Ativan and blood pressure

What Does Ativan Do to Your Heart?

Benzodiazepines or benzos are central nervous system depressants that increase levels of GABA (gamma-aminobutyric acid) in the brain to reduce nerve activity and produce relaxation. GABA works by blocking brain signals (neurotransmissions), reducing nerve activity, and making drugs like Ativan effective medications for seizures and anxiety disorders. But while it may help treat some conditions, what does Ativan do to your heart? This is a concerning topic for those taking this drug regularly for their conditions.

How Does Ativan Affect Your Heart?

Despite being a prescription drug, Ativan poses the threat of tolerance and addiction because of its impact on the brain, which is why it’s only recommended for short-term use. However, anxiety disorders, insomnia, and seizures aren’t usually short-term problems. As a result, when this drug is no longer an option for people who once took it for their conditions, they may try to self-medicate by obtaining it illegally or doctor shopping (going to several doctors for a prescription).

Unfortunately, because of benzos’ effects on the brain, long-term abuse often leads to addiction. With an Ativan addiction comes a variety of health issues, such as heart problems. Ativan affects the heart by slowing your heart rate and lowering your blood pressure. This drug depresses the central nervous system, and physiological functions like breathing, heart rate, blood pressure, and circulation are reduced, contributing to relaxation.

Bradycardia (Slow Heart Rate)

Although these side effects are common in people who take Ativan, they can become dangerous when the drug is abused; this includes taking a higher dose than directed and mixing it with other drugs or alcohol. Otherwise known as bradycardia, having a slower than normal heart rate can have a huge impact as, usually, adults have a resting heartbeat of between 60 and 100 times a minute.

Although these side effects are common in people who take Ativan, they can become dangerous when the drug is abused; this includes taking a higher dose than directed and mixing it with other drugs or alcohol. Otherwise known as bradycardia, having a slower than normal heart rate can have a huge impact as, usually, adults have a resting heartbeat of between 60 and 100 times a minute.

While it’s normal for Ativan to reduce your heart rate slightly when taking it as prescribed, if abused or mixed with other depressants like alcohol, it can potentially lead to heart attack and sudden heart failure.

Hypotension (Low Blood Pressure)

Additionally, not only does Ativan lower heart rate, but it can also lower your blood pressure, which can also take a toll on the heart. Blood pressure is the pressure of blood in your arteries, which carry your blood from your heart to the rest of your body. You need a certain amount of pressure to get the blood to your body.

Also known as hypotension, low blood pressure causes your heart rate to increase, and the blood vessels in other parts of your body constrict or narrow to help maintain blood pressure. If your heart rate doesn’t increase enough, or your blood vessels don’t constrict enough, your blood pressure drops.

Although rare, severe hypotension can lead to shock, which can be fatal. More commonly, however, hypotension makes the heart work harder to maintain blood pressure and also prevents the heart from getting blood to other areas of the body. Hypotension can also cause injuries related to fainting and falling.

Long-Term Effects of Ativan on the Heart

So, what does Ativan do to your heart over time? Because Ativan is usually prescribed for short-term use, those who take it for longer than a few weeks usually obtain it illegally and abuse it. When taken in larger doses than recommended, lorazepam’s side effects can become worse, increasing the individual’s potential for heart, liver, and kidney problems as well as overdose. Taking benzos like Ativan with alcohol can also intensify the effects of lorazepam on the heart.

The effects of Ativan long-term use on the heart include:

  • Hypotension
  • Changes in heart rate
  • Heart rhythm problems
  • Circulatory problems
  • Cardiac arrest

Ativan can also cause heart problems if the person stops taking it suddenly, which can result in heart arrhythmia or even heart attack. Withdrawal symptoms are common in people who are physically dependent on drugs of abuse when they suddenly reduce or stop taking them. These withdrawal symptoms can become complicated, which is why a medically monitored detox is recommended for people who want to quit a particular drug or alcohol.

Finding Lorazepam Addiction Treatment

Long-term Ativan abuse can lead to a multitude of problems in addition to low blood pressure and changes in heart rhythm. A common side effect of chronic lorazepam use is addiction, a chronic disease characterized by uncontrollable substance abuse. If you’re addicted to this drug, the good news is that you aren’t alone.

