Most Ativan side effects are the drug simply doing its job a little too well: you feel calmer, and also slower, sleepier and less steady on your feet. That is the honest headline. The rest of the story depends on who you are. A 30-year-old taking an occasional dose before a flight has a very different risk picture from an 80-year-old who has taken lorazepam every night for two years.
So this guide does something a little different. Instead of walking through every organ in the body, it starts with the four numbers that matter most, then lets you jump to the section that sounds like you. Find your profile, read what applies, and bring your questions to the person who prescribed the medicine.
The four numbers on the Ativan label
When the makers of Ativan (lorazepam) studied about 3,500 people taking it for anxiety, four side effects showed up more than any others. These figures come straight from the FDA prescribing information for Ativan.
| Side effect | How often it was reported | What it can feel like in daily life |
|---|---|---|
| Sedation | 15.9% | Heavy eyelids, wanting to nap after lunch, feeling “foggy” in meetings |
| Dizziness | 6.9% | A light or floaty head when you stand up or turn quickly |
| Weakness | 4.2% | Arms and legs feeling heavier, less energy for stairs or the gym |
| Unsteadiness | 3.4% | Bumping into door frames, wobbling on uneven ground, clumsy hands |
These are the core Ativan side effects. Put another way, roughly one person in six felt noticeably sedated. That means five in six did not, or not enough to report it. The label also notes that sedation and unsteadiness became more common as age went up, which is why one of the profiles below is for readers 65 and older.
Beyond these four, the label lists a longer tail of lorazepam side effects that are less common: tiredness, memory gaps, confusion, low mood, slurred speech, blurred vision, changes in appetite, changes in sex drive and, rarely, hair loss. Some of these matter much more for certain people than for others. That is where the profiles come in.
Which reader are you?
Read the section that fits you best. Many people fit more than one (for example, an older adult who also has sleep apnea), so feel free to read several. Each profile focuses on the side effects of Ativan that are most likely to matter for that group, plus what your prescriber may want to watch.
If you just started
The first few days are when you learn how your body responds. Lorazepam is absorbed well and reaches its peak level in the blood around two hours after a tablet, so that is often when you will feel the effects most. If you want the full timing picture, our guide on how long Ativan takes to work walks through onset and peak.
Here are the Ativan side effects new users most often notice:
- Drowsiness. You may feel ready for bed earlier, or sleepy in the afternoon. For many people this eases over the first week or two as the body adjusts.
- Slowed reactions. Your reaction time can be slower even when you feel fine. This is the sneaky one, because you may not notice it yourself.
- Feeling a little flat. Some people describe a muted, cotton-wool feeling. Others mainly notice relief from tension.
- Short memory gaps. You might forget a conversation that happened soon after a dose, especially at higher doses.
The driving rule
Do not drive, ride a bike in traffic, or use power tools until you know how lorazepam affects you. MedlinePlus gives the same advice in plain terms. Even after you feel used to the medicine, a dose taken late at night can leave you less sharp the next morning. If that sounds familiar, our article on next-day drowsiness and driving explains how sleep medicines can linger, and many of the same ideas apply here.
One more early-days point: alcohol. Drinking while taking lorazepam stacks two sedatives together, and the result can be far stronger than either one alone. We cover this in detail in can you drink alcohol on Ativan.
If you are 65 or older
If you are in this group, the side effects of Ativan deserve extra attention. Older bodies tend to be more sensitive to benzodiazepines, and the Ativan label notes that sedation and unsteadiness rise with age. The label also suggests a lower starting dose for older adults, which tells you how seriously this sensitivity is taken.
The main Ativan side effects to watch in later life are:
- Falls. A bit of dizziness or a slower reflex can turn a stumble into a fall. A night-time trip to the bathroom is a classic danger moment.
- Hip and other fractures. Falls in later life are more likely to break bones, and recovery can be long.
- Confusion and memory trouble. Lorazepam can make thinking slower and memory patchier. In some older people it can bring on delirium, a sudden state of confusion that needs medical attention.
- Car crashes. Slower reactions matter more when vision and hearing may already be changing.
Because of these risks, the American Geriatrics Society’s 2023 Beers Criteria, a widely used list of medicines that are often a poor fit for older adults, recommends avoiding benzodiazepines in people 65 and older in most situations. It cites higher risks of cognitive impairment, delirium, falls, fractures and motor vehicle crashes. The criteria do recognize some situations where a benzodiazepine may still be reasonable, such as certain seizure disorders, alcohol or benzodiazepine withdrawal, and severe generalized anxiety.
