Many patients prescribed medications for anxiety often wonder how these treatments might affect their body beyond symptom relief. Lorazepam is a prescription medication classified as a benzodiazepine. It is the active ingredient in Ativan, a brand name commonly used in medical settings. This article provides an overview of lorazepam, its uses, potential side effects, and its relationship with weight changes.
What is Lorazepam?
Lorazepam (Ativan) is a generic prescription medication used to treat anxiety in adults and children ages 12 years and older. It’s also used short term to treat anxiety related to depression in these age groups. With anxiety, you may have symptoms including panic, heart palpitations, sweating, or nervousness.
Lorazepam works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that slows down brain activity. This calming effect helps reduce excessive nerve signaling, making it effective for conditions where the nervous system is overstimulated. Lorazepam is considered one of the strongest benzodiazepines used primarily for its strong sedative and anti-anxiety effects. By increasing GABA’s effects, Ativan reduces anxiety and promotes relaxation and sleep.
Lorazepam is used for the short-term treatment of different types of anxiety, including:
- Temporary relief of anxiety symptoms related to depression
- Anxiety disorders, such as panic disorder and generalized anxiety disorder
- Insomnia (trouble sleeping) related to anxiety
It’s not known whether lorazepam may be safe to take for longer than 4 months or what effects the drug may have when it’s taken long term. So your doctor may recommend taking lorazepam short term.
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Lorazepam comes as an oral tablet. It also comes in other forms, such as oral capsules, an oral solution, and an injection.
Common Side Effects of Lorazepam
Some people may experience mild to serious side effects during their lorazepam treatment. Examples of more commonly reported side effects of lorazepam oral tablet and lorazepam oral concentrate include:
- Sleepiness
- Dizziness
- Weakness
- Feeling unsteady
- Confusion
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Examples of mild side effects that have been reported with lorazepam include:
- Dizziness
- Weakness
- Balance problems
- Fatigue (low energy)
- Euphoria (intense feeling of happiness)
- Sexual side effects, such as erectile dysfunction
- Agitation (restlessness)
- Blurry vision
- Confusion
- Sleepiness
- Nausea
- Headache
- Constipation
- Memory loss
- Mild allergic reaction
In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking lorazepam unless your doctor recommends it.
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Serious Side Effects of Lorazepam
It’s possible to experience serious side effects from taking lorazepam, although these are less common than the drug’s mild side effects.
If you develop serious side effects while taking lorazepam, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported include:
- Respiratory depression (severely slow, shallow breathing) or trouble breathing
- Seizures
- Changes in mood, such as depression or suicidal thoughts or behaviors
- Risk of serious side effects when taken with opioid medications
- Risk of misuse and addiction
- Risk of dependence and withdrawal
Lorazepam and Weight Changes: What You Need to Know
Weight gain is not a known side effect of lorazepam. Weight changes weren’t reported in clinical trials of people taking lorazepam. However, weight changes may be a symptom of certain side effects of lorazepam. These include mood changes, such as depression. It’s possible for these side effects to cause weight changes, including weight gain or weight loss.
It’s possible for the conditions lorazepam treats, anxiety and anxiety associated with depression, to increase the risk of weight gain or obesity.
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Indirect Effects on Weight
Though not directly proven to cause weight gain, lorazepam can cause side effects that affect eating habits and physical activity. These drug effects that may be dangerous in long-term use could alter metabolism or suppress appetite in some patients.
Lorazepam may increase the risk of certain side effects that indirectly affect weight, such as reduced physical activity due to sedation or altered appetite. Side effects such as drowsiness and reduced energy can lead to lifestyle changes that may impact weight.
Here's how lorazepam might indirectly influence weight:
- Changes in Appetite: Ativan’s influence on appetite is complex and can vary widely among individuals. Lorazepam increases hunger and cravings for calorie-dense foods by affecting neurotransmitters like serotonin and dopamine, which regulate mood and appetite. The calming effects of this medication may reduce anxiety-driven overeating in some men, potentially aiding weight management.
- Reduced Physical Activity: Common side effects of Ativan include drowsiness, dizziness, fatigue, and sedation. These are mild side effects that usually improve over time, but the drug can also cause adverse effects that vary from person to person.
- Mental Health Conditions: However, when used for mental health conditions, lorazepam may sometimes be used alongside other drug classes like antidepressants or antipsychotics, which have both been linked to weight gain. Generally, recommended treatments for anxiety include antidepressants and antipsychotics, which are both linked to weight gain.
Comparison with Other Anxiety Medications
Compared to SSRIs or other anxiety medications, Ativan may cause fewer weight-related issues. Some antidepressants are known to trigger significant weight gain, while lorazepam’s side effects are more commonly neurological or behavioral. However, the long-term side effects from taking lorazepam may still include dependency, cognitive impairment, and physical inactivity-all of which could contribute to weight gain.
Important Considerations Before Starting Lorazepam
Before taking lorazepam, discuss your health history with your doctor. Lorazepam may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
- Depression or suicidal thoughts and behaviors
- Breathing or lung problems, such as asthma or chronic obstructive pulmonary disorder
- Are an older adult (age 65 years or older)
- Liver problems
- Glaucoma
- Memory problems, such as dementia
- Balance problems
- Seizures
- Previous allergic reaction to this or a similar drug
- Pregnancy
- Breastfeeding
- Alcohol consumption
Boxed Warnings for Lorazepam
Lorazepam has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
- Risk of serious side effects when taken with opioid medications: Taking opioids together with lorazepam increases your risk of dangerous side effects, such as respiratory depression and coma. It can even be fatal.
- Risk of misuse and addiction: Misusing lorazepam can increase your risk of serious side effects, which may be life threatening. To help prevent serious side effects, it’s important to always take lorazepam as prescribed by your doctor.
- Risk of dependence and withdrawal: Lorazepam may cause withdrawal symptoms if you stop taking the medication. Withdrawal symptoms can happen when your body becomes used to a medication, and then you suddenly stop taking it. In some cases, withdrawal symptoms may be long term, lasting anywhere from weeks to up to 12 months.
Managing Side Effects
There may be things you can do to help make certain lorazepam side effects more manageable. If you have ongoing, worsening, or bothersome side effects, talk with your doctor or pharmacist. They can suggest tips for managing them or recommend other available treatment options for your condition.
- Nausea: If you develop nausea from taking lorazepam, talk with your doctor or pharmacist. They can suggest ways to ease this side effect, such as taking your dose of the drug with food.
- Constipation: If you develop constipation that’s bothersome to you while taking lorazepam, tell your doctor or pharmacist. They may be able to recommend ways to decrease this side effect. For example, taking an over-the-counter medication, such as MiraLAX (polyethylene glycol), might ease your constipation.
- Agitation: If you feel agitated during treatment with lorazepam, talk with your doctor. You may be having a paradoxical reaction. (This refers to experiencing effects that are the opposite of what is expected from the drug.) Such reactions are more likely to occur in children and older people (ages 65 years and over).
What to Do If You Experience Weight Changes
Patients taking lorazepam should monitor their weight and energy levels regularly. Unexplained weight changes could be a side effect of Ativan or a response to reduced physical activity.
If you are experiencing weight gain or weight loss during your lorazepam treatment, talk with your doctor. They can help determine what may be causing your weight changes. They may also recommend ways to help manage your weight. For example, they may suggest changes to your diet or exercise routine to help manage your weight.
If you suspect that you’re taking Ativan and experiencing weight-related changes, talk to your doctor. If you develop serious side effects while taking lorazepam, such as extreme fatigue, disorientation, or difficulty breathing, seek medical help immediately. Stop taking Ativan only under your doctor’s supervision.