Ativan (Lorazepam) for Panic Disorder and Anxiety

Ativan (lorazepam) is a common medication used for the treatment of panic disorder and other anxiety conditions. This medication works by slowing down activity in the central nervous system to produce a calming effect in the brain.

Ativan is a type of benzodiazepine, a class of medications sometimes referred to as sedatives or tranquilizers due to their calming and relaxing effect on the body. Other common benzodiazepines include Xanax (alprazolam), Klonopin (clonazepam), and Valium (diazepam). 

While Ativan is most frequently used to treat anxiety disorders, it’s often prescribed to treat anxiety symptoms that accompany other psychiatric conditions as well as for other illnesses, despite not being approved for them by the Food and Drug Administration (aka an “off-label use”). For instance, some doctors prescribe Ativan for alcohol withdrawal, to prevent nausea and vomiting during chemotherapy, and for insomnia.

At a Glance

Ativan helps reduce anxiety by boosting the amount of gamma-aminobutyric acid (GABA) in the brain. GABA is an inhibitory neurotransmitter that slows brain activity, promoting calmness and relaxation. Continue reading to learn more about using Ativan for anxiety, including possible side effects and important precautions.

Illustration by JR Bee, Verywell

How Ativan Works to Treat Panic Disorder

Neurotransmitters in the brain, known as gamma-aminobutyric acid receptors (GABA), help regulate sleep and feelings of relaxation and anxiety. Ativan works on these receptors to slow down the central nervous system (CNS), reducing excess agitation and excitement. This creates a calming and relaxing effect.

Because of Ativan’s calming effects on the central nervous system, it can provide relief for many of the symptoms of anxiety and panic disorder, including:

• Agitation
• Restlessness
• Sleep problems
• Panic
• Irritability
• Muscle tension
• Difficulty concentrating

By depressing the CNS, Ativan is also able to lessen the intensity of anxiety and panic attacks. Ativan works quickly, making it an effective solution to temporarily managing panic symptoms. The drug enters your system relatively rapidly and lasts a few hours.

Side Effects of Ativan

Common side effects of Ativan can include:

• Blurred vision
• Constipation
• Dizziness and lightheadedness
• Drowsiness
• Dry mouth
• Headache
• Heartburn
• Lack of coordination or unsteadiness
• Loss of interest in sex
• Nausea

If these side effects persist or worsen, talk to your doctor. They may need to adjust your dose or change your medication. Never stop taking your medication or change your dose without consulting your doctor first.

Serious side effects are also possible, such as mental and mood changes, hallucinations, thoughts of suicide, difficulty walking, and breathing issues. If you experience any of these symptoms, contact your doctor immediately.

Ativan and Addiction

Like all benzodiazepines, Ativan is a controlled substance, meaning its possession and use are regulated by the government. Ativan can be misused, potentially leading to physical or psychological dependence.

Your doctor will likely discuss strategies to minimize the risk of addiction. Never attempt to stop your medication on your own. If you suddenly stop taking Ativan, you may experience symptoms of withdrawal. Typical withdrawal symptoms include sleep disturbances, irritability, increased nervousness, and muscle cramps.

Benzodiazepine withdrawal comes with potential risks of hallucinations and seizures. Other symptoms, such as nausea, headaches, and severe restlessness, can also occur.

Should you decide to discontinue your prescription, your prescribing doctor will assist you in gradually decreasing your dosage. Slowly tapering your dose over a period of time can minimize withdrawal symptoms.

Additional Precautions For Taking Ativan

Caution should be taken if you have a history of certain medical conditions. Before taking Ativan, consult your doctor if you’ve been diagnosed with these or any other medical condition:

• Depression
• Drug or alcohol addiction
• Glaucoma
• Liver disease
• Lung disease
• Sleep apnea

Ativan Drug Interactions

Ativan depresses the central nervous system (CNS). Alcohol and certain medications that have a similar effect on the CNS should be avoided. Make certain that your doctor is up to date on all of your current prescription and over-the-counter medications.

Drowsiness and Dizziness

Feeling tired and lightheaded are common side effects of Ativan. Until you are used to how this medication affects you, caution should be taken while driving or performing other tasks that require your full attention and concentration.

Pregnancy and Nursing

It is possible for Ativan to be passed to a child during pregnancy or while breastfeeding. Talk to your doctor about the risk of using Ativan while pregnant or nursing.

Some research indicates that benzodiazepine use during pregnancy may increase the risk of certain birth defects. However, more research is needed to better understand these risks.

Older Adults Taking Ativan

The side effects of Ativan are often more noticeable in older adults. To limit these effects, your doctor may need to adjust your dosage. This information is intended to provide a general overview of the use of Ativan for panic disorder. Any questions or concerns you may have about your prescription should be addressed with your doctor or pharmacist.

Keep in Mind

Ativan is one type of medication that may be useful in the treatment of anxiety and panic disorder. Because it is a benzodiazepine and comes with a risk of dependence and addiction, it is frequently used for short-term relief. Other medications that may be prescribed include antidepressants, buspirone, and beta-blockers.

Medications tend to be most effective when they are used alongside psychotherapy and self-help strategies. Cognitive-behavioral therapy (CBT) can be helpful, and strategies like exercise, meditation, and journaling can also help you cope with feelings of panic and anxiety.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. National Alliance on Mental Illness. Lorazepam (Ativan).

2. U.S. National Library of Medicine. Lorazepam.

3. Mathew SJ, Jean-Lys S, Phull R, Yarasani R. Characterization of Extended-Release Lorazepam: Pharmacokinetic Results Across Phase 1 Clinical Studies. J Clin Psychopharmacol. 2023;43(4):350-360. doi:10.1097/JCP.0000000000001715

4. U.S. Food and Drug Administration. Ativan.

5. National Institute of Mental Health. Mental health medications.

6. Tinker SC, Reefhuis J, Bitsko RH, et al. Use of benzodiazepine medications during pregnancy and potential risk for birth defects, National Birth Defects Prevention Study, 1997-2011. Birth Defects Res. 2019;111(10):613-620. doi:10.1002/bdr2.1497

By Katharina Star, PhD

Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. 

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