That does not mean you should stop on your own if you have been taking lorazepam for a while. Stopping suddenly carries its own risks. It does mean it is worth asking your doctor, “Is this still the best option for me, and if not, what would a safer plan look like?”
Simple steps that lower fall risk
- Use night lights between the bed and bathroom.
- Sit on the edge of the bed for a moment before standing.
- Clear loose rugs and cords from walkways.
- Ask a pharmacist to review every medicine you take, including sleep aids and allergy pills.
If you take it most days for months
The label notes that Ativan’s effectiveness beyond four months has not been checked in systematic studies. Yet many people do take it daily for much longer. If that is you, the long-term side effects of Ativan look a little different from the early ones, and Ativan side effects that faded early on may be replaced by quieter ones.
Tolerance
Over weeks to months, the calming effect can feel weaker. Some people find the drowsiness fades, which is welcome, while the anxiety relief also seems smaller, which is not. This is tolerance. If you notice it, talk to your prescriber rather than taking extra doses.
Memory and thinking
Here is a detail many people do not know. The Ativan label says that little tolerance develops to the memory and thinking effects. In other words, your body may get used to the sleepiness, but the effect on memory and focus can stick around. If you feel less sharp at work, keep forgetting where you put things, or struggle to follow a plot, mention it. These are real side effects, not a personal failing.
Physical dependence
With steady daily use, the body adapts to having lorazepam on board. According to the FDA’s 2020 benzodiazepine safety communication, physical dependence can develop over days to weeks of regular use, even when you take the medicine exactly as prescribed. That is why the label carries a boxed warning about dependence and withdrawal, and why stopping should always be planned with your prescriber.
The same boxed warning covers abuse, misuse and addiction. Most people taking lorazepam as directed do not develop addiction, but the risk is real, especially with a personal or family history of substance use.
Blood and liver checks
For people on long-term treatment, the label recommends periodic blood counts and liver function tests. A low white blood cell count and rises in a liver-related enzyme have been reported. These problems are not common, but routine labs are the way to catch them early. If your doctor has not mentioned bloodwork in a while, it is fair to ask.
If you have lung or sleep problems
Lorazepam slows the parts of the brain that drive breathing. For most healthy people at usual doses, this is not noticeable. If your breathing is already under strain, it can matter a lot.
- COPD or other chronic lung disease. The label advises caution and lists worsening of COPD as a possible reaction. Shallow breathing or more breathlessness than usual is a reason to call.
- Sleep apnea. Benzodiazepines can relax throat muscles and dull the brain’s wake-up signal when oxygen drops. The label lists worsening sleep apnea as a possible effect. If you use a CPAP, use it every night you take lorazepam.
- Opioids on top. The boxed warning is clearest here: combining a benzodiazepine with opioid pain medicine or cough syrup can cause profound sedation, dangerously slowed breathing, coma and death. Our guide to Ativan drug interactions lists the combinations to discuss with your doctor.
If someone taking lorazepam is very hard to wake, breathing slowly or making gurgling or snoring sounds that are unusual for them, call 911.
If you live with depression
Ativan is approved for anxiety, including anxiety that comes with depressive symptoms. Still, the label is clear on two points that matter if depression is part of your life.
First, lorazepam can bring depression to the surface or make it worse. Sometimes anxiety was covering low mood, and when the anxiety eases, the depression becomes more obvious. Second, the label says Ativan is not recommended for people whose main problem is depression, and it reminds doctors to keep suicide risk in mind.
Mood changes are among the Ativan side effects most worth flagging. Watch for these changes, and tell someone you trust if you notice them:
- Feeling hopeless or numb most of the day
- Losing interest in things you usually enjoy
- Sleeping much more or much less than usual
- Thoughts that life is not worth living, or thoughts of harming yourself
If you have thoughts of suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911 if you are in immediate danger. You do not need to be sure it is “bad enough.” Reaching out early is always the right call.
For a broader look at where lorazepam fits in anxiety treatment, including when doctors prefer antidepressants or therapy as the long-term plan, see our guide to Ativan for anxiety.
If you are pregnant or breastfeeding
Pregnancy changes the question from “What will this do to me?” to “What will this do to both of us?” Here is what the Ativan label says:
- First trimester. The label advises avoiding lorazepam during the first trimester. StatPearls, an NIH-hosted clinical reference, notes that some case-control studies have linked early-pregnancy benzodiazepine use with cleft lip or palate, though the overall risk remains low.
- Late pregnancy. Babies exposed to benzodiazepines near birth can be born sleepy and floppy, with weak sucking, or can go through withdrawal after delivery.