Once patients at our Delaware drug rehab have completed their medical detox programs, they can then move on to one of our substance-specific programs. In addition to detox, we also offer benzo addiction treatment on a residential level of care for those who are addicted to drugs like Ativan, Valium, and Xanax. During their treatment, patients may also receive drug therapy – such as cognitive or dialectical behavior therapy – to learn how to regain control over their thoughts and actions.

Our Milford treatment center is dedicated to the safety and well-being of our patients. For more information regarding Ativan (lorazepam) addiction and treatment options available at our inpatient drug rehab, call Banyan Treatment Centers Delaware today at 888-280-4763.

Related Readings:

  • Benzos and Weight Gain
  • Benzodiazepines and Breastfeeding: Is It Safe?
  • How Long Benzos Stay in Your System

Effects of lorazepam on film-induced differentiated emotions in healthy volunteers

Clinical Trial

. 1997;11(5):466-75.

doi: 10.1111/j.1472-8206.1997.tb00210.x.

C Garcia  1 , P Philippot, B Lacarelle, M Valli, B Rimé, B Bruguerolle, O Blin



  • 1 Clinical Pharmacology & CPCET, Timone Hospital, Marseille, France.
  • PMID: 9342601
  • DOI: 10.1111/j.1472-8206.1997.tb00210.x

Clinical Trial

C Garcia et al. Fundam Clin Pharmacol. 1997.

. 1997;11(5):466-75.

doi: 10.1111/j.1472-8206.1997.tb00210.x.


C Garcia  1 , P Philippot, B Lacarelle, M Valli, B Rimé, B Bruguerolle, O Blin


  • 1 Clinical Pharmacology & CPCET, Timone Hospital, Marseille, France.
  • PMID: 9342601
  • DOI: 10. 1111/j.1472-8206.1997.tb00210.x


We studied the effects of lorazepam, a benzodiazepine, on differentiated emotions in healthy volunteers. In order to induce differentiated emotions, film excerpts were selected on the basis of the type of emotion they induced (fear, anger and for affective tone neutral film). For 6 days (D1 to D6), ten healthy volunteers received lorazepam (1 mg bid) or placebo in a randomized cross-over double-blind trial. During each treatment period, emotional induction occurred on D4, D5 and D6. One film excerpt (fear, anger or neutral) was presented each morning after relaxation. Evaluation was performed before and after each emotional induction and included questionnaires (Differential Emotions Scale and physical activation visual analog scales), and neurophysiological parameters (systolic and diastolic blood pressure, heart rate and norepinephrine levels). Globally, the film excerpts induced the predicted emotions. An analysis of variance was undertaken and revealed a significant effect of lorazepam versus placebo. On the Differential Emotions Scale and during fear induction, lorazepam induced a significantly higher increase in fear, anxiety and disgust emotions than placebo, whereas no effect was observed after anger induction. Lorazepam also induced a significantly higher increase in diastolic and systolic blood pressure with no change in heart rate, and physical activation items ("tears" and "faster breathing") without no significant change in norepinephrine. In conclusion, our results are consistent with an overall increase in emotional reactivity with lorazepam (1 mg bid) as compared to placebo. The pertinence of film-induced differentiated emotions has to be confirmed for clinical pharmacological use.

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MeSH terms



Tell your doctor if you are taking, have recently taken or might take any other medicines. It is especially important to note the following drugs:

If necessary, your doctor will reduce the dose of these drugs before you use lorazepam.

Avoid alcohol while taking lorazepam as this may increase the sedative properties of the drug.

Tell your doctor or pharmacist if you are taking Lorazepam before using any other medicines or when you are hospitalized.

Some elderly patients may experience dizziness and fainting after taking Lorazepam.

When taking Lorazepam, there is a risk of developing addiction, which can lead to a gradual decrease in effectiveness after several weeks of taking Lorazepam.

Lorazepam has the potential to develop dependence, particularly in patients with a history of alcohol and/or recreational drug abuse.

With the usual regimen of lorazepam, the development of dependence is unlikely, but the risk increases with increasing dose and duration of treatment, as well as in patients with a history of alcohol and / or recreational drug abuse, or in patients with a personality disorder. Therefore, lorazepam should be avoided in patients with a history of alcohol and/or recreational drug abuse.

Dependence can lead to the development of a withdrawal syndrome, especially when treatment is stopped abruptly. Therefore, it is necessary to cancel the drug gradually.

