Ativan side effects: what to expect and how to stay safe
Ativan (lorazepam) can calm severe anxiety, help with panic attacks, and ease insomnia. But it also causes side effects you should know about before you take it. This page explains the most common reactions, who’s at higher risk, and simple steps to reduce harm.
Common short-term effects
Most people notice drowsiness and slowed thinking soon after a dose. You may feel dizzy, unsteady, or weak—so avoid driving or heavy machinery until you know how it affects you. Memory gaps and trouble concentrating are common, especially with higher doses. Some people report blurred vision, dry mouth, or nausea.
Watch for paradoxical reactions too: instead of calming you, Ativan can cause increased anxiety, agitation, aggression, or sleeplessness in a small number of users. These reactions are more likely in children and older adults.
Long-term risks, dependence, and withdrawal
Using Ativan for more than a few weeks raises the risk of tolerance (needing more to get the same effect) and physical dependence. Stopping suddenly after regular use can lead to withdrawal symptoms: rebound anxiety, insomnia, tremors, sweating, and in severe cases, seizures. Tapering slowly under a doctor’s guidance is the safest way to stop.
There’s growing evidence from observational studies that long-term benzodiazepine use may harm memory and could be linked to a higher risk of dementia. The data aren’t definitive, but this is one reason clinicians recommend short courses or alternative treatments for chronic anxiety.
Special groups need extra caution. Older adults face a higher risk of falls, confusion, and prolonged drowsiness. Pregnant or breastfeeding people should discuss risks with their clinician—lorazepam crosses the placenta and appears in breast milk. People with lung problems, sleep apnea, or who take opioids are at extra risk for dangerous breathing suppression.
Interactions matter. Avoid alcohol and other sedatives (opioids, strong antihistamines, some antipsychotics) while using Ativan—mixing them can cause severe drowsiness or life‑threatening breathing problems. Lorazepam is mainly cleared by glucuronidation, so it has fewer CYP drug interactions than some benzodiazepines, but always tell your prescriber about all medicines and supplements you take.
What to do if you get side effects: for mild drowsiness or dizziness, lower the dose and avoid risky tasks. If you notice severe confusion, breathing trouble, fainting, persistent hallucinations, or suicidal thoughts, seek immediate medical help. For dependence or withdrawal, contact your doctor—do not stop abruptly.
Practical tips: use the lowest effective dose for the shortest time, avoid alcohol, review your need for continued treatment regularly, and consider non‑drug options like cognitive behavioral therapy for long‑term anxiety. Talk openly with your clinician about goals and risks so you can pick the safest plan for you.
