Ativan (lorazepam) is a benzodiazepine commonly prescribed for anxiety, insomnia, and seizures. It can also cause a slight reduction in heart rate and blood pressure due to its effects on the central nervous system. These cardiovascular effects are generally mild in healthy individuals but may be more pronounced and potentially risky for those with underlying heart conditions or the elderly.
This article explains the science behind Ativan’s impact on heart rate, who may be at risk, and what patients should discuss with their doctors before starting or continuing this medication.
Ativan’s Impact on Blood Pressure and Circulation
One of Ativan’s notable cardiovascular effects is its ability to suppress activity in the autonomic nervous system, which helps regulate heart rate and blood pressure. This calming effect is part of what makes Ativan effective in managing acute anxiety, as it reduces the heightened physiological responses, such as rapid heart rate and elevated blood pressure, that often accompany intense stress or panic.
It’s also important to remember that prolonged use or misuse can cause Ativan addiction, which can further complicate its impact on both physical and mental health. With the right professional support, like our ativan addiction treatment program in Minneapolis, MN, recovery is absolutely possible.
Slow Heart Rhythm (Bradycardia)
Ativan can reduce the firing rate of the sinoatrial (SA) node which is the heart’s natural pacemaker. This can result in bradycardia, or a slowed heart rhythm. The severity of this effect varies from person to person and is influenced by several factors, including dosage, frequency of use, route of administration (oral vs. intravenous), and the presence of underlying health conditions.
In patients with pre-existing cardiovascular conditions, particularly those with arrhythmias, heart failure, or hypotension, this bradycardic effect may become more pronounced and clinically significant. The elderly, who generally have reduced physiologic resilience and may be on multiple medications, are especially vulnerable to adverse cardiac events related to Ativan use.
Low Blood Pressure (Hypotension)
Ativan can also cause vasodilation, or the widening of blood vessels, which leads to a decrease in systemic vascular resistance and can result in hypotension (low blood pressure). When both heart rate and blood pressure drop, blood circulation can be compromised. This may impair oxygen delivery to vital organs, including the brain and kidneys, especially in those with compromised cardiovascular function. In extreme cases that involve high doses, misuse, or intravenous administration, these effects can result in syncope (fainting), shock, or even a heart attack.
Poor Blood Flow or Circulation
Since Ativan can interfere with normal heart function, it may lead to poor blood flow, limiting the oxygen and nutrients your organs need to function properly. Even at therapeutic doses, some people may experience side effects such as dizziness, fatigue, light-headedness, unsteadiness, or shortness of breath often linked to the drug’s impact on circulatory dynamics.
These symptoms may be more intense when Ativan is used with other depressants like opioids, alcohol, or antihypertensives, which increases the risk of a serious cardiovascular event.
Long-Term and High-Dose Use: Cardiac Concerns
Chronic or high-dose use of Ativan can lead to persistent changes in your heart rate and rhythm. You may develop tolerance or even become addicted, and later on suffer from Ativan withdrawal if you stop taking it, which can provoke cardiac symptoms like arrhythmia and, in severe cases, heart attack.
Withdrawal from Ativan can cause rebound increases in heart rate and blood pressure, as well as potentially dangerous heart rhythm disturbances.
For those who have been using Ativan for a long time, or at high doses, it’s important to collaborate with a healthcare provider to develop a gradual tapering schedule, as this approach lessens the risk of serious complications, including cardiac events. Going cold turkey should not be attempted since sudden withdrawal can result in life-threatening cardiac risks, particularly in those with pre-existing heart conditions.
First Aid and Emergency Considerations
If you notice signs of an Ativan overdose or a severe reaction in yourself or another person, such as extreme drowsiness, a very slow or irregular heartbeat, fainting, or difficulty breathing, it’s crucial to act fast.
Call emergency services immediately if any life-threatening symptoms appear. While waiting for help to arrive, monitor your or the other person’s vital signs and keep yourself or them comfortable.
It’s important to remember that an abrupt withdrawal from Ativan can be dangerous, especially for those with heart conditions, as it may trigger withdrawal-induced cardiac complications. If you suspect someone has been misusing Ativan or is experiencing withdrawal, seek medical advice promptly.
Final Thoughts from Northwoods Haven Recovery
At Northwoods Haven, our outpatient treatment for Ativan-related issues addresses both the physical symptoms and the emotional roots of dependence. We provide medically supervised treatment as well as a holistic, trauma-informed approach that includes wellness support, individualized care, and peer connection to help you on your path to recovery.
