Ativan side effects most commonly involve sedation and impaired coordination. In the clinical trials summarized in the FDA label, sedation was reported by 15.9 percent of patients, followed by dizziness, weakness, and unsteadiness [1]. Ativan, the brand name for lorazepam, is a benzodiazepine used for anxiety and anxiety-related insomnia, and many of its benefits and adverse effects come from central nervous system depression. Most side effects are mild, but breathing problems, severe allergic reactions, profound sedation, or signs of overdose need urgent medical attention. If the concern is that lorazepam has become difficult to reduce or stop, benzodiazepine addiction treatment in Minnesota can help address problematic use and dependence.
The key takeaways:
- Sedation, dizziness, weakness, and unsteadiness are among the most common Ativan side effects [1].
- Lorazepam is not used as a heart-rate-lowering medication. Blood pressure may fall slightly in some people, and changes in pulse can reflect anxiety, sedation, other medications, or overdose.
- Memory problems, confusion, disorientation, and rare paradoxical agitation can occur, with older adults generally more vulnerable to cognitive and fall-related effects.
- Slow or difficult breathing, severe allergic reactions, profound unresponsiveness, and overdose symptoms need urgent medical attention. Physical dependence and withdrawal are important longer-term risks.
Common Side Effects of Lorazepam
The Ativan label lists the common side effects seen in clinical trials: sedation in 15.9 percent of patients, dizziness in 6.9 percent, weakness in 4.2 percent, and unsteadiness in 3.4 percent [1]. Other side effects listed less often include fatigue, blurred vision, headache, slurred speech, nausea, constipation, and changes in appetite and sex drive [1]. Weight loss appears only in connection with withdrawal; does Ativan cause weight gain has its own chapter.
Does Ativan Make You Sleepy?
Yes. Sleepiness is the most common side effect, and the intended one when lorazepam is prescribed for anxiety-related insomnia. Taken during the day, the same sedation shows up as drowsiness, slowed reaction time, and difficulty concentrating. The NHS advises not to drive, ride a bike, or use tools or machinery until you feel better, and not to drink alcohol, which makes the sleepiness worse [2]. Drowsiness usually eases within a week or two; if it does not, tell your prescriber. The felt effects run 6 to 8 hours, and how long each dose lasts is covered in its own chapter.
Dizziness, Weakness, and Coordination
Dizziness, muscle weakness, and unsteadiness come from the same muscle-relaxing and sedating action. They matter most for older adults, in whom a stumble becomes a fall, and the NHS lists repeated falls among the reasons to see a doctor [2]. Stand up slowly, sit down when lightheaded, and drink water; weakness without exertion should be reported. Muscle pain is not typical while taking lorazepam; it is a common withdrawal symptom in people who have become dependent.
Does Ativan Lower Heart Rate or Blood Pressure?
Lorazepam is not a heart-rate or blood-pressure medication. By reducing anxiety and central nervous system arousal, it may indirectly lower a fast pulse caused by anxiety, but it is not prescribed as a treatment for tachycardia. The Ativan label states that small decreases in blood pressure and hypotension may occur but are usually not clinically significant [1]. More pronounced hypotension can occur when lorazepam is combined with other depressants or certain medications such as clozapine [1]. The parent guide explains what benzodiazepines are and how they work.
New palpitations, fainting, chest pain, or an irregular heartbeat should be evaluated rather than automatically attributed to lorazepam. A racing heartbeat can also occur during benzodiazepine withdrawal symptoms. People with cardiovascular disease should make sure the prescriber knows their heart conditions and other medications so blood pressure, sedation, and drug interactions can be considered.
Effects of Lorazepam on Memory, Mood, and Thinking
Benzodiazepines can interfere with memory formation, attention, and thinking while they are active. The Ativan label lists amnesia, memory impairment, confusion, and disorientation among reported effects [1], and NHS guidance lists memory loss as a reason to speak with a doctor [2]. Acute cognitive effects often improve as the drug wears off, but persistent or progressive memory changes, especially in an older adult, should be medically evaluated rather than assumed to be temporary. Questions about possible longer-term cognitive effects are examined in our chapter on Xanax and dementia.
Lorazepam can also affect mood and behavior. The label lists depression, unmasking of depression, disinhibition, and rare suicidal thoughts [1]. Paradoxical reactions including anxiety, excitation, agitation, hostility, aggression, rage, insomnia, sexual arousal, and hallucinations have also been reported [1]. NHS guidance flags unusual mood changes, aggression, and hallucinations as reasons to seek medical advice, particularly in children and adults over 65 [2]. New severe agitation, aggression, hallucinations, or major mood changes should be reported promptly.
Serious Side Effects: When to Call a Doctor Immediately
Many lorazepam side effects are uncomfortable rather than dangerous, but some symptoms need urgent medical attention:
- Very slow, difficult, or stopped breathing; blue or gray lips; collapse; or inability to wake. These are overdose emergencies. Call 911.
- A severe allergic reaction, including swelling of the lips, tongue, mouth, or throat or difficulty breathing. Call 911 [2].
- Severe confusion, hallucinations, delusions, or extreme behavioral changes. Seek urgent medical evaluation [2].
- Suicidal thoughts or behavior. Seek immediate crisis or emergency help [1].
- Yellowing of the skin or eyes, which may indicate a liver problem [2].
