Ativan (lorazepam) belongs to the class of drugs known as benzodiazepines. These are central nervous system (CNS) depressants that are commonly used to treat anxiety, panic, and sleep disorders. Doctors may also prescribe Ativan to treat seizures.

Benzodiazepines like Ativan work by increasing the activity of a neurotransmitter, or brain chemical, called GABA, which slows the nervous system and calms the body. While Ativan is a prescription drug with legitimate medical uses, people may develop a physical dependence upon this drug, meaning they will experience withdrawal when they stop using it. Physical dependence can occur even when a person uses Ativan as prescribed, but some people may abuse the drug because they enjoy its calming effects.

Patients should always take the prescribed Ativan dosage to prevent a possible overdose, and should avoid using this drug unless a doctor prescribes it. In the event that someone does overdose on Ativan, it is important to know the signs of overdose and what to do to give them the best chance at recovery.

Can You Overdose on Ativan?

It is possible to overdose on Ativan or any other benzodiazepine. However, there are many factors that determine whether a person is at risk of overdose. These include:

  • Ativan Overdose Factors
  • How long someone has used Ativan
  • The amount of Ativan someone uses each day
  • Age
  • Weight
  • Gender

How Much Ativan Does It Take to Overdose?

According to the Food and Drug Administration (FDA), most people begin with a daily dose of 2 to 3 milligrams of Ativan to treat anxiety, divided up into two to three tablets over the course of the day. Ativan is available in 0.5 milligram, 1 milligram, and 2 milligram tablets. A doctor works with each individual patient to determine the appropriate Ativan dosage based upon a person’s age, needs, and response to the medication, so it is important that people take Ativan exactly as prescribed to avoid overdose.

There are many tests performed with a drug before it is determined to be safe, including an LD50 (lethal dose). This measures how much of a drug is required to kill 50% of mice that are treated. The LD50 of Ativan is roughly 1,850 mg/kg (milligrams of drug per kilogram of a person’s body weight). The peak amount of Ativan in the blood after a 2 mg dose is 20 ng/ml (nanograms per milliliter). This means that the Ativan overdose amount is extremely high for a human. However, lower doses can still be dangerous and result in serious signs of overdose that must be addressed immediately, especially if a person combines Ativan with other substances.

Signs of Ativan Overdose

Signs of Ativan overdose look similar to overdoses with other CNS depressants, such as other benzodiazepines or opioids. The most recognizable Ativan overdose symptom will be respiratory depression, where a person has abnormally short, labored breathing. Other signs to look for include:

  • Ativan Overdose Symptoms

    Severe drowsiness and fatigue

    Extremely low blood pressure

    Excessive sweating

    Loss of reflexes and coordination

    Coma

While the symptoms above may not seem life-threatening, it is important that people receive immediate medical treatment to prevent complications from Ativan overdose. More severe Ativan overdose symptoms may include low blood pressure, loss of coordination, breathing difficulties, hypnosis, coma, and even death.

Common Ativan side effects that are not immediately dangerous are as follows:

  • Ativan Side Effects

    Slight drowsiness

    Calmness

    Dizziness

    Fatigue

    Lightheadedness

It is also possible for people to experience memory problems, fatigue and slight confusion when using Ativan. To avoid overdose complications, it is important to be aware of any side effects that appear extreme or markedly different from a person’s usual behavior.

Ativan and Suicide

Ativan is used to treat anxiety that co-occurs with depression, but it does not treat the underlying depression itself. That being said, some patients may intentionally overdose on Ativan if they are experiencing depression with suicidal thoughts. According to the National Institute on Drug Abuse, there were 10,724 fatal benzodiazepine overdoses in 2018, 9,140 of which involved an opioid drug and 1,584 which did not. It is unknown how many of these overdoses were intentional, but people may take high doses of benzodiazepines like Ativan or combine these drugs with opioids in an attempt to take their own lives.

If you or a loved one is experiencing suicidal thoughts or tendencies, call the National Suicide Prevention Hotline at 1-800-273-8255.

Dangers of Combining Ativan with Other Substances

As noted previously, a majority of Ativan overdoses in 2018 involved an opioid drug, which is not surprising given that mixing Ativan with other substances, such as opioids, increases the overdose risk. The FDA reports that most Ativan overdoses involve alcohol or another drug taken in combination with Ativan. It is for this reason that the FDA warns that people should not use alcohol, opioids or other central nervous system depressants while taking Ativan. Doing so can lead to respiratory depression and elevate a person’s risk of experiencing a fatal overdose.

Ativan Overdose Treatment

If there is a suspected Ativan overdose, contact emergency medical services immediately. At the hospital, there are treatment options available to stop an Ativan overdose. Medical staff will monitor symptoms and provide treatment as needed to address them. They may give activated charcoal to stop the body from absorbing Ativan. Doctors may prescribe medication if necessary.

Flumazenil is a benzodiazepine antagonist that can be given as an Ativan overdose treatment. Doctors exercise caution when using this medication to treat Ativan overdose, though, because it can cause seizures in people who are withdrawing from benzodiazepines or who have recently taken these drugs via injection. Other common side effects are as follows:

  • Flumazenil Side Effects

    Seizures

    Chest pain

    Severe dizziness

    Agitation

    Lightheadedness

    Upset stomach and vomiting

    Increased sweating

    Headache

    Blurred vision

Ativan Overdose Prevention

The most effective way to prevent Ativan overdose is to take the medicine as prescribed by a doctor and to avoid obtaining the medication illegally without a prescription. Misusing Ativan for reasons other than a legitimate medical concern is dangerous and can lead to dependence, withdrawal and possible overdose. To prevent any adverse drug reactions that may increase the chances of an overdose, it is also important to talk with your doctor about any other medications you are taking.

If you or someone you love is seeking treatment for Ativan misuse, there are drug addiction and detox centers in Florida available to help. The Recovery Village Palm Beach at Baptist Health offers evidence-based programs that can treat substance use disorders and co-occurring mental health conditions. Contact us today to learn more about treatment options that meet your individual needs.

  • Sources

    Harvard Medical School. “Benzodiazepines (and the alternatives).” March 15, 2019. Accessed June 24, 2020

    Food and Drug Administration. “Ativan.” Accessed June 25, 2020.

    DrugBank. “Lorazepam.” June 13, 2005. Accessed June 25, 2020.

    National Institute on Drug Abuse. “Overdose Death Rates.”March 10, 2020. Accessed June 25, 2020.

    Drugs.com. “Flumazenil.” December 13, 2018. Accessed June 25, 2020.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.