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By Kajal Jain

M. Pharm

07 January 2023
Medically reviewed by
CAN ATIVAN CAUSE ANXIETY
Table of Contents

People have struggled with depression and Anxiety for decades. You might also remember times when you felt an acute sense of Anxiety. Different situations can lead to Anxiety. For most people, those anxious feelings, fear, and worries subside after the problem is resolved. But for the remaining people, Anxiety is ongoing, even without a clear cause. 

In those cases, a person may be desperate to find relief and turn to their doctor for help. Various therapies and medications have ranged wildly from century to century for these common mental health concerns. The doctor may prescribe Ativan, a drug belonging to benzodiazepines that effectively calm the racing mind.

Ativan is FDA-approved and ranked 48 in 2012 on a list of the 200 most frequently prescribed medications. In 2017, physicians wrote almost 26.5 million prescriptions for Ativan alone. Since Ativan is approved for Anxiety, can it also become one of the reasons for Anxiety?

What Is Ativan?

Ativan, containing Lorazepam as its active ingredient, belongs to a class of drugs called benzodiazepines. The U.S. Food and Drug Administration (FDA) approved this medicine in 1977. 

It is a sedative/hypnotic or anxiolytic drug that helps to treat Anxiety disorders such as panic attacks, obsessive-compulsive disorder (OCD), generalized Anxiety disorder, and social phobias.

It is also used for the short-term relief of Anxiety symptoms such as trembling, excessive sweating, increased heart rate, rapid breathing, nervousness, and weakness or lack of concentration.

This drug is suitable for treating Anxiety in adults and children 13 years and older. It can also be taken by adults and children 5 years or older as a "pre-medication" before surgery.

Ativan is available in two forms, i.e., 

  • A tablet: suitable for children 12 years and older and adults to treat Anxiety symptoms and insomnia
  • A Solution: given by IM or IV bolus, which is used in adults before surgery to make you sleep and to treat status epilepticus  

How Does Ativan Work?

Ativan (Lorazepam) acts on the Gamma-aminobutyric acid receptors (GABA) to slow down the Central Nervous System. This reduces excess excitement and agitation, inducing a calming and relaxing effect.

This also reduces the intensity of panic attacks and Anxiety. The drug has fast-acting compounds that make it an effective solution to manage panic symptoms temporarily. The drug enters your system rapidly and lasts a few hours. It should only be consumed briefly to avoid any adverse effects. 

Systematic clinical studies have not assessed the effectiveness of Ativan for more than four months. Physicians or concerned medical practitioners should periodically evaluate the drug's efficacy for the individual patient. 

Does Ativan Cause Anxiety?

Ativan can have powerful effects on the nerves and brain. However, most users experience "rebound" effects or worsening of the same symptoms that a drug is designed to treat. Specifically, Ativan can cause rebound Anxiety, sleep disturbances, abnormal body movements, and agitation.

  • Restlessness
  • Rebound Anxiety
  • Depression
  • Loss of pleasure in day-to-day experiences
  • Learning difficulties
  • Memory problem

The chemical structure of Ativan is intended to reduce the excitation of the nerves and brain while soothing emotional responses that create Anxiety, uneasiness, and restlessness.

Individuals taking Ativan may lose interest in their daily responsibilities or experiences. They might feel constantly sluggish and tired and have an exhausted appearance.

Ativan starts to work in around 20 to 30 minutes. It reaches its peak effects within two hours for most individuals.
The most common side effect is feeling sleepy (tired) during the daytime. If Ativan makes you tired, do not drive, use tools, or operate machinery.
Ativan is not recommended to use for longer than 4 weeks. There are chances of you getting addicted or abuse the medicine consumption.

Why Does Rebound Anxiety Appear?

The Rebound effect usually occurs when a medication having a contrary impact on the disorder is discontinued, which makes the original condition more difficult to treat due to serious health effects. 

Between 10%-35% of individuals will experience a rebound of Anxiety symptoms, especially panic attacks, when they discontinue benzodiazepines too rapidly. A slow tapering of the medication is best, which can lead to fewer withdrawal symptoms.