- Repeated falls, especially in an older adult, which should be medically evaluated [2].
MedlinePlus lists overdose symptoms including drowsiness, confusion, extreme tiredness, slowed breathing and heartbeat, poor coordination, and loss of consciousness [3]. Naloxone does not reverse lorazepam, but if opioid exposure is possible, it can reverse the opioid component and should be used while emergency help is on the way.
Drug Interactions That Make Side Effects Dangerous
The serious side effects above are far more likely when lorazepam is combined with other drugs. The boxed warning covers opioids, which together with lorazepam “may result in profound sedation, respiratory depression, coma, and death” [1]. Alcohol, sleep medications, other sedatives, muscle relaxants, sedating antihistamines sold over the counter, and some dietary supplements marketed for sleep add to the same CNS depression, and probenecid and valproic acid raise lorazepam levels [1]. The full list of what to avoid is here.
Who Has a Higher Risk of Side Effects
Some people are more vulnerable to sedation, falls, respiratory problems, or other adverse effects and may need closer monitoring or a different treatment:
- Older adults, who are generally more sensitive to sedation, confusion, impaired coordination, and falls [1].
- People with respiratory disease, including COPD or sleep apnea, because CNS depressants can worsen breathing problems [1].
- People with significant medical illness or impaired drug clearance, who may respond differently and need individualized dosing and monitoring. Lorazepam is less dependent on CYP-mediated liver metabolism than many other benzodiazepines.
- Children younger than 12, because the safety and effectiveness of oral Ativan have not been established for that age group [1].
- Pregnant or breastfeeding patients. Lorazepam enters breast milk, and exposed infants should be monitored for sedation, poor feeding, or inadequate weight gain [1].
- People with a history of substance misuse or addiction, particularly when alcohol or opioids are also involved.
Tell the prescriber about all medical conditions, prescription and nonprescription medications, and supplements before taking lorazepam.
Long-Term Side Effects: Dependence and Withdrawal
Lorazepam is a Schedule IV controlled substance, and continued use can lead to tolerance and physical dependence. The Ativan label states that tolerance may develop with continued therapy and that ongoing benzodiazepine use may lead to clinically significant physical dependence [1]. The FDA’s class-wide boxed warning says physical dependence can develop after steady use for several days to weeks, even when the medication is taken exactly as prescribed [4]. NHS guidance generally recommends limiting lorazepam treatment to short periods and notes that doses may need to be reduced gradually after longer use [2].
Withdrawal is not simply the opposite of the drug’s ordinary side effects. Symptoms can include rebound anxiety, insomnia, tremor, muscle pain, palpitations, perceptual changes, and, in severe cases, seizures and other life-threatening reactions [4]. Symptoms may appear after missed or reduced doses in someone who is physically dependent, but the timing varies. Current clinical guidance advises against abrupt discontinuation in people likely to be physically dependent and recommends an individualized taper when stopping is appropriate. Our chapter on how to wean off lorazepam explains how that process works.
Frequently Asked Questions About Ativan Side Effects
What Is the Most Serious Side Effect of Lorazepam?
Respiratory depression. Slowed or stopped breathing is the effect that kills, and it happens almost always when lorazepam is combined with opioids, alcohol, or other sedatives, which is why the FDA’s boxed warning names that combination [1]. The most serious long-term effect is dependence, with seizures possible if the drug is stopped abruptly.
Can People With Heart Problems Take Lorazepam?
Some people with heart conditions can take lorazepam, but the decision depends on the specific heart problem, blood pressure, breathing risk, and other medications. Lorazepam is not prescribed to lower heart rate, and the Ativan label says small decreases in blood pressure and hypotension may occur but are usually not clinically significant [1]. New fainting, chest pain, or irregular heartbeat should be evaluated rather than assumed to be a normal medication effect.
What Happens If You Take Lorazepam Every Day?
Taking lorazepam every day can lead to tolerance and physical dependence, although the timing and degree vary from person to person. The FDA warns that physical dependence can develop after steady benzodiazepine use for several days to weeks, even at prescribed doses [4]. Some people become less sleepy with repeated use, but cognitive and other adverse effects can persist. If physical dependence has developed, lorazepam should not be stopped abruptly and may need to be tapered gradually under clinical supervision.
Getting Help With Ativan in Minnesota
If you keep taking Ativan because stopping brings back everything it was quieting, that is dependence, and it is treatable. Northwoods Haven’s intensive outpatient program offers personalized treatment plans for benzodiazepine dependence: a supervised taper, therapy for the anxiety underneath, and support for long-term recovery. Reach out for a confidential conversation about your treatment options.
Sources
- U.S. Food and Drug Administration, ATIVAN (lorazepam) tablets prescribing information, revised January 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/017794s049lbl.pdf
- National Health Service (UK), “Side Effects of Lorazepam,” page last reviewed February 14, 2023. https://www.nhs.uk/medicines/lorazepam/side-effects-of-lorazepam/
- MedlinePlus (National Library of Medicine), “Lorazepam,” last revised November 15, 2025. https://medlineplus.gov/druginfo/meds/a682053.html
- U.S. Food and Drug Administration, “FDA Requiring Boxed Warning Updated to Improve Safe Use of Benzodiazepine Drug Class,” Drug Safety Communication, September 23, 2020. https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class