When taking lorazepam for more than 4 weeks, your doctor should conduct a study of the peripheral blood picture, as well as a biochemical blood test for liver markers, since drugs in this group can lead to impaired liver function.

Long-term use of Lorazepam may lead to the development of drug dependence. Therefore, Lorazepam is usually prescribed in short courses lasting from several days to 4 weeks, including a period of dose reduction and drug withdrawal. This reduces the risk of developing drug dependence or adverse side effects observed when the drug is discontinued. (See section "Cancellation of Lorazepam").

The dose of Lorazepam should be increased gradually to avoid side effects.

How to take Lorazepam

Lorazepam should be taken exactly as directed by your doctor. If you have any doubts, then you should consult with your doctor.

When Lorazepam is used to treat anxiety and insomnia, treatment usually lasts from a few days to 4 weeks, including a period of dose reduction and drug withdrawal.

The physician should prescribe the lowest effective dose, calculated for the shortest possible period of taking the drug.

Lorazepam tablets should be swallowed with water.

Adults and children over 13 years of age

For anxiety, the daily dose of Lorazepam is 1-4 mg taken in divided doses. Your healthcare provider will determine how often you should take Lorazepam. It is not recommended to take Lorazepam to children under 12 years of age with anxiety.

For sleep disturbances, 1-2 mg Lorazepam at bedtime is prescribed. Before taking the drug, you must be sure that you can sleep for 7-8 hours.

Lorazepam 2-3 mg is given the night before surgery and 2-4 mg 1-2 hours before surgery.

Children 5 to 13 years old

For surgery, the dose is usually 0.5-2.5 mg (depending on your child's weight) taken one hour before the procedure.

Lorazepam is not recommended for use in children 5 to 13 years of age for the treatment of anxiety and sleep disorders, and in children under 5 years of age.


The physician should prescribe lorazepam to elderly or malnourished patients at low doses.

The drug may be effective at half or even less than the recommended dose in elderly patients, but if necessary, the dose should be adjusted.

Patients with renal and hepatic insufficiency

In case of impaired renal function or mild to moderate hepatic insufficiency, Lorazepam is allowed to be taken only in low doses.

Lorazepam is contraindicated in patients with severe hepatic impairment.

If you forget to take Lorazepam

If you forget to take Lorazepam to treat anxiety and if less than 3 hours have passed from your scheduled appointment time, you should take it as soon as you remember. If more than 3 hours have passed from the appointed time, do not worry, take the next dose at the appointed time. Do not take a double dose to make up for a missed one.

If you forget to take Lorazepam to treat a sleep disorder, take it if you are sure you can sleep for 7-8 hours after taking the drug.

If you have taken more Lorazepam than recommended

If you have taken more Lorazepam than prescribed by your doctor, get medical help right away, call your doctor or go to the nearest hospital. Take the medicine package with you, even if there are no pills left.

Stopping Lorazepam

After completing the prescribed course of treatment, your doctor will decide whether to continue further treatment.

The dose and frequency of lorazepam should be reduced gradually until the drug is discontinued. This allows your body to adjust to the absence of Lorazepam and reduce the risk of adverse effects when the drug is discontinued. Your doctor will explain to you how to do this.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.


Abrupt discontinuation of Lorazepam may result in withdrawal symptoms such as headaches, muscle pain, anxiety, tension, depression, restlessness, dizziness, nausea, diarrhea, loss of appetite, irritability, confusion, confusion agitation, tremors, abdominal pain, heart rhythm disturbances, short-term memory loss, fever, and sweating. Possible relapse of insomnia. If you have any of these symptoms, contact your doctor.

Do not stop taking Lorazepam suddenly. This can lead to more severe withdrawal symptoms such as loss of sense of reality, feelings of unreality or detachment from everyday life, loss of the ability to feel emotions.

Some patients experience numbness or tingling of the hands or feet, vomiting, ringing in the ears, muscle twitches, hallucinations, seizures, and hypersensitivity to light, sound, and touch. If you have any of these symptoms, contact your doctor immediately.

