Benzodiazepines & Z-drugs

Lorazepam

A benzodiazepine used for short-term relief of severe anxiety and a number of other situations, valued for its relatively quick, reliable effect.

What is Lorazepam?

Lorazepam is a benzodiazepine that calms the nervous system, used mainly for short-term relief of severe or disabling anxiety. It works quite quickly but is intended only for brief use, because regular use can lead to tolerance and dependence. It also causes drowsiness and must not be combined with alcohol.

Class: Benzodiazepines & Z-drugs · Brands: Ativan

Education and reference only. This is a plain-language guide to Lorazepam — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review
Class: Benzodiazepines & Z-drugs → Brands: Ativan
Lorazepam (Benzodiazepines & Z-drugs) — Meds Global Health reference card with 2D molecular structure
Lorazepam — Benzodiazepines & Z-drugs. The image shows the active ingredient's 2D molecular structure.

What it is

Lorazepam is a benzodiazepine. In the UK it is used for the short-term relief of severe anxiety that is causing real distress or disability, and it has other roles such as helping with sleep when anxiety is a major factor, settling agitation, and use before some medical procedures. It is not a treatment for everyday worry, and because of the risk of tolerance and dependence it is meant for short courses rather than ongoing daily use. Longer-term anxiety is usually better managed with talking therapies and antidepressants.

How it works

Lorazepam enhances the effect of GABA, the brain's main calming (inhibitory) signal. By making GABA act more strongly, it dampens down over-activity in the nervous system, which reduces anxiety, relaxes muscles and promotes sleepiness. This same mechanism explains both its benefits and its drowsiness, and why combining it with alcohol or other sedatives is dangerous.

Company & origin

Originated / developed by: Wyeth.

Lorazepam was developed by Wyeth in the United States and introduced in the 1970s. It remains a widely used benzodiazepine in UK practice.

What it treats

Conditions Lorazepam is used for

Anxiety disordersPersistent, excessive worry and physical tension that interfere with daily life — treated …

Practical use

How to take Lorazepam

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Take it exactly as prescribed and only for as long as advised, which is usually a short course.
  • It can be taken with or without food.
  • Avoid alcohol completely while taking it, as the combination is dangerous.
  • Do not drive or use machinery if you feel drowsy, slowed or unsteady.
  • Do not stop suddenly after regular use; ask your prescriber about reducing it gradually.
  • If you miss a dose, do not double up; follow the advice you were given for that situation.

Weighing it up

Advantages & disadvantages of Lorazepam

Advantages

  • Works relatively quickly to relieve severe, distressing anxiety.
  • Useful for short-term crises where rapid calming is needed.
  • Well-established medicine with predictable effects.
  • Available in forms that suit several different situations.

Disadvantages

  • Risk of tolerance and dependence with regular use, so it is for short-term use only.
  • Causes drowsiness and can impair driving, memory and concentration.
  • Stopping suddenly after regular use can cause withdrawal, including seizures.
  • Must not be combined with alcohol or other sedating substances.
  • Does not treat the underlying cause of anxiety, which usually needs other approaches.

Practical use

Good to know

Lorazepam is intended for short-term use only. Used regularly for more than a short period it can cause tolerance (needing more for the same effect) and dependence, and stopping suddenly after regular use can cause a withdrawal reaction including, in some cases, seizures, so it should be reduced gradually under medical guidance rather than stopped abruptly. It causes drowsiness, can impair driving and operating machinery, and must not be taken with alcohol.

Who should not take it / use with caution

  • People with a known allergy to lorazepam or other benzodiazepines.
  • People with severe breathing problems or severe sleep apnoea.
  • People with myasthenia gravis (a muscle-weakness condition).
  • Use with great caution in older people, who are more sensitive to drowsiness and falls, and in those with a history of alcohol or drug dependence.

Monitoring

  • Review of whether it is still needed, to keep courses short.
  • Watching for signs of tolerance or dependence.
  • Extra care and review in older people because of falls and confusion.

