Ativan (Lorazepam) Overdose: Symptoms, Signs, & Treatment

Ativan (lorazepam) is a medication often prescribed to help with anxiety, sleep problems, or seizures [1]. While it can be helpful when used correctly, it also carries serious risks, especially if taken in larger amounts than prescribed. Misusing Ativan can lead to dangerous side effects, including the possibility of an overdose. 

In this guide, we explain how Ativan works, how much lorazepam is too much, how you can overdose on lorazepam, what happens during an OD, and the steps you can take to prevent and treat one. Recognizing the warning signs early can help save lives. You will also discover how to connect with effective treatment for prescription drug addiction.

What Is Ativan (Lorazepam)?

Ativan, available in generic form as lorazepam, is a type of medication known as a benzodiazepine [2]. Doctors usually prescribe it to help people with anxiety, insomnia, or to control seizures. It works by calming the brain and nerves, making you feel more relaxed. Ativan affects a chemical in the brain called GABA, which helps slow down brain activity when you’re feeling anxious or overwhelmed [3]

While Ativan can be helpful for short-term use, it can be risky if used for too long or in higher doses than prescribed. Over time, some people may become dependent on the medication, meaning they feel like they need it to function. This is why doctors usually recommend using it only in the short term and following the dosage instructions closely.

Can You Overdose on Ativan?

Yes, you can OD on Ativan. It is possible to take too much of this powerful medication from the benzodiazepine family, which affects the brain and central nervous system (CNS)[4]. While it can be effective for treating anxiety, sleep disorders, or seizures, taking too much Ativan can lead to serious health risks, including overdose. 

An overdose occurs when someone takes more than their body can handle, and this can happen accidentally or intentionally. Although Ativan is usually safe when taken as prescribed, overdose is still possible, especially with misuse. People who take too much Ativan or combine it with other substances like alcohol or opioids are at a much higher risk of overdose.

Ativan works by slowing the activity of the brain and nerves. This calming effect makes it useful for treating anxiety and other disorders, but excessive dosing can slow the brain down too much. This can lead to dangerous effects, including severe drowsiness, breathing problems, and even loss of consciousness.

4 Common Causes of Ativan Overdose

1. Mixing Ativan with Other CSN Depressants: One of the most common causes of an Ativan overdose is mixing it with other CNS depressants. Alcohol, opioids, and other sedatives can intensify Ativan’s effects, increasing the risk of overdose. People who take Ativan with these substances may not realize how dangerous it is until they experience severe symptoms.
2. Developing a Tolerance to Ativan [5]: Over time, a person might need more of the drug to feel the same effects. This can lead to taking larger doses than prescribed, which increases the risk of overdose. Tolerance develops when the body gets used to the medication, reducing its initial effectiveness. This is why doctors often recommend using Ativan only for short periods.
3. History of Substance Abuse: Certain factors can increase the risk of an Ativan overdose. People who have a history of substance abuse are more likely to misuse Ativan, which raises their risk. Those who take high doses of the drug or use it without a prescription are also more likely to overdose – read on to find out how much Ativan is too much.
4. Advanced Age or Poor Health: Older adults may be at a higher risk due to how their bodies process medications. Seniors may not metabolize Ativan as quickly as younger people, causing the drug to build up in their system over time [6].

Mixing Ativan with other drugs or alcohol is one of the most dangerous combinations. Because both substances can slow down breathing and heart rate, using them together can cause these functions to stop completely. Even small amounts of alcohol or opioids can drastically increase the risk of a life-threatening overdose when taken with Ativan. 

Symptoms of Lorazepam (Ativan) Overdose

Getting help quickly if you suspect benzo overdose can save a life. Sometimes, it’s hard to recognize an overdose right away, as symptoms may appear gradually. At first, it might seem like the person is just sleepy or unusually calm, but as the overdose worsens, the symptoms can become more severe.

Here are some common Ativan overdose signs and symptoms:

• Extreme drowsiness or sleepiness: Someone overdosing on Ativan may struggle to stay awake, even in situations where they would normally be alert.
• Confusion and disorientation: The person might seem confused, have difficulty concentrating, or not remember where they are or what’s happening around them.
• Slow or slurred speech: Speech may slow or become difficult to understand, much like when someone is extremely intoxicated.
• Weakness or lack of coordination: Ativan can cause muscle weakness and loss of coordination, making it hard for the person to walk or move.
• Blurred vision or trouble seeing: Vision problems like blurriness or double vision are also signs of an overdose.
• Slow or shallow breathing: This is one of the most dangerous symptoms of an Ativan overdose. The drug can slow down breathing so much that it becomes shallow or stops altogether, depriving the brain and body of oxygen.
• Low blood pressure and slow heart rate: Ativan slows down the CNS, potentially leading to dangerously low blood pressure and a slowed heart rate.
• Loss of consciousness or coma: In severe cases, an overdose can cause the person to pass out or slip into a coma, where they are unresponsive and cannot be woken up.
• Seizures: Seizures may occur during an Ativan overdose, especially if the drug was taken in combination with other substances.
• Bluish lips or skin: If the overdose causes breathing to slow or stop, the person’s skin and lips may turn blue from lack of oxygen. This is a sign of a life-threatening emergency.

