Lorazepam Overdose


What is Lorazepam?

Lorazepam is a benzodiazepine drug used for various conditions. Taking the medications according to the prescription of the physician may achieve the therapeutic effect but ingesting an excessive amount of Lorazepam can lead to overdose symptoms [1, 2].


Being a benzodiazepine, it has various functions such as being an anxiolytic, sedative or hypnotic, amnesic, antiemetic, anticonvulsant and muscle relaxant. Lorazepam is available under the brand names of Temesta and Ativan. Lorazepam has a very high potential for addiction because of its short-acting effects [1]. It also has the potential for tolerance and drug withdrawal, which tend to be life-threatening. Lorazepam exerts its effects by binding on the GABA receptors located in the Central Nervous System (CNS) [2, 3]

Lorazepam is primarily used in the management of anxiety disorder. Side effects associated with the intake of lorazepam may include severe drowsiness, hallucinations, aggression, changes in the mood or behavior or changes in the vision [1]. Once these side effects are present, they should be reported to the physician immediately for management [1, 2, 3].


Lorazepam Overdose Amount

The initial recommended dosage for Lorazepam is between 1-2mg/day which is divided in several doses [1]. An overdose amount of lorazepam in adults is more than 8 mg a day. Others may begin to develop significant effects in as little as 4 mg in a day. For pediatric clients, more than 2 mg of lorazepam in a day may already cause lorazepam overdose [1, 2, 3].

Signs and Symptoms

The effects of lorazepam overdose are due to the excessive action of the GABA in the CNS. Because of this, there is excessive inhibition of the CNS process leading to the following symptoms [1, 2, 3]:


Lorazepam Overdose

Mental confusion

Since GABA is an inhibitory neurotransmitter, too much level of lorazepam leads to severe inhibition of CNS functions that may lead to metal confusion [1, 2, 3].

Paradoxical reactions

Lorazepam overdose may also lad to paradoxical reactions, specifically seizures. Lorazepam is an anticonvulsant, but may result in paradoxical seizures in cases of lorazepam overdose [1, 2, 3].

Dysarthria

The speech center in the frontal lobe may also be affected leading to difficulty forming and initiating speech [1, 2, 3].

Drowsiness and hypnosis

The decreased nerve impulse transmission in the brain also leads to altered level of consciousness. Too much hypnotic effect may lead to prolonged hypnosis [1, 2, 3].

Ataxia

The cerebellar function may also be impaired in lorazepam overdose leading to ataxia or unstable gait [1, 2, 3].

Hypotonia

Decreased brain activity also slows down the nerve impulses to the motor cortex leading to decreased muscle strength and tone [1, 2, 3].

Hypotension

Apparently, GABA receptors are also present in the smooth muscles in the cardiovascular system. This may lead to excessive dilation of the blood vessels causing hypotension [1, 2, 3].

Cardiovascular depression

The myocardial contractility may also be affected. Hypotension and cardiac problems may result in cardiac depression that may potentially lead to cardiovascular collapse [1, 2, 3].

Respiratory depression

Respiratory depression is a potentially life-threatening effect of lorazepam overdose. The respiratory center in the brain is commonly affected leading to decreased depth and rate of breathing that may eventually lead to apnea or absence of respiration [1, 2, 3].

Coma

Severe inhibition of the central nervous system in lorazepam overdose may result in irreversible coma [1, 2, 3].


Causes

Lorazepam overdose is usually caused by accidental or intentional ingestion of large doses of lorazepam. Because of its amnesic and hypnotic effect, lorazepam is also used for criminal purposes in large doses leading to lorazepam overdose among victims [1, 2, 3].

Diagnosis

A serum test for lorazepam is the confirmatory test for the diagnosis of lorazepam overdose. The normal blood level of lorazepam is 10 to 300 ug/L. Lorazepam overdose may reach up to 300 to 1000 ug/L in the blood [1, 2, 3].

Treatment and Management

Treatment of Lorazepam overdose focuses on removing the excess level of Lorazepam in the body as well as supportive managements for the symptoms [4].