Side effects

  • Drowsiness, tiredness and slowed reactions.
  • Unsteadiness, dizziness and risk of falls, especially in older people.
  • Confusion or memory problems.
  • Sometimes the opposite of the intended effect, such as agitation or restlessness.
  • Dependence and withdrawal symptoms with regular or prolonged use.

Key interactions

  • Alcohol, which greatly increases sedation and is dangerous.
  • Strong painkillers (opioids), which combined with benzodiazepines can dangerously slow breathing.
  • Other sedating medicines, such as some antihistamines, sleeping tablets and certain antidepressants.
  • Always tell your pharmacist or prescriber about all medicines you take.

Available as: Tablets, and a liquid and injection that are used in some settings.

Answers

Lorazepam: frequently asked questions

Is lorazepam addictive?

It can be. Used regularly, lorazepam can lead to tolerance and dependence, which is why it is prescribed for short periods. After regular use it should be reduced gradually rather than stopped suddenly.

Can I drink alcohol while taking lorazepam?

No. Alcohol and lorazepam both slow the nervous system, and together they can cause heavy sedation and breathing problems. You should avoid alcohol completely while taking it.

Can I drive while taking lorazepam?

Lorazepam can cause drowsiness and slow your reactions, so you should not drive or operate machinery if you feel affected. It can also impair driving even when you feel alright, so follow your prescriber's advice.

What is the difference between lorazepam and Ativan?

They are the same medicine. Lorazepam is the active-ingredient (generic) name and Ativan is a brand name; both contain identical lorazepam.

How long can I take lorazepam for?

It is intended for short-term use only, typically a brief course, because of the risk of dependence. Your prescriber will advise on the shortest course that helps and how to come off it safely.

The wider class

About Benzodiazepines & Z-drugs

Lorazepam belongs to the benzodiazepines & z-drugs class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.

Benzodiazepines and Z-drugsCalming and sleep medicines for short-term use — effective but habit-forming. DiazepamA long-acting benzodiazepine used short-term for severe anxiety, certain muscle spasms and…ZopicloneA Z-drug sleeping tablet used for short-term treatment of insomnia; it can cause next-day …TemazepamA benzodiazepine used for the short-term treatment of insomnia, helping people who are hav…ZolpidemA 'Z-drug' used for the short-term treatment of insomnia, helping people fall asleep when …ClonazepamA benzodiazepine used to help control certain types of epilepsy; it can cause drowsiness a…NitrazepamA long-acting benzodiazepine sleeping tablet for short-term, severe insomnia; it can cause…OxazepamA short-acting benzodiazepine used only for the short-term relief of severe anxiety, effec…ClobazamA benzodiazepine used mainly as an add-on treatment to help control epileptic seizures, wh…ChlordiazepoxideA benzodiazepine used mainly for the short-term management of alcohol withdrawal.…LormetazepamA benzodiazepine sleeping tablet for the short-term treatment of insomnia.…ZaleplonA very short-acting Z-drug sleeping tablet for short-term insomnia.…BuspironeAn anti-anxiety medicine that eases generalised anxiety over time, without the dependence …RemimazolamA short-acting benzodiazepine given into a vein to provide sedation during procedures, und…AlprazolamA short-acting benzodiazepine sometimes used for anxiety or panic, but not a first-line UK…EszopicloneA 'Z-drug' sleeping tablet used for short-term help with insomnia.…MidazolamA short-acting benzodiazepine used for sedation during procedures, to stop prolonged seizu…TriazolamA short-acting benzodiazepine used for the short-term treatment of severe insomnia.…EstazolamA benzodiazepine sleeping tablet used for the short-term treatment of insomnia.…

Browse by body system

Mental healthConditions and medicines for mood, anxiety, psychosis, sleep and dependence — used alongsi…

Authoritative sources

  • BNF: Lorazepam.
  • NICE CKS: Lorazepam.
  • electronic Medicines Compendium (SmPC): Lorazepam.

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