- Breastfeeding. Lorazepam passes into breast milk. The label says it should not be given to nursing mothers unless the expected benefit clearly outweighs the risk to the baby. Watch a nursing baby for unusual sleepiness or poor feeding.
If you find out you are pregnant while taking lorazepam, do not stop suddenly. Call your prescriber or obstetric team soon so you can make a plan together. We cover the general approach to sleep and calming medicines in pregnancy in our article on Ambien in pregnancy.
If you are taking it for a child or teen
The label states that the safety and effectiveness of Ativan tablets in children under 12 have not been established. Doctors sometimes use lorazepam in children in hospital settings, but routine use at home is a different matter.
The side effect to know about here is the paradoxical reaction, where a medicine meant to calm instead causes excitement, agitation or aggression. The label says these reactions are more likely in children and in older adults. If your child seems wired, angry, tearful or unable to settle after a dose, call the prescriber. The label advises stopping the drug if paradoxical reactions occur, but that decision belongs with the doctor.
For teens, add two more concerns: the risk of misuse (or of pills being shared with friends) and the danger of mixing with alcohol. Store tablets securely and count them now and then.
Paradoxical reactions: when a calming pill does the opposite
Most people expect lorazepam to calm them down, so a reaction in the other direction can be confusing and frightening. The label describes these paradoxical reactions as including:
- Agitation, restlessness or irritability
- Aggression or rage that is out of character
- Trouble sleeping or nightmares
- Hallucinations, or in rare cases, very unusual behavior
- Muscle twitching or spasms
Related to this is disinhibition. Benzodiazepines can loosen the brakes on behavior, a bit like alcohol does. Someone might say or do things they normally would not, then remember little of it later.
Why does this happen? Experts do not fully know. It seems to be more common at the extremes of age, in people with certain brain conditions, and sometimes with higher doses. The practical point is simple: if a calming pill makes you feel worse, more agitated or not like yourself, call your prescriber. Do not take a second dose to “push through” it.
Side effect or the anxiety itself?
This is one of the hardest puzzles for people who take lorazepam. Many classic anxiety symptoms look a lot like possible Ativan side effects, and both can look like the early signs of withdrawal between doses. The table below can help you sort out what to report.
| What you notice | Clues that help tell them apart |
|---|---|
| Racing heart | Usually anxiety rather than a direct lorazepam side effect. If it shows up a few hours after a dose wears off, it may be rebound anxiety, which is worth telling your prescriber about. |
| Trouble sleeping | Insomnia is a core anxiety symptom. If it is new and started right after beginning lorazepam, or comes with restlessness, a paradoxical reaction is possible. |
| Irritability | Common with anxiety. If it is sharply worse after doses, or comes with aggression, think paradoxical reaction. |
| Dizziness | Anxiety can cause a light head through fast breathing. Lorazepam dizziness tends to peak a couple of hours after a dose and is worse when you stand. |
| Poor concentration | Worry steals focus. Lorazepam can also slow thinking. If concentration worsens as anxiety improves, the medicine is a likely cause. |
| Feeling low or numb | Can come with anxiety or depression. Lorazepam can also unmask or worsen depression, so any persistent low mood should be reported. |
| Shakiness or sweating | Common in anxiety. If it happens mainly when a dose is late or after stopping, it may be withdrawal. |
A symptom diary can help a lot here. Jot down the time of each dose and how you feel at a few points through the day. Patterns often jump out within a week, and your prescriber will find it much easier to help.
When to act: three tiers of Ativan side effects
Not all Ativan side effects need a phone call tonight. Some can wait for your next appointment. A few cannot wait at all. Here is one way to sort them.
Mention at your next visit
- Mild daytime sleepiness that is slowly improving
- Mild dizziness when standing quickly
- Feeling a bit tired or flat
- Small changes in appetite or sex drive
- Thinning hair you have noticed over months
- Feeling the medicine works less well than it used to
Call your prescriber within a day
- Memory gaps or confusion that worry you or your family
- A fall, or near-falls that are becoming more frequent
- Low mood that is getting worse, or new loss of interest in life
- Agitation, aggression or insomnia that started after the medicine
- Blurred vision or slurred speech that does not clear
- Withdrawal-type symptoms (shakiness, rebound anxiety, sweating) when a dose is late
- Yellowing of the skin or eyes, which MedlinePlus lists as a reason to seek help right away; if you cannot reach your prescriber quickly, go to urgent care
Call 911 now
- Very slow, shallow or labored breathing
- Someone who cannot be woken or is barely responsive
- A seizure
- Swelling of the face, lips, tongue or throat, or trouble breathing (signs of a serious allergic reaction)
- Thoughts of suicide with a plan or intent, or any immediate danger (you can also call or text 988)
- Suspected overdose, especially if opioids or alcohol may be involved
For a suspected overdose, you can also call Poison Control at 1-800-222-1222 for advice, but call 911 first if the person is hard to wake or breathing poorly. If opioids might be involved, give naloxone if you have it. It will not reverse lorazepam, but it can reverse the opioid part.