What Is a Lethal Dose of Lorazepam?

It’s difficult to say exactly how much Ativan is lethal, as it depends on a person’s age, weight, tolerance to the drug, and whether other substances were involved. That said, extremely high doses of Ativan can be dangerous, especially when taken with alcohol, opioids, or other CNS depressants. 

For most people, the recommended maximum dose of Ativan for treating anxiety is about 10mg per day. Taking more than this amount significantly increases the risk of overdose. However, what constitutes a lethal dose can vary from person to person. For some, 10mg could be dangerous, while others may tolerate more due to factors like body size or a history of using similar drugs.

When Ativan is combined with other substances that affect the central nervous system, a lethal dose of Ativan may be lower. Taking Ativan along with alcohol or opioids, for instance, can slow breathing to a point where the body shuts down completely, leading to death. This is why you should never mix Ativan with other CNS depressants unless specifically instructed by a doctor.

Ativan Max Dosage for Adults: Is 5mg of Lorazepam a lot?

For adults, the usual dose of Ativan varies depending on the condition being treated. For anxiety, doctors typically prescribe 2 to 6mg per day, divided into smaller doses. For sleep disorders or insomnia, a smaller dose of 1 to 2mg at bedtime may be recommended. It’s essential to follow your doctor’s instructions closely, as taking more than the prescribed amount can quickly lead to an overdose.

The maximum daily dose of Ativan should generally not exceed 10mg per day. Exceeding this amount dramatically increases the risk of overdose, especially if taken over a long period. Consult your physician if you feel your prescribed dose isn’t working. Never adjust the dosage independently, as it can trigger adverse outcomes. 

Long-Term Effects of Lorazepam Overdose

An overdose of lorazepam can trigger serious long-term effects on a person’s health, especially if the overdose is severe or not treated quickly. While lorazepam is normally used to treat anxiety or insomnia, taking too much can cause lasting damage to the body and brain. Some long-term effects of an overdose may include:

• Memory problems: Lorazepam affects the brain’s memory functions, and a large overdose can lead to long-term memory issues. This can make it hard to recall recent events or form new memories [7]
• Cognitive impairment: After an overdose, some people may struggle with thinking or concentrating. This can affect daily activities and the ability to work or study.
• Physical weakness: Overdosing on lorazepam can cause lasting muscle weakness or lack of coordination. In some cases, people may experience trouble with balance and walking.
• Emotional changes: A lorazepam overdose can affect a person’s mood and emotions. Some people may feel increased anxiety, depression, or mood swings long after the overdose has occurred.
• Organ damage: In severe cases, a lorazepam overdose can damage vital organs like the liver or kidneys, especially if other substances are involved. This damage may require ongoing medical care.
• Dependence and addiction: Even after recovering from an overdose, a person may develop a dependence on lorazepam [8]. This means they may feel they need to continue using the drug just to feel normal, promoting a cycle of abuse.
• Brain damage: If an overdose causes a significant lack of oxygen to the brain due to slowed breathing, it can result in permanent brain damage. This can affect cognitive abilities, memory, and motor skills.

Treatment for Ativan (Lorazepam) Overdose

Treating an Ativan overdose requires immediate medical attention to prevent serious health complications or death. If you suspect someone has overdosed on lorazepam, act quickly – it could be life-saving.

Here’s how an Ativan overdose is typically treated:

• Call 911: The first step in treating an Ativan overdose is to call emergency services right away. Medical professionals are needed to assess the situation and provide life-saving treatment.
• Monitoring and stabilization: When emergency responders arrive, they will monitor the person’s vital signs, including breathing, heart rate, and blood pressure. Stabilizing these functions to prevent further complications.
• Activated charcoal: In some cases, doctors may use activated charcoal if the overdose is recent. This substance helps absorb the excess lorazepam in the stomach, preventing more of it from entering the bloodstream.
• Flumazenil: This medication can reverse the effects of benzodiazepines like lorazepam, acting as an Ativan antidote. Flumazenil works by blocking the receptors in the brain to which lorazepam attaches [9]. That said, it is used with caution, as it can trigger seizures, especially for people who have been taking Lorazepam for a long time. 
• Oxygen therapy: If the overdose has caused breathing problems, doctors may provide oxygen or use a ventilator to help the person breathe. This prevents oxygen deprivation, which can lead to brain damage.
• IV fluids: Intravenous fluids may be given to help stabilize blood pressure and support overall body function during recovery from the overdose.
• Hospitalization: In severe cases, the person may need to stay in the hospital for several days to be closely monitored. This is especially important if the overdose has caused breathing problems, organ damage, or unconsciousness.

