mind. from https://www.verywellmind.com/how-long-does-ativan-stay-in-your-system-80222

(May 2017) Lorazepam. MedlinePlus. from https://medlineplus.gov/druginfo/meds/a682053.html

(September 2014) Adverse performance effects of acute lorazepam administration in elderly long-term users: pharmacokinetic and clinical predictors. Progress in Neuropharmacology & Biological Psychiatry. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258460/

(September 2017) Taking the Benzodiazepine Ativan (Lorazepam). Verywell Mind from https://www.verywellmind.com/benzodiazepine-ativan-lorazepam-379676

(November 2010) Brain Damage from Benzodiazepines: The Troubling Facts, Risks, and History of Minor Tranquilizers. Psychology Today. from https://www.psychologytoday.com/us/blog/side-effects/201011/brain-damage-benzodiazepines-the-troubling-facts-risks-and-history-minor

(February 2019) Lorazepam (Oral Route). Mayo Clinic. from https://www.mayoclinic.org/drugs-supplements/lorazepam-oral-route/side-effects/drg-20072296?p=1

(January 2017) I Tried To Get Off Ativan. Tonic. from https://tonic.vice.com/en_us/article/nzn8dq/i-tried-to-get-off-ativan

(December 2016) Benzodiazepine use may raise risk of Alzheimer’s disease. Harvard Medical School. from https://www.health.harvard.edu/blog/benzodiazepine-use-may-raise-risk-alzheimers-disease-201409107397

(December 2009) Exploring the relationship between perceived inter-dose opioid withdrawal and patient characteristics in methadone maintenance treatment. Drug and Alcohol Dependence. from https://www.ncbi.nlm.nih.gov/pubmed/19713051

(July 2018) Drugs and the Brain. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

(March 2017) Health Consequences of Drug Misuse: Neurological Effects. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/health-consequences-drug-misuse/neurological-effects

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