Ativan for Anxiety
Anxiety is a common feeling which every human being experiences whenever one gets excited or nervous. This feeling is considered normal as it is part of human emotions, however, if the anxiety levels becomes aggravated, it results out into disorders characterized by mental illness and distress in carrying out day to day work. Worry and fear become a constant part of their living which can further result out into depression. Ativan is the drug which physicians prescribe normally to lower down the anxiety levels.
What is Ativan?
Ativan is the brand name for lorazepam which belongs to pharmacological class, benzodiazepine. It provides a short term relief for symptoms of excessive anxiety. It is available as oral tablets, injection for emergency purpose as well as in oral concentrate solution dosage form. Ativan may be a habit forming drug and therefore it is very important to take it only with physician’s advice. Therefore it is sold as a prescription drug.
How Does Ativan Work in Treating Anxiety?
Ativan acts in the human body by increasing the level of GABA (Gamma Aminobutyric Acid) chemical in the brain. GABA is a natural brain chemical that acts as an inhibitory chemical and instructs the neurons to slow down or stop firing. Around 40% of the neurons respond to GABA, therefore it is quite effective in marking a slowdown influence on the brain, hence, leading to a hypnotic or tranquilizer type action.
Thus by increasing the level of GABA in the body, Ativan creates a slowdown effect, which leads to a decrease in the levels of anxiety.
Effectiveness of Ativan
As per physicians, following are the medical conditions where in Ativan is highly effective:-
- Anxiety, phobias and panic disorders
- Muscle Spasm
- Spastic Disorder
- Sedation before minor surgical procedure
- Pre-medication before operation
- Acute psychosis along with aggressiveness and hyper excitability
The medication Ativan usually starts showing the positive effects in the human body in half an hour after the consumption of medication depending upon the prevailing conditions and the number of risk factors associated with the subject. Depending upon the level of anxiety, with time, physician may decide to stop or continue. Initially the physician may start with 2-3 dose of Ativan a day and after seeing the progress, he may decide to reduce the number of dose in the tapering manner and finally withdraw Ativan, once the symptoms of anxiety cease.
Dosage of Ativan
Ativan is available as oral tablets in the dosage strengths of Ativan 0.5 mg, Ativan 1 mg and Ativan 2 mg. As injections, it is available in the dosage strength of 2 mg/ml and 4 mg/ml and is administered either intravenously or intramuscularly. Depending upon the patient’s age, weight, height and the severity of the condition, the physician prescribes the required dosage strength of Ativan. Compliance with the prescription regime, as decided by the physician is very important to get well on time.
Side Effects of Ativan
Side effect is termed as an unsolicited reaction in a human body, to a medication, when taken in normal doses (therapeutic dose), as prescribed by the doctor. Side effects of Ativan range from temporary to severe and in worst cases, can even be permanent. It is therefore important to be conscious of any undesirable change that may occur, post consumption of the medication.
Following are some of the side effects of the Ativan:-
Category 1 – Temporary Side Effects of Ativan
This category includes the most common form of side effects of Ativan which are easy to manage and gets reversed after the withdrawal of the medication or after the drug gets excreted out from the body. The temporary side effects of Ativan are as follows:-
- Low blood pressure
- Excessive sleepiness
Category 2 – Severe Side Effects of Ativan
This category of side effects include the undesirable changes that occur in the body after the consumption of Ativan which are dangerous for the human body and if not addressed on time, can even lead to the death of the patient. The serious side effects of Ativan are as follows:-
- Respiratory IssuesWhile consuming Ativan, following are the various types of side effects that may be visible in the human body:-
- Shallow breathing
- Weakness in the body leading to difficulty in breathing
- Slowness in the breathing rate
- Paradoxical Reaction
- Paradoxical reactions occur in the body when the individual’s body does not respond to the medication as desired. It is also termed as an opposite reaction to the medication. The symptoms of the paradoxical reaction to Ativan are as follows:-
- A high sense of irritability
- An urge of agitation
- Periods of intense excitement, also termed as mania or joy
- Hallucination feelings wherein a person starts hearing or seeing the things that do not exist
- High on aggression
- Psychosis wherein a person feels that he or she has lost his touch with the reality.
- Loss of muscle coordination leading to trouble in walking
- Decrease in the levels of consciousness
- Slurred speech
What Your Physician Should Know While You Take Ativan?
Ativan is a prescription drug and has a black box warning attached to it. Therefore your physician ought to know about the below mentioned condition(s) while prescribing Ativan. Ignoring or forgetting to tell him about any of the below mentioned conditions while consuming Ativan can lead to serious issues and may even lead to the death of the patient.
