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Lorazepam and Ativan FAQs

Misconceptions about benzodiazepines such as Ativan (lorazepam) can have detrimental and potentially lethal consequences. The following Ativan facts will help readers separate fact from fiction and dispel myths. Having accurate knowledge about this powerful prescription drug is empowering and may even be lifesaving, because even unintentional abuse can result in a fatal lorazepam overdose.

Is Injectable Lorazepam Used Routinely?

No, intravenous or intramuscular administration of 2 mg to 4 mg of lorazepam is used primarily in preoperative adults. Injection typically results in dose-related sedation effects (sleepiness or drowsiness), relief of preoperative anxiety and lack of recall of events related to the day of surgery. The clinical sedation is minimal, enabling most people to be able to respond to simple instructions even if they have the appearance of being asleep.1

It is also used for status epilepticus, a condition causing continuous seizures, for intubated individuals who cannot breathe on their own (e.g. in severe pneumonia), to prevent nausea and vomiting in individuals undergoing chemotherapy, and to treat delirium.2

Is It Safe to Take Ativan With Alcohol?

No, the use of any benzodiazepine with alcohol is not recommended. Alcohol can increase the central nervous system (CNS) side effects of Ativan, including dizziness, drowsiness and concentration problems and in some cases, impaired thinking and judgment. Individuals with acute alcohol intoxication already exhibit depressed vital signs. The CNS depressant effects of benzodiazepines may compound those of alcohol, resulting in severe respiratory depression and death. Therapy with benzodiazepines must be administered cautiously in individuals with a propensity for acute alcohol use.3

How Is Lorazepam Intentionally Abused?

All benzodiazepines, particularly those with a rapid onset such as lorazepam, are abused to produce a euphoric effect. This behavior is often associated with multiple-substance abuse such as methadone and cocaine. Benzodiazepines taken by those who abuse them usually exceed recommended therapeutic doses. Their availability and synergistic effects with alcohol and other CNS depressants provide high potential for inducing states such as hypnosis, anterograde amnesia and muscle relaxation. As such, benzodiazepines have been used as adulterating agents in alcohol, nonalcoholic drinks and food to perpetrate crimes such as sexual assault and robbery.5

What Is the Difference Between Ativan and Xanax?

Both drugs are benzodiazepines designed for short-term use. They impart their effects by slowing down the CNS, thereby providing a tranquilizing effect. While Ativan (lorazepam) is approved for individuals age 12 and older, Xanax (alprazolam) is FDA-approved in adults age 18 and older. Although both are used to treat anxiety disorder or anxiety associated with depression, off-label usage varies greatly.6 Additional clinical uses of lorazepam include:

  • Irritability
  • Mania
  • Pre-surgery sedation
  • Alcohol withdrawal
  • Chemotherapy-induced vomiting
  • Status epilepticus or severe, recurring seizures6

Additional clinical uses of alprazolam include:

  • Irritable bowel syndrome
  • Severe premenstrual syndrome
  • Essential tremor
  • Ringing in the ears (e.g. tinnitus)6

Statistics suggest Xanax is subject to more abuse than Ativan. In 2015, Xanax was the ninth-bestselling drug and fifth-most-prescribed drug in the U.S. One in 11 high school seniors admitted abusing Xanax at some point in their lives and 49% of teens who used Xanax combined it with another substance such as alcohol.7,8

  1. Lorazepam Injection. Drugs website. https://www.drugs.com/pro/lorazepam-injection.html Updated February 6, 2017. Accessed February 7, 2017.
  2. Lorazepam Injection. WebMD website. http://www.webmd.com/drugs/2/drug-3953/lorazepam-injection/details Accessed February 7, 2017.
  3. Ativan (lorazepam) Disease Interactions. Drugs website. https://www.drugs.com/disease-interactions/lorazepam,ativan.html#Acute_Alcohol_Intoxication Updated February 6, 2017. Accessed February 7, 2017.
  4. U.S. Drug Enforcement Administration website. https://www.deadiversion.usdoj.gov/drug_chem_info/benzo.pdf Published January 2013. Accessed February 7, 2017.
  5. Soltaninejad K, Karimi M, Nateghi A, Daraei B. Simultaneous Determination of Six Benzodiazepines in Spiked Soft Drinks by High Performance Liquid Chromatography with Ultra Violet Detection (HPLC-UV). Iran J Pharm Res. 2016;15(2):457-463.
  6. Lorazepam vs. Xanax: What’s the Difference? Healthline website. http://www.healthline.com/health/mental-health/lorazepam-vs-xanax#Overview1Published July 20, 2016. Accessed February 7, 2017.
  7. Xanax: Side Effects, Drug Information. Medical News Today website. http://www.medicalnewstoday.com/articles/263490.php Updated February 4, 2016. Accessed February 7, 2017.
  8. 20 Profound Xanax Addiction Statistics. Health Research Funding website. http://healthresearchfunding.org/20-profound-xanax-addiction-statistics/ Published February 1, 2015. Accessed February 7, 2017.
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