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Ativan and Lorazepam: Signs and Symptoms of Abuse

Like all prescription drugs, Ativan use can lead to troubling consequences, particularly when it comes to the central nervous system. Ativan side effects are too numerous to mention herein and their incidence is unknown. Hives, difficulty breathing or swelling of the face, lips, tongue or throat indicate an allergic reaction and require emergency intervention (call 911).1 In addition, the following symptoms may indicate a lorazepam overdose and 911 should be called without delay:

  • Reduced blood pressure
  • Rapid heart rate with weak pulse
  • Difficulty breathing
  • Clammy skin
  • Increased sweating
  • Dilated pupils
  • Lethargy
  • Profound sedation
  • Loss of control over body movements
  • Depressed reflexes2

If any of the following serious lorazepam symptoms occur, a physician should be contacted immediately.1,3

  • Confusion
  • Depressed mood
  • Thoughts of suicide or hurting oneself
  • Sudden hyperactivity or agitation
  • Unusual changes in mood or behavior
  • Hostility or aggression
  • Hallucinations
  • Feeling lightheaded
  • Fainting
  • Severe drowsiness
  • Worsening sleep problems
  • Muscle weakness
  • Drooping eyelids
  • Trouble swallowing
  • Vision changes
  • Upper stomach pain
  • Dark urine
  • Jaundice (yellowing of the skin or eyes)1,3

Short-Term Ativan Symptoms

  • Reduced feelings of physical and psychological anxiety, worries or tension
  • Increased feelings of euphoria
  • Heightened sense of well-being
  • Drowsiness or tiredness
  • Dizziness
  • Sleep problems
  • Lack of balance or coordination4

Possible Signs of Ativan Abuse

  • Blurred vision
  • Muscle weakness
  • Slurred speech
  • Lack of coordination
  • Impaired judgment
  • Reduced reaction time
  • Memory loss
  • Confusion
  • Hallucinations
  • Impaired temperature regulation
  • Skin irritation or rash
  • Low blood pressure
  • Slow or shallow breathing
  • Depression
  • Suicidal thoughts
  • Agitation
  • Personality changes2

Behavioral Signs of Ativan Abuse

  • Irritability
  • Changing friends
  • Becoming more secretive
  • Running out of medication before anticipated
  • Visiting different physicians for multiple prescriptions
  • Stealing prescription pads
  • Forging prescriptions
  • Stealing money or medications2

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, a new diagnosis of sedative, hypnotic and anxiolytic use disorder requires at least two of the following criteria:5

  • Continued use of a substance, e.g. a benzodiazepine such as Ativan or other sedative-hypnotic, despite negative personal consequences.
  • Repeated inability to carry out major functions at work, school or home due to use.
  • Recurrent use in physically hazardous situations.
  • Continued use despite recurrent, persistent or worsening social or interpersonal problems associated with use.
  • Tolerance, manifested by needing a markedly increased dose to achieve intoxication or desired effect, or by markedly diminished effect with continued use of the same amount.
  • Withdrawal accompanied by characteristic symptoms, or use of the drug to avoid withdrawal.
  • Using more of the drug or for a longer period than intended.
  • Persistent desire to reduce use or unsuccessful attempts to control use.
  • Spending a lot of time obtaining, using or recovering from use of the substance.
  • Stopping or decreasing important work, social or recreational activities due to use.
  • Craving or strong desire to use.5

Many side effects dissipate after drug cessation. Some degree of cognitive impairment may remain, even after detox and rehab, especially in older adults. Moreover, research indicates the cognitive impact of benzo abuse can accelerate the rate of mental decline associated with existing cases of dementia.4

  1. RX List website. http://www.rxlist.com/ativan-drug.htm Updated September 27, 2016. Accessed February 7, 2017.
  2. What Does a Lorazepam Overdose Look Like? Project Know website. http://www.projectknow.com/research/lorazepam-overdose/?v=lib1-control Accessed February 7, 2017.
  3. Drugs website. https://www.drugs.com/pro/lorazepam.html Updated February 6, 2017. Accessed February 7, 2017.
  4. The Effects of Ativan Use. Drug Abuse website. http://drugabuse.com/library/the-effects-of-ativan-use/ Accessed February 7, 2017.
  5. Sedative, Hypnotic and Anxiolytic Use Disorder DSM-5 304.1 (F13.1). Theravive website. http://www.theravive.com/therapedia/Sedative,-Hypnotic-and-Anxiolytic-Use-Disorder-DSM–5-304.1-(F13.1) Accessed February 7, 2017.
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