How Long Does Lorazepam Stay in Your System?

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Approximately 40 million adults in the United States suffer from an anxiety disorder, making anxiety the most commonly experienced mental illness in the country.

In fact, about one in every five people experience anxiety on a regular basis. Unfortunately, despite the fact that anxiety disorders can be easily treated, less than 40 percent of those diagnosed with the condition receive treatment.

Lorazepam is a powerful drug that can effectively treat acute anxiety symptoms on a short term basis.

If you've considered taking medication to manage your anxiety, you might be wondering about the pros and cons of using lorazepam and how long lorazepam stays in your system.

What is lorazepam?

Lorazepam is a drug belonging to a class of medications called benzodiazepines.

This tranquilizing medication, also referred to as a sedative-hypnotic or anxiolytic medication, is similar in nature to medications like Xanax (alprazolam), Klonopin (clonazepam), and Valium (diazepam), and flurazepam.

When purchased in its brand name form, the medication is sold as Ativan.

Lorazepam comes in the form of both tablets and intravenous injections; the form in which a patient receives lorazepam depends on the condition being treated. 

What is lorazepam used to treat?

Lorazepam is FDA-approved for several treatment option indications, including anxiety, insomnia, and seizures. 

Anxiety

Lorazepam is most commonly used to treat anxiety. Anxiety, which is defined by apprehension or fear about what is to come, is the body's natural response to stress.

While most people experience anxiety at some point or another, anxiety becomes a major issue when it causes extreme feelings or lasts longer than six months.

There are eight main types of anxiety disorders, including:

  • Generalized anxiety disorder
  • Panic disorder
  • Separation anxiety disorder
  • Illness anxiety disorder
  • Post-traumatic stress disorder
  • Phobia
  • Social anxiety disorder
  • Obsessive-compulsive disorder

People with generalized anxiety disorder, the most common type of anxiety, experience symptoms that include an increased heart rate, rapid breathing, restlessness, trouble concentrating, and difficulty falling asleep.

Panic attacks, a more acute form of anxiety, cause symptoms like feeling faint or dizzy, sweating, chills or hot flashes, shortness of breath, dry mouth, apprehension and worry, restlessness, distress, fear, numbness or tingling.

Insomnia

Lorazepam is sometimes prescribed to treat acute insomnia for short periods of time, especially when the condition is caused by extreme anxiety or stress.

Insomnia should not be treated for long periods of time by lorazepam due to the medication's tendency to be habit-forming and addictive.

People who take lorazepam for extended periods of time are at an increased risk of certain side effects, especially physical and psychological dependence, and are more likely to experience withdrawal symptoms when the medication is stopped.

Seizures

Lorazepam is FDA-approved as an anticonvulsant. When given intravenously, lorazepam is used to treat a severe type of seizure called status epilepticus.

Status epilepticus presents in two different forms: two or more seizures within a five-minute period without the person recovering in between, or a single seizure that lasts longer than five minutes.

How long does lorazepam stay in your system?

One of the biggest benefits to lorazepam is that the medication takes effect immediately, which makes it highly effective in treating acute symptoms of anxiety and panic disorders. It can even slightly lower blood pressure due to its sedative effects.

Lorazepam reaches its peak in approximately an hour to an hour and a half after ingestion and generally lasts around six to eight hours.

Therefore, the medication may need to be taken several times per day. 

Lorazepam has a high risk of dependence and drug abuse, so despite the fact that it is extremely effective at treating anxiety, it must be used with caution.

When used to treat anxiety, lorazepam should only be taken for the short-term in order to reduce the likelihood of the medication becoming habit-forming.

Lorazepam is a good medication to bridge the gap while you wait for a more appropriate long-term anxiety medication, such as Zoloft, to kick in. 

Are there any side effects associated with lorazepam?

Side effects for lorazepam are generally divided into three categories and include common, less common, and serious side effects.

Common side effects include:

  • Dizziness
  • Weakness
  • Drowsiness

Less common side effects include:

  • Depression
  • Fatigue
  • Confusion
  • Lack of coordination
  • Headaches
  • Restlessness

Serious side effects include:

  • Slowed breathing
  • Serious allergic reaction (antihistamines may be needed)
  • Suicidal thoughts
  • Respiratory failure
  • Psychological and physical dependence

Be on the lookout for signs of physical or psychological dependence on lorazepam. Symptoms of dependence may include:

  • Muscle weakness
  • Nightmares
  • Anxiety
  • Depression 
  • Nausea
  • Vomiting 
  • Body aches
  • Sweating

If you experience an allergic reaction to lorazepam, you should seek medical attention immediately. Symptoms of an allergic reaction include:

  • Swelling of lips, tongue, or face
  • Rapid heartbeat
  • Rash or hives
  • Trouble breathing or swallowing

Does lorazepam come with any warnings for use?