Lorazepam - description of the substance, pharmacology, use, contraindications, formula


  • Russian name
  • English name
  • Latin name of the substance Lorazepam
  • Chemical name
  • Gross formula
  • Pharmacological group of the substance Lorazepam
  • Nosological classification
  • CAS code
  • Pharmacological action
  • Characteristic
  • Pharmacology
  • Use of the substance Lorazepam
  • Contraindications
  • Restrictions for use
  • Use in pregnancy and lactation
  • Side effects of the substance Lorazepam
  • Interaction
  • Overdose
  • Dosage and administration
  • Precautions
  • Special instructions
  • Trade names with the active substance Lorazepam

Structural formula

Russian name


English name


Latin name of the substance Lorazepam

Lorazepamum ( genus Lorazepami)

Chemical name


Generic formula

C 15 H 10 Cl 2 N 2 O 2

Pharmacological group of the substance Lorazepam 9002


Nosological classification

ICD-10 code list

  • R45. 1 Anxiety and agitation
  • F51.0 Insomnia of non-organic etiology
  • G47.0 Disorders of falling asleep and maintaining sleep [insomnia]
  • F10.5 Alcoholic psychosis
  • F91 Conduct disorders
  • F30 Manic Episode
  • F42 Obsessive-compulsive disorder
  • F25 Schizoaffective disorders
  • F41.0 Panic disorder [episodic paroxysmal anxiety]
  • Z100* CLASS XXII Surgical practice
  • F60 Specific personality disorders
  • G44. 2 Tension headache type
  • R45.0 Nervousness
  • R45.7 State of emotional shock and stress, unspecified
  • F32 Depressive episode
  • F43.1 Post-traumatic stress disorder
  • F40.0 Agoraphobia
  • F43.2 Adjustment disorder
  • F34.1 Dysthymia
  • F41.1 Generalized anxiety disorder
  • F43.0 Acute stress reaction
  • G40 Epilepsy
  • F10.3 Withdrawal state

CAS code


Pharmacological action

Pharmacological action - anxiolytic , muscle relaxant , anticonvulsant , sedative , hypnotic , central .


Anxiolytic, benzodiazepine derivative.

Almost white powder, very slightly soluble in water.


Interacts with specific benzodiazepine receptors of the GABA-benzodiazepine receptor complex, increases the sensitivity of GABA receptors to GABA. As a result, the frequency of opening of transmembrane channels for chloride ions increases, the postsynaptic membrane of the neuron is hyperpolarized, neuronal activity is inhibited, and interneuronal transmission to the CNS is inhibited. The effects are due to the influence on various parts of the central nervous system: the amygdala complex of the limbic system (anxiolytic), the reticular formation of the brain stem and nonspecific nuclei of the thalamus, hypothalamus (sedative and hypnotic), spinal cord (muscle relaxant), hippocampus (anticonvulsant). It reduces the excitability of subcortical formations (limbic system, thalamus, hypothalamus) responsible for the implementation of emotional reactions, and inhibits the interaction of these structures with the cerebral cortex. Stabilizes vegetative functions.

Suppresses anxiety, fear, reduces psychomotor agitation, emotional stress. It has anti-panic and amnestic (mainly for parenteral use) action. It is effective for insomnia caused by anxiety or a short-term stressful situation: it facilitates the onset of sleep (shortens the period of falling asleep), reduces the number of night awakenings, and increases the duration of sleep. It inhibits polysynaptic spinal reflexes and lowers the tone of skeletal muscles.

Lorazepam has low toxicity and wide therapeutic range.

An animal reproduction study showed that administration of lorazepam at doses of 40 mg/kg orally and 4 mg/kg or more IV to rabbits resulted in fetal resorption and an increased incidence of fetal death. Causes developmental anomalies in rabbits, regardless of dose. In an 18-month study in rats, no carcinogenic activity was found.

Good but slowly absorbed from the gastrointestinal tract when taken orally, bioavailability is 90%. max "> C max is achieved within 2 hours and is dose dependent: at a dose of 2 mg max"> C max is 20 ng / ml. About 85% binds to plasma proteins. The equilibrium concentration in the blood is usually reached after 2-3 days. Passes through the BBB and the placental barrier. It is rapidly metabolized in the liver by conjugation to form the main inactive metabolite, lorazepam glucuronide. 1/2 "> T 1/2 unconjugated lorazepam - about 12 hours, the main metabolite - 18 hours. Excreted mainly by the kidneys, mainly in the form of glucuronide.