Emergency Care

A person who has overdosed on Lorazepam should be brought to the hospital immediately. The initial priority is the maintenance of the airway, breathing and circulation. There may be a need to perform an emergency endotracheal intubation if the patient can’t maintain respiration. An intravenous access needs to be established for the administration of fluids to prevent hypotension [4].

Decontamination

A single dose of activated charcoal may be given to the patient if the ingestion occurred less than an hour prior.  The airway must be protected during the administration of activated charcoal to prevent aspiration [4].

Symptom Management

Flumazenil is the antidote for benzodiazepine overdose. It competes at the GABA receptors in order to prevent binding of the benzodiazepine in the receptor sites, thereby reversing the symptoms [4].

Referral

Once the patient of Lorazepam overdose has become asymptomatic, they can be discharged. Those who have intentionally ingested a toxic amount of medications must be referred to a psychiatrist for an evaluation [4].

People who are taking lorazepam should be monitored for any signs of drug dependence. If you know more about this condition, feel free to share your thoughts in the comment section below.

References

  1. Lorazepam. Retrieved from Drugs.com: https://www.drugs.com/lorazepam.html
  2. Project Know. (2016). What Does a Lorazepam Overdose Look Like? Retrieved from Project Know: http://www.projectknow.com/research/lorazepam-overdose/
  3. Rx List. (2016, September 27). Ativan. Retrieved from Rx List: http://www.rxlist.com/ativan-drug/side-effects-interactions.htm
  4. Gresham, C. (2016, April 29). Benzodiazepine Toxicity Treatment & Management. Retrieved from Medscape: http://emedicine.medscape.com/article/813255-treatment

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40 thoughts on “Lorazepam Overdose

  • 19/01/2014 at 3:43 pm
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    Write more, thats all I have to say. Literally, it seems as though you relied on the video to
    make your point. You definitely know what youre talking about, why waste your intelligence on
    just posting videos to your weblog when you could be giving
    us something enlightening to read?

    Reply
    • 26/08/2016 at 10:35 pm
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      lorazepam over dose could 20mg I function most days on 15mg but I have taken then for 40 years . it kills me to take them but will surely kill me if I dont / cover with a ssri ad to kill the depression at low dose

      Reply
  • 15/09/2014 at 11:17 am
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    I have a burning question as to how It’s possible I could of taken 90mg’s (90 1mg pills) of Ativan with a 1/5th of tequila, besides the obvious “You Have a problem seek help” (which I am receiving) , no one seems to be able to understand why I’m alive. I clearly consumed the alcohol, ingests the bottle the pills and did not vomit) I was hoping for an answer something more then “that’s weird you’d should be dead” or ” that’s not possible”
    Respectfully,
    AAMike

    If this is an inappropriate forum for a question like this please lease me know

    Reply
    • 28/04/2015 at 12:14 am
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      I wonder if you use or have used other drugs which might have a mitigating effect on effects of lorazapam.

      Reply
    • 05/07/2015 at 3:45 pm
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      Totally believeable. I’ve done this but I drank a bottle of jacks not tequila. Woke up feeling like shit.. couldn’t believe I was awake haha.

      Reply
    • 26/08/2016 at 10:37 pm
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      very rare a benzo will kill you

      Reply
    • 18/11/2016 at 3:59 am
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      so that much won’t kill me, I was thinking it would be enough

      Reply
  • 16/01/2015 at 8:47 am
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    yeah mike, my friend tried to kill himself with lorazepam. he took 30mg and woke up alive and well 2 days later.

    Reply
    • 28/04/2015 at 12:18 am
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      There is a drug antidote for diazapines. Is it possible that either of the above persons took other drugs which might have altered the effects of the lorazapam?

      Reply
    • 16/06/2017 at 7:07 am
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      Daing. I took luke 15mg. And woke up live and well the next day.

      Reply
  • 28/07/2016 at 8:26 am
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    Strange…my daughter tried to OD on this. Took around 30mg over 4 hours. Showed several signs and was rushed to ER. Her labs came back negative? How is this possible?