Because lorazepam has the potential to create psychological and physical dependence and can be habit-forming, the medication guide comes with several warnings for adverse effects.

Patients with a history of drug or alcohol abuse or alcohol withdrawal are more likely to abuse lorazepam, and patients with addictive tendencies may struggle to use the drug properly.

Lorazepam can cause a worsening of depression symptoms, so people with depression should communicate with their healthcare professionals if they notice that their symptoms are worsening, including the onset of suicidal thoughts.

Lorazepam can cause fatal respiratory depression when used in combination with other central nervous system depressants, so pharmacists and healthcare providers must pay attention to the possibility of drug interactions.

People taking lorazepam must be upfront with their doctors regarding any prescriptions, over-the-counter medications, supplements, vitamins, or herbs that they are taking in order to receive appropriate medical advice and drug information, and don't end up with inappropriately high doses.

Continuous long term use of lorazepam is not recommended; the medication should be prescribed for no longer than four months consecutively.

Women who are pregnant or breastfeeding should not use lorazepam due to the potential for serious birth defects and life-threatening withdrawal symptoms for the infant.

Are there any withdrawal symptoms associated with lorazepam?

Lorazepam is a habit-forming drug that can lead to physical and psychological dependency and addiction.

As a result, stopping the medication abruptly can cause withdrawal symptoms, particularly in people who have been taking the medication for an extended period of time.

If you've been taking lorazepam regularly for more than two weeks, it's incredibly important that you slowly taper down your dose of the medication under the supervision of a healthcare professional in order to prevent withdrawal symptoms from occurring. Common withdrawal symptoms include:

  • Trouble sleeping
  • Irritability
  • Headache
  • Anxiety
  • Sweating
  • Dizziness 

People who are severely dependent on lorazepam can experience serious withdrawal symptoms, especially if the medication is stopped abruptly. These include:

  • Tremors
  • Panic attacks
  • Hallucinations
  • Seizures

Is it possible to overdose on lorazepam?

Lorazepam does carry the risk of overdose, and people have overdosed on lorazepam in the past. This most often occurs when people who become dependent on the drug start taking more and more of the medication in order to achieve the same calming effect that they experienced the first time they took the drug.

Eventually, this can lead to overdose, which is lorazepam should be taken only as prescribed and only for short periods of time. Signs of an overdose include: 

  • Slurred speech
  • Feeling restless
  • Extreme drowsiness/sleepiness
  • Confusion
  • Feeling light-headed
  • Slow heartbeats
  • Muscle weakness
  • Loss of balance or coordination
  • Difficulty breathing 
  • Coma

Medical help should immediately be sought in the event of an overdose or possible overdose of lorazepam.

Who should not take lorazepam?

Because lorazepam can cause psychological and physical dependence and has a long list of adverse side effects, some groups of people should not take lorazepam. These groups include:

  • Children under age 12. Although some doctors prescribe lorazepam off-label to children under the age of 12, the medication is not approved by the U.S. Food and Drug Administration (FDA) for this use, as children are more likely to experience adverse reactions from lorazepam than adults. 
  • People with untreated depression or personality disorders. People with depression are more likely to experience suicidal thoughts when taking lorazepam.
  • Pregnant women and breastfeeding mothers. Pregnant and breastfeeding women should not take lorazepam under any circumstances, as the medication can cause serious birth defects or life-threatening withdrawal symptoms in newborn babies.
  • Senior citizens. Older adults are more likely to experience side effects of lorazepam that include drowsiness or dizziness, which can increase their risk of suffering from a fall. Adults over the age of 60 may require a substantially lower dose of lorazepam. 

Additionally, people with certain medical conditions should not take lorazepam. Make sure to tell your doctor if you have a history of any of the following medical conditions:

  • Acute narrow-angle glaucoma
  • Depression, mood problems, breathing problems, COPD, sleep apnea, drug or alcohol addiction, kidney/liver disease, seizures, glaucoma, suicidal thoughts or behavior
  • History of allergic reaction to any benzodiazepine

Finally, due to its depressive effects, you should not drink alcohol when taking lorazepam. 

References:

https://www.webmd.com/drugs/2/drug-8892-5244/lorazepam-oral/lorazepam-oral/details 

https://www.drugs.com/lorazepam.html 

https://medlineplus.gov/druginfo/meds/a682053.html

https://www.rxlist.com/consumer_lorazepam_ativan/drugs-condition.htm 

https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Lorazepam-(Ativan) 

https://adaa.org/about-adaa/press-room/facts-statistics

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