When administered intramuscularly, max "> C max is achieved in 60-90 minutes. 1/2"> T 1/2 when administered parenterally is 16 hours. When used for 6 months, no cumulation phenomena are observed. The pharmacokinetic parameters of lorazepam do not change in the elderly.

Application of the substance Lorazepam

Neuroses accompanied by anxiety, agitation, incl. generalized anxiety disorder, post-traumatic stress disorder, phobias, obsessive-compulsive disorder, psychoreactive states, emotional reactive disorders, anxiety in depressive states of various origins (usually in combination with antidepressants), insomnia, psychosomatic disorders (including heart - vascular, gastrointestinal and other diseases), premedication before surgical and diagnostic manipulations (in combination with analgesics), tension headache; nausea and vomiting caused by chemotherapy, epilepsy (as part of combination therapy), alcoholic delirium and withdrawal syndrome in chronic alcoholism (as part of combination therapy).


Hypersensitivity, incl. to other benzodiazepines, myasthenia gravis, angle-closure glaucoma, acute intoxication with CNS depressants, respiratory depression, liver failure, pregnancy (especially the first trimester), breast-feeding, age up to 18 years.

Restrictions on use

Chronic respiratory failure, sleep apnea syndrome, open-angle glaucoma, drug and alcohol dependence, depression (see Precautions), psychosis, severe renal impairment.

Use during pregnancy and lactation

Contraindicated during pregnancy (especially in the first trimester). At the time of treatment should stop breastfeeding.

Side effects of the substance Lorazepam

From the side of the nervous system and sensory organs: lethargy, fatigue, drowsiness, disorientation, headache, dizziness, depression, ataxia, sleep disturbance, agitation, visual impairment, episodes of amnesia.

From the digestive tract: dry mouth, nausea, vomiting, diarrhoea, change in appetite.

From the side of the skin: erythema, urticaria.

Other: changes in blood composition (leukopenia), increased LDH activity.

May develop addiction, drug dependence, withdrawal syndrome, rebound syndrome (see "Precautions").


Lorazepam enhances the effect of CNS depressants, incl. phenothiazines, narcotic analgesics, barbiturates, antidepressants, hypnotics, anticonvulsants, antihistamines with a sedative effect. Potentiates the action of general and local anesthetics, enhances the action of curare-like drugs. With simultaneous use with alcohol, in addition to increasing the inhibitory effect on the central nervous system, paradoxical reactions are possible (psychomotor agitation, aggressive behavior, a state of pathological intoxication). Nicotine inhibits the activity of lorazepam (accelerates its metabolism).


Symptoms: drowsiness, arterial hypotension, confusion, depression of reflexes, coma.

Treatment: induction of vomiting, gastric lavage, intravenous administration of norepinephrine to increase blood pressure, symptomatic therapy, monitoring of vital signs. The introduction of a specific antidote - an antagonist of benzodiazepine receptors flumazenil (in a hospital setting).

Dosage and administration

Inside. The dosage regimen and the duration of the course of treatment are set strictly individually.

In neurological practice - 1 mg 2-3 times a day; in psychiatric practice - 4-6 mg / day; with insomnia - 1-2 mg 30 minutes before bedtime. In elderly and debilitated patients, the dose should not exceed 2 mg / day (in divided doses). In patients with liver and / or kidney disease, as well as in patients with cerebral sclerosis, hypotension, heart failure, underweight, dose adjustment is recommended.


Use with caution in depressed patients due to suicidal tendencies. In patients with drug and alcohol dependence, use under close medical supervision.

Side effects are usually observed at the beginning of therapy. The possibility of a more frequent occurrence of side effects in elderly and debilitated patients should be taken into account.

During treatment and for 2 days after its completion, it is necessary to exclude the intake of alcoholic beverages; drivers of vehicles and people whose work requires a quick mental and physical reaction, and is also associated with increased concentration of attention, should not engage in professional activities during this period.

With prolonged use, addiction and drug dependence may occur (especially when taking high doses). In this regard, lorazepam should not be used for longer than 4-6 weeks. If long-term treatment is necessary, weekly breaks in taking the drug should be periodically taken. With a sharp cessation of treatment, a withdrawal syndrome may occur (tremor, convulsions, abdominal or muscle cramps, vomiting, perspiration), and symptoms similar to those of the disease (anxiety, agitation, irritability, emotional stress, insomnia, convulsions) may also occur.

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