It is important to let your physician know about your habit of consuming alcohol, even if it is just 30 mL a day as taking Ativan along with alcohol can increase the risk of drowsiness. Excess consumption of alcohol with Ativan may initially cause breathing issues and can eventually lead to death. The ideal gap that a person should maintain between consuming alcohol and Ativan is at least 24 – 48 hours.
In case if you are suffering from narrow angel glaucoma, please let your physician know about it as consuming Ativan in such a condition can lead to the worsening of the situation.
Patients suffering from breathing issues such as COPD (Chronic Obstructive Pulmonary Disease) as well as sleep apnea should avoid takin Ativan as lorazepam present in it worsens COPD and can even turn out to be fatal.
Depression and Psychosis
Your physician needs to know about your episodes of depression or Psychosis, as prescribing Ativan in such cases may lead to the worsening of the situation and the patient may enter the stage of coma or death.
Any drug that is consumed, is excreted by kidneys however in case of unhealthy kidneys, the drug may not get excreted properly and its deposition may start occurring in the blood. As a result, various side-effects associated with Ativan may start occurring in the body that may range from temporary to permanent. Therefore, do let your physician know about your kidney disease while getting treated with Ativan.
The function of the liver is to metabolize the drug consumed by the human body. In case the liver is not functioning properly, the drug shall not be broken down by the liver properly. As a result, the drug gets excreted out from the body, in an indigested form, without lowering down the levels of anxiety. If your physician is aware of your liver issues, he may reduce the dose of Ativan, such that your liver is able to metabolize it comfortably.
Allergies to Benzodiazepines
Do let your physician know about your medical history of allergies to benzodiazepines as consuming Ativan in such a case can cause severe allergic reactions leading to the development of following conditions:-
- Rashes all over the body
- Difficulty in breathing
- Swelling of lips, face, throat or tongue
As per the clinical trials of Ativan on pregnant women, it has been classified as ‘D’ category drugs which means that it is not safe for pregnant women as it shows adverse effects on fetus. If it is a necessity to administer Ativan to a pregnant woman, the physician should evaluate the potential benefit vs potential risk and if the potential benefit outweighs the potential risk, then only the drug should be administered.
As per the research studies done, it has been found that the drug may pass on to the child while breast feeding which may cause adverse effects in the child. A mother should therefore let her physician know about breast feeding while consuming Ativan.
Children and Seniors
Please let your physician know about your age accurately as prescribing Ativan to individuals of below 18 years of age, can be hazardous.
Similarly, in case of individuals who are above 60 years of age, Ativan again may not be a safe option. Senior patients may have weak kidney, which means that the drug may not be excreted out of the body properly. This shall lead to the accumulation of the drug inside the body for a longer period of time and hence would lead to the development of side effects. Also, the senior patients are quite sensitive to the sedation effects of Ativan.
Contraindications of Ativan
Since Ativan has been labeled as a drug with black box warning, therefore, it is very important for the physician to be aware of your current medication regime so that if any of the below mentioned drug happens to be the one that you are consuming currently, the possibilities of contra-indication and its associated side effects increase. The side effects for such contraindications may range from temporary to permanent or even death.
Following are the list of medications that contraindicate with Ativan:-
- Barbiturates like Fioricet, Mebaral, Nembutal, Solfoton, Amytal, Butisol, Seconal or Luminal
- Sleep inducing medications like Unisom, Sonata, Lunesta, Ambien, Rozerem, Alprex
- Benzodiazepines like Librium, Klonopin, Valium, Xanax, Librax, Tranxene
- Narcotic medication like Codeine, Vicodin, Demerol, Methadose, Narcan, Darvon, Stadol, Lortab, Levo-Dromoran, Dolophine, Morphine, OcxContin
- Anti-seizure medications like Depakene or Depakote
- Anti-depressants like Etrafon, Celexa, Norpramin, Lexapro, Sarafem, Elavil, Asendin, Anafranil, Sinequan, Prozac etc.
It is therefore very important to let your physician know about any of the above medical condition(s) and the current medication regime, as in order to lower down the anxiety levels, Ativan needs the right environment inside the human body to show its effectiveness and efficiency. It is very important to treat anxiety with Ativan as soon as possible, because longer the duration of consumption of Ativan, the difficult would it be for you to get rid of it because of the withdrawal effects.
The best way to have the desired effects of Ativan without developing the addiction for the drug is to be compliant with your physician’s medication regime and secondly by being honest with him regarding your medical history.
Written, Edited or Reviewed By:
Pramod Kerkar, MD, FFARCSI