Rebound symptoms are common with depressants and other drugs used to treat Anxiety and panic disorders. For the most part, Anxiety medications are ideally used for short-term therapeutic use.

That means you take the drug for a certain amount of time to correct any chemical imbalances, and then you stop taking the medication or taper off. However, when you stop using the drug, it may come with withdrawal symptoms. Rebound symptoms are usually the most common withdrawal symptoms regarding Anxiety medications. 

How Long Does Rebound Anxiety Last?

Benzodiazepine medications are intended for short-term use to cope with some of the most extreme Anxiety symptoms. Tolerance to these drugs can occur in as little as three weeks, so doctors prescribe smaller doses.

It's possible to experience these withdrawal symptoms for several weeks after abstaining, even when used as prescribed. Those who abuse the medication place themselves in a more difficult situation and can experience more profound side effects such as hallucinations and seizures. 

How Long does Anxiety Last?

Anxiety disorder can be scary and disorienting, not because of the physical symptoms that manifest when you start to worry. These disorders may also raise your risk of developing medical problems like heart disease, depression, diabetes, and substance Abuse difficulties.

Approx. 31.1% of Americans are likely to develop Anxiety at some point. This disorder stops an individual from functioning normally and is experienced for most days, i.e., six months or longer.

No specific period for how long an Anxiety disorder is expected to last. However, there are some highly individual factors. According to one three-year study, the following factors affect the duration of Anxiety disorder duration:

  • Having a physical disorder
  • Lacking a paid job
  • Being in an older age group
  • Living alone
  • Having multiple Anxiety disorders 
  • How quickly you are diagnosed or treated 
  • Type of Anxiety disorder (e.g., social Anxiety disorder tends to last longer)

Ativan Withdrawal Symptoms

Benzodiazepines like Ativan were initially intended for short-term use, but prolonged usage of Ativan for insomnia and Anxiety has become common. Taking Lorazepam for a short term of three to six weeks daily, even at prescribed doses, can cause dependence and mild withdrawal symptoms.

Ativan withdrawal is a challenging experience. Many people take this drug regularly for years without realizing how dependent they have become on Ativan. 

Around 40% of people on benzodiazepines for longer than six months are likely to experience moderate to severe withdrawal symptoms if they discontinue taking it abruptly. The remaining 60% will have mild symptoms. When your daily dose of Ativan is stopped suddenly or significantly reduced, withdrawal symptoms can appear in less than 8 to 12 hours.

The severity of these symptoms is also associated with your current dose. If you take more Ativan or mix it with other benzo drugs, your withdrawal symptoms may become more severe.

Potential withdrawal symptoms include:

  • Irritability
  • Anxiety
  • Restlessness
  • Insomnia
  • Muscle spasms
  • Sweating
  • Hand tremors
  • Headache
  • Hyperventilation
  • Panic attacks
  • Nausea or vomiting
  • Racing pulse
  • Hypersensitivity to stimuli like light and touch
  • Depression
  • Problems with concentration and memory
  • Visual disturbances 
  • Feelings of unreality
  • Auditory, tactile, or visual hallucinations
  • Delirium
  • Abnormal bodily sensations (skin-crawling, goosebumps)

Some studies describe acute withdrawal as at its worst phase on the second day and improving by the fourth or fifth day. 

Ativan and Addiction

Ativan is a potent benzo drug with a high potential for addiction and Abuse. Taking Ativan for any period leads to physical and psychological dependence based on various factors, including personal history, method of misuse, and genetics.

People with a history of substance or alcohol abuse or untreated mental health disorders are at higher risk of developing Ativan addiction. As a pharmacotherapeutic agent, Ativan is intended for short-term use.

If taken beyond the point when it should be discontinued (e.g., two weeks to months), the medication is unlikely to retain its efficacy. The compulsive patterns of use typical of addiction might more readily take shape.

The following criteria may be warning signs for a developing Ativan addiction-

  • Increased intolerance
  • Withdrawal
  • An inability to fulfill work/school/domestic obligations without Ativan
  • Spending a lot of time to get more Ativan (and to recover from its effects)

In many cases, the risks of severe withdrawal require vigilant observation. To be safe, all benzo drugs should be tapered gradually rather than quitting abruptly, regardless of the dose and duration of use. This process is known as medical detox, an early treatment for Ativan addiction to ensure safe and easy recovery.