What to do If You Overdose on Lorazepam

If you believe you are experiencing an overdose of lorazepam, seek help immediately. An overdose can quickly become life-threatening, and prompt action could mean the difference between life and death. Here’s what you should do:

• Call 911 immediately: Don’t wait to see if the symptoms worsen. Even if you’re unsure, get medical help as soon as possible.
• Stay awake and alert: Try to stay awake while waiting for medical help to arrive. If you feel sleepy, ask someone to keep talking to you and encourage you to remain conscious.
• Inform the medical team: If possible, provide details about how much lorazepam you took and whether you’ve mixed it with other substances, like alcohol or other medications. This information helps the emergency team treat you more effectively.
• Don’t handle it alone: Avoid trying home remedies or waiting it out. An overdose requires professional medical treatment to prevent serious health issues or death.

If you are with someone who overdosed on lorazepam, keep them awake and sitting upright if possible. If they lose consciousness, place them on their side to prevent choking. Stay with them until emergency services arrive. 

Prevention of Ativan Overdose

Preventing an overdose of Ativan is possible with careful use and following the guidelines provided by a healthcare professional.

• Follow prescription instructions: Always take lorazepam exactly as prescribed by your doctor. Don’t increase your dose or take it more frequently than instructed, even if you feel like it’s not working as well.
• Avoid mixing substances: Never mix Ativan with alcohol, opioids, or other sedatives unless your doctor specifically advises it. Combining Ativan with other substances that slow down the CNS greatly increases the risk of overdose.
• Communicate with your doctor: If your current dosage isn’t working, don’t adjust it yourself. Speak with your doctor about your concerns so they can alter your medication safely or suggest alternative treatments.
• Store safely: Keep Ativan in a secure place where others, especially children or anyone struggling with substance use, can’t access it. Proper storage helps prevent accidental or intentional misuse.
• Know your limits: Some people may be more sensitive to medications like lorazepam, especially seniors or those with certain health conditions. Be mindful of how the drug affects you and talk to your doctor about adjusting your dosage if needed.
• Educate yourself and others: Understanding the risks of Ativan and sharing that knowledge with family and friends can help prevent accidental overdoses. Being aware of the signs of an overdose can also help you act quickly in an emergency.
• Taper off slowly: Don’t stop suddenly. Stopping abruptly can cause withdrawal symptoms and increase the risk of overdose if you relapse. Your doctor can help you taper off the medication safely over time.
• Have an emergency plan: If you or someone you know is at risk of overdose, keep an emergency plan in place. This may include having a list of emergency contacts, knowing how to recognize the signs of overdose, and having a clear plan for seeking help quickly.

Ativan (Lorazepam) | FAQs

How much Lorazepam can I take at once?

The max dose of Ativan at one time varies depending on what it’s prescribed for, but adults usually take between 2 to 6mg per day, split into smaller doses. Follow your doctor’s instructions and never take more than prescribed, as higher doses can increase the risk of overdose. 

Is lorazepam addictive?

Yes, lorazepam can be addictive, especially if taken for long periods or in higher doses. Over time, your body may become dependent on it, leading to dependence and withdrawal symptoms if you stop taking it suddenly. 

What do I do if I am overdosing on Ativan?

If you think you’re overdosing on Ativan, call 911 or seek emergency medical help immediately. Signs of Lorazepam overdose include: 

• Drowsiness or sleepiness
• Confusion 
• Lack of Coordination
• Slurred speech
• Slowed Breathing
• Blurred Vision 
• Seizures and loss of consciousness which can be life-threatening.

Get Compassionate Addiction Treatment at Renaissance Recovery

When you’re ready to fight back against addiction to prescription medication, reach out to Renaissance Recovery. We treat all addictions in an outpatient setting, enabling you to carry on at home, work, or school while getting effective treatment for substance abuse during the day. 

Every prescription drug addiction is unique, and our treatment plans reflect this with personalized therapies, such as: 

• MAT (medication-assisted treatment)
• Counselling
• Motivational therapy
• Talk therapy
• Family therapy
• Group therapy
• Holistic treatment
• Aftercare 

Get help for prescription drug addiction, call 866-330-9449.

Sources

1. https://www.drugs.com/ativan.html
2. https://www.ncbi.nlm.nih.gov/books/NBK470159/
3. https://pubmed.ncbi.nlm.nih.gov/24025066/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/
5. https://pubmed.ncbi.nlm.nih.gov/11224198/
6. https://www.mayoclinicproceedings.org/article/S0025-6196(16)30509-2/fulltext
7. https://pubmed.ncbi.nlm.nih.gov/7871060/
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583742/
9. https://www.ncbi.nlm.nih.gov/books/NBK470180/