    Reply
  • 16/09/2016 at 6:51 pm
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    So how much do you actually need to kill yourself…

    Reply
    • 02/01/2017 at 2:50 pm
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      sad to read all the thoughts of death. it happens to us all one day…or night. high rent and no wage increase for 30 years and homelessness just around the corner are whats freaking me out. this planet sucks. i,m off to buy some smokes.. my questions are. 30 lorazapams? or a six story car park? and dont tell me to see any medical fuck knuckle rich doctor jerkarse twat!!!! i,m well past that stage.

      Reply
  • 16/09/2016 at 6:52 pm
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    So how much do you actually need to kill yourself? …

    Reply
  • 09/10/2016 at 11:40 pm
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    One more dose than that which
    Eft you alive.

    Reply
  • 09/10/2016 at 11:41 pm
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    Just one more dose than that which left you alive

    Reply
  • 19/12/2016 at 3:17 am
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    I want to kill myself with this drug. I normally take 50 mg. How much do I need?

    Reply
    • 27/12/2016 at 1:01 am
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      Hey…are you still ok? I don’t know why you want toend your life but im not gere to judge…I also have been having really dark thoughts about it…im in a separation with my husband and I just want to fix things…so so badly…but he is so cold towards me…I feel lost and alone…im 28 years old and feeling whats the point of it all? if you want to talk…just know that you are not alone in experiencing pain…and its really difficult to feel hope when you feel so low…hope you will find some comfort in knowing that you are not alone.

      Reply
      • 12/05/2017 at 9:14 pm
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        My wife left me and I can’t seem to move forward she left for her ex that was before us it’s been three months but I still feel like I’m dying inside don’t know what to do she wants nothing to do with me and we have a little girl I get to see her but it’s not the same I can’t take it anymore

        Reply
      • 08/02/2017 at 5:48 am
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        You realize if you believe in god…saying god loves you as a reason not to kill yourself is absolutely ridiculous, if you believe in god. GOD CREATED YOU WITH THE ISSUES IN THE FIRST PLACE. Fuck I hate the god argument.

        Reply
        • 07/06/2017 at 7:02 pm
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          I hate it when people throw the god card, its a lie, if he had your life planned b4 u were born. So he or it is to blame?

          Reply
      • 18/04/2017 at 5:34 am
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        No he doesn’t. No one cares about me!!!

        Reply
  • 28/12/2016 at 12:32 am
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    I am sick, for four years now, my energy continues to slide. I’m at the point where there is no point… Many doctors, none have really been able to help much.
    My energy is so low I can’t do anything anymore. I’m ready to go, but can’t find an acceptable way to exit. I was hoping I could just take enough Lorazapam and be done, but it doesn’t look like that will work.
    I have taking care of myself during my life, my labs are great, angio was good. No indications of illness just no life energy left. Is this an appropriate place to ask for ideas on how to?

    Reply
  • 16/02/2017 at 12:14 pm
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    I took:
    125 mg of doxepin (5 25 mg tablets)
    15 mg of ativan
    And a shot of makers mark whisky. I feel like I’m
    Gonna die. I sure want to but will this be a painful way to go?