You can also report side effects to the FDA through MedWatch, its safety reporting program. Patients can file reports directly, and those reports help the agency spot patterns.
Ways prescribers reduce side effects
If Ativan side effects are bothering you, you have more options than “put up with it” or “stop.” Here are some of the tools a prescriber may use. They are decisions to make together, not changes to make on your own.
- Using the lowest dose that works. The label lists a usual range of 2 to 6 mg a day split into doses, with a much lower starting point suggested for older adults. Many people do well at the lower end of that range. Small changes can make a real difference in sedation.
- Adjusting timing. Taking a larger share of the dose in the evening can let sleepiness fall during the night. The label notes that when doses go up, the evening dose is usually increased first, before daytime doses.
- Cutting out other sedatives. Alcohol, sleep aids, sedating antihistamines, muscle relaxants and opioids all add to the effect. Removing one of them can ease side effects without touching the lorazepam.
- Checking for interactions. Some medicines, such as valproate and probenecid, raise lorazepam levels in the blood. The label says the lorazepam dose may need to be cut by about half in those cases.
- Choosing a different medicine. Some people do better on a different benzodiazepine or a non-benzodiazepine treatment. Our comparison of lorazepam vs clonazepam explains how a longer-acting option can feel different, and our guide to non-addictive alternatives covers options such as SSRIs, buspirone and therapy.
- Reassessing the need. Benzodiazepines are often meant as a bridge. A regular check on whether you still need lorazepam, and at what dose, is good care rather than a sign of distrust.
For people with liver disease, lorazepam is sometimes chosen over other benzodiazepines because it is processed by a simpler route that does not depend on the liver’s main drug-processing enzymes. That is one reason prescribers reach for it in certain patients.
Side effects when you stop
Stopping lorazepam can cause its own set of symptoms: rebound anxiety, trouble sleeping, irritability, shakiness and sweating, and in more serious cases, seizures. The label warns that stopping suddenly or cutting the dose quickly can cause withdrawal reactions that may be life-threatening, and that some people have symptoms that last weeks to more than a year.
That is why the answer to troublesome Ativan side effects is never to quit cold turkey without a plan. Your prescriber can set up a gradual reduction that fits you. Our full guide to Ativan withdrawal explains the timeline, warning signs and what a careful taper looks like.
Frequently asked questions about Ativan side effects
Does Ativan cause weight gain?
Weight gain is not listed as a typical lorazepam side effect on the label. The label does mention changes in appetite, which could nudge weight up or down for some people. If you notice steady weight change, mention it, since other medicines or changes in activity may also play a part.
Can Ativan cause hair loss?
Yes, but it is uncommon. Alopecia (hair loss) is listed among the skin-related reactions on the Ativan label. If you notice thinning, tell your prescriber at your next visit. Thyroid issues, stress and nutrition can also cause hair loss, so it is worth checking for other causes too.
Does Ativan cause memory loss?
It can. Short-term memory gaps, especially around the time of a dose, are a known effect. The label notes that little tolerance develops to these memory effects, so they may persist with long-term use. For a related look at how sedatives affect memory, see our article on Ambien side effects.
Can Ativan affect sex drive?
Yes. The label lists changes in libido, along with erectile problems and reduced orgasm. These effects are often linked to dose. Anxiety and depression can also lower sex drive, so it helps to describe the timing to your prescriber.
Is Ativan safe for the liver?
Liver injury is not one of the common side effects on the label, though yellowing of the skin or eyes is a reason to seek help right away. Lorazepam is processed by a simple route that is less affected by liver disease than many other benzodiazepines, which is why doctors sometimes prefer it in people with liver problems. Long-term users should still have periodic liver tests, as the label recommends.
Can Ativan cause depression?
It can bring hidden depression to the surface or make existing depression worse, according to the label. If your mood drops after starting lorazepam, let your prescriber know. If you have thoughts of suicide, call or text 988 right away.
Do Ativan side effects go away?
Drowsiness and dizziness often ease over the first one to two weeks. Memory and thinking effects may not fade as much. If side effects of Ativan are still bothering you after a few weeks, ask about a dose or timing change rather than waiting it out.
