From the Research
Yes, Ativan (lorazepam) can cause bradycardia, which is an abnormally slow heart rate. This benzodiazepine medication primarily works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity, but it can also affect the cardiovascular system. Bradycardia is considered a less common side effect of Ativan but may occur, particularly with higher doses, intravenous administration, or in patients with pre-existing heart conditions. The risk increases in elderly patients, those with respiratory disorders, or when Ativan is combined with other medications that slow heart rate such as beta-blockers or certain calcium channel blockers. If you experience unusual slowing of your heart rate while taking Ativan, especially if accompanied by dizziness, weakness, or fainting, you should seek medical attention promptly. Healthcare providers typically start with the lowest effective dose of Ativan and monitor patients with cardiovascular risk factors more closely to minimize this potential side effect, as seen in a study where bradycardia occurred more frequently in patients receiving dexmedetomidine, another medication that can cause bradycardia, in combination with lorazepam 1. Additionally, a study comparing lacosamide and sodium valproate in status epilepticus noted that lacosamide was associated with hypotension and bradycardia in one patient, highlighting the potential for lorazepam to contribute to bradycardia in certain contexts 2. It's essential to weigh the benefits of Ativan against the potential risks, including bradycardia, and to closely monitor patients, especially those with pre-existing cardiovascular conditions, as emphasized in guidelines for evaluating and managing bradycardia 3. Key points to consider include:
- Ativan can cause bradycardia, especially in higher doses or with certain comorbidities
- Monitoring for bradycardia is crucial, particularly in patients with cardiovascular risk factors
- Healthcare providers should start with the lowest effective dose and adjust as needed to minimize the risk of bradycardia
- Combination with other medications that slow heart rate can increase the risk of bradycardia.