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Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication.^[3] It is used to treat anxiety disorders, trouble sleeping, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy-induced nausea and vomiting.^[3] It is also used during surgery to interfere with memory formation and to sedate those who are being mechanically ventilated.^[3][7] While it can be used for severe agitation, midazolam is usually preferred.^[3] It is also used, along with other treatments, for acute coronary syndrome due to cocaine use.^[3] It can be given by mouth or as an injection into a muscle or vein.^[3] When given by injection onset of effects is between one and thirty minutes and effects last for up to a day.^[3]

Common side effects include weakness, sleepiness, low blood pressure, and a decreased effort to breathe.^[3] When given intravenously the person should be closely monitored.^[3] Among those who are depressed there may be an increased risk of suicide.^[3][8] With long-term use, larger doses may be required for the same effect.^[3] Physical dependence and psychological dependence may also occur.^[3] If stopped suddenly after long-term use, benzodiazepine withdrawal syndrome may occur.^[3] Older people more often develop adverse effects.^[9] In this age group lorazepam is associated with falls and hip fractures.^[10] Due to these concerns, lorazepam use is generally only recommended for up to two to four weeks.^[11]

Lorazepam was initially patented in 1963 and went on sale in the United States in 1977.^[12][13] It is on the World Health Organization’s List of Essential Medicines, the safest and most effective medicines needed in a health system.^[14] It is available as a generic medication.^[3] The wholesale cost in the developing world of 1 mg dose by mouth is about US$0.02 to US$0.21 as of 2015.^[15] This amount in the United Kingdom costs the NHS about £0.14.^[16] In the United States, as of 2015, a typical month’s supply is less than US$25.^[17] In 2017, it was the 60th most commonly prescribed medication in the United States, with more than twelve million prescriptions.^[18][19]

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