    Reply
    • 03/05/2017 at 7:21 am
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      I took at least 40 25mg doxepin plus two boxes sleeping pills. about 10 zanax and a hell of a lot of alcohol. I woke up 2 days later. Everything was blurry and I was jerking a lot. I called in sick that night, then went to work the next day, had my blood drown and found my CK (cardiac enzyme) elevated along with and elevated LDH and an elevated liver enzyme called ALT. Why didn’t that work? Maybe my number wasn’t up at that time. Maybe this time it will be. I think I will take about 120 1 mg Lorazepam mixed with about 100 hydrocodones, about 60 muscle relaxers and a bottle of good wine. That ought to do it. I’m thinking about this because I have 8 chronic illnesses that keep me from keeping a job due to having to miss days. I only get harassed and accused of faking it, and an all around bad attitude from co-workers. I’ve been harassed off two jobs and fired from one for it. I had Social Security disability up until they found out that I play drums for a hobby. They sent a detective to my house asking about a drug and ID theft ring and said my address was given on one of the cards. I believed him and answered his questions; such as, where do you use credit and debit, where do you work, what hobbies do you have. Then when my band Bleed together played a 40 minute set, they came and made a video which they refuse to let me look at. they interpreted everything wrong. they said I moved and set up most of my drums myself, which never happened. They accused me of fraud. For the last 4 and a half years I have been fighting to get the benefits back, but they keep saying no. Last summer I was told that I have Lynch syndrome, which causes all types of cancer. I already had to have surgery for two types and was just told some of it is back. How the hell am I supposed to work being so sick like this? I’ve worked so hard in my life, Mostly as a Med tech, payed 914 dollars a month in federal medicare and S.S. taxes and this is what I get. So much for doing the right thing. There is no right thing except to just give up!!!!!!!!!! I think this will work.

      Reply
  • 04/03/2017 at 3:14 am
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    Ok , so how many 1 mg pills does it take…. For a 120lb person to make things end?

    Reply
  • 01/04/2017 at 9:47 pm
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    Want to know how to kill yourself with diphenhydramine sleeping pills and how many to take?

    Reply
  • 02/04/2017 at 8:26 am
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    You all might want to consider abstention from any and all consumption of alcohol or drugs. I take .5 mg on rough days and none in the other 15 in the month. But I do drink 2 bottles of wine per day. Normally don’t feel as dark as all y’all.

    Reply
    • 09/04/2017 at 6:36 am
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      pills are on my desk, wine in the refer- let me try that first

      Reply
  • 22/04/2017 at 12:11 am
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    So how many to just put me to sleep for a couple days?

    I live in a rural location where mental issues are considered either a joke or a stigma and I’m sooooooooo tired of having to go in explaining I cannot control my thoughts, trying not to freak out in emerge while waiting where they tell me to suck it up and take more lorazapam

    I have severe anxiety, depression and PTSD

    New antidepressant though so here’s hoping.

    Otherwise I just wanna sleep for a few days and maybe they will finally see I want and need their fucking help

    I’ve been dealing this since I was a child and know the signs but I cannot get a handle on it this time…

    Reply
  • 11/05/2017 at 5:26 am
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    i’m 200 lb woman with a great deal of ativan and a large bottle of wine at home. i can’t take this fucking life anymore. i’m such a failure! How much would it take of each for me not to wake up tomorrow morning? I really need to know. and know now!!!!!

    Reply
    • 12/05/2017 at 9:36 pm
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      I feel the same I lost my family soon to be ex wife Hates me my daughter is only 18 months old left me for an ex boyfriend loved her with all I’ve got not it’s all shit need to ck out

      Reply
  • 11/05/2017 at 11:44 am
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    New antidepressant though so here’s hoping…….; does anything help depresion?

    Reply
  • 05/06/2017 at 3:45 am
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    If I took to many could I make it look like an accident or would my family know I did it on purpose? I don’t want them to hurt as much as if they knew I did it on porpose.

    Reply
  • 25/06/2017 at 7:41 pm
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    Killing your self solves nothing pick your self up dust your self off and be a fighter

    Reply
  • 04/07/2017 at 10:36 am
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    We should have the right to diced when we want to die like the right to live, i don’t want to live anymore and yes i have multiple problems i can’t resolve and nobody can’t ether why i need to suffer ??? i give up and i want to die in a decent conditions .And for those believers i Know God loves me and i love God but i can’t keep going, I’m exhausted.

    Reply
  • 05/07/2017 at 6:51 am
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    I’ve had major depression PARALYZING OCD and anxiety and I’m bipolar, been going on since I was 15, I’m 32 today. Have committed suicide almost 30 times but push myself not to…..knowing I need to keep fighting and I will get better. I’ve had almost 30 rounds of ECT. I highly suggest it if you’re SUICIDAL or severely depressed. I hope none of you give up and cut out on life. Keep fighting.

    Reply

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