How Is Rebound Anxiety Treated?

If you have come off any medication and started experiencing rebound symptoms, speak to your doctor. Mental health issues are complicated, even ordinary problems like Anxiety. It is essential to work with your physician to find the best and most effective treatment, which may require some trial and error.

Your healthcare provider can work with you to alter your dose or try a different medication to find one that works effectively. If you come off a medicine only to see your symptoms return, it means you need to find a more effective, long-term solution.

It is also helpful to pair pharmacological treatments with other forms of therapy. Psychotherapy may help you learn to cope with Anxiety triggers better than medication alone. In many cases, underlying issues like past traumas must be addressed to treat your concern effectively.

Possible Side Effects Of Ativan

Various severe side effects may occur with the use of Ativan. The side effects of Ativan tend to be stricter with high doses. If it appears that someone is in an overdose state due to taking Ativan or other benzodiazepines, get emergency medical help immediately. 

Common side effects

Severe side effects

Lightheadedness

Aggression, Agitation

Sedation

Convulsions or seizures

Unsteadiness

Suicidal thoughts

Drowsiness or sleepiness

Low blood pressure

Dizziness

Erectile dysfunction

Depression

Swelling on lips/tongue

Muscle weakness

Allergic reactions

Changes in libido (sex drive)

Breathing difficulty (or respiratory failure

Precautions of Ativan

Before taking Ativan, please inform your doctor about your medical history or any medications, as they might interfere with the drug's functioning.

  • Acute narrow-angle glaucoma: Ativan might increase eye pressure, worsening glaucoma. 
  • Kidney or liver problems: The renal or hepatic disease affects how your body breaks down medicine after taking a dose. You might be prescribed a different quantity of Ativan.
  • Allergic reaction: Avoid taking Ativan if you are allergic to this drug or its ingredients.
  • Breathing disorders: Ativan can slow breathing rate. People with COPD, sleep apnea, or other breathing disorders should be cautious with this medicine.
  • Depression: Ativan can worsen the symptoms of depression. 
  • Breastfeeding: Ativan should be avoided while breastfeeding; Ativan can mix in breast milk.
  • Pregnancy: Ativan should be avoided during pregnancy. It might affect the newborn baby.
  • Alcohol: Ativan should not be consumed with Alcohol. As it can lead to dangerous side effects.

Ativan Interactions

Ativan can interact with several medicines. Different interactions can cause varying effects and interfere with the performance of a drug. It should not be taken with benzodiazepine medications such as Clonazepam, Alprazolam, Midazolam, and Diazepam. 

Ativan causes drowsiness, so caution should be taken in combination with other sedatives. These include:

  • Antihistamines such as diphenhydramine
  • Other anti-anxiety medications, antipsychotic medications, certain anticonvulsant medications, and tricyclic antidepressant medications (such as amitriptyline) 
  • Antipsychotic drugs such as haloperidol, clozapine, risperidone
  • Sleeping medications such as zolpidem 
  • Narcotic pain medication such as morphine, oxycodone, and hydrocodone
  • Barbiturates such as phenobarbital
  • Opioid cough medications such as codeine cough syrup
  • Ativan can also interact with certain herbs, supplements, and foods such as Kava Kava,
  • Lavender, and Melatonin.
  • Cannabis 

Bottom Line From Practical Anxiety Solutions1

Suppose you face challenges finding peace of mind or staying calm and generally free from irrational worries or fears. In that case, you may consider seeking professional help for your Anxiety.

However, it is easy to use Ativan to relieve Anxiety symptoms. It is a benzodiazepine medication for short-term use to cope with extreme Anxiety symptoms. It has powerful effects on the nerves and brain.

However, most users experience "rebound" effects or worsening of the same symptoms that a drug is designed to treat. Seek advice from the medical practitioner for adequate treatment and check with your doctor if you have any concerns about your medicine or if your medical condition does not improve.

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