Is Ativan Constipating?
No, lorazepam (Ativan) is not typically considered a constipating medication based on available evidence, though benzodiazepines as a class may have some association with constipation in specific populations.
Evidence from Guidelines and Drug Labels
The FDA drug label for Ativan does not list constipation as a recognized adverse effect 1. The documented side effects include sedation, respiratory depression, amnesia, and various cardiovascular effects, but constipation is notably absent from both common and rare adverse reactions.
Guideline evidence shows that when constipation is discussed in palliative care settings, benzodiazepines are mentioned for managing anxiety-related nausea, not as constipating agents. The NCCN Palliative Care Guidelines specifically identify anticholinergic drugs (antidepressants, antispasmodics, phenothiazines, haloperidol), antacids, and antiemetics as known constipating medications, with opioid analgesics being most commonly associated with constipation 2, 3. Benzodiazepines are not included in this list of constipating medications.
Research Evidence Shows Mixed Findings
The most recent research (2025) found an association between benzodiazepine prescriptions and laxative use in patients with schizophrenia 4. In this study, 66.1% of patients using laxatives were prescribed benzodiazepines versus 39.0% in the non-laxative group, with benzodiazepine prescriptions showing an odds ratio of 3.059 for laxative usage. However, this association does not establish causation and may reflect confounding factors such as:
- Polypharmacy with antipsychotics (which are known to cause constipation)
- Reduced physical activity in psychiatric populations
- Dietary factors
- Concurrent use of other constipating medications
A 2019 review noted that while opioids and anticholinergic agents are well-established causes of constipation, the relationship between hypnotics (including benzodiazepines) and constipation is "less well understood" 5.
Clinical Context from IBS Studies
Interestingly, older studies examining lorazepam for irritable bowel syndrome treatment showed that lorazepam provided symptomatic improvement in some patients 6, 7. This suggests that if anything, lorazepam may have neutral or potentially beneficial effects on bowel function in certain contexts, rather than being constipating.
Clinical Recommendation
In routine clinical practice, lorazepam should not be considered a constipating medication and does not require prophylactic laxative therapy. If a patient on lorazepam develops constipation, look for other causes first:
- Opioid co-administration (the most common culprit) 2, 3, 8, 9
- Anticholinergic medications (antidepressants, antipsychotics, antihistamines) 2, 3
- Reduced mobility and dietary factors 10
- Metabolic causes (hypercalcemia, hypokalemia, hypothyroidism, diabetes) 2, 3
Important Caveat
In patients with schizophrenia or other psychiatric conditions on multiple psychotropic medications, be aware that benzodiazepines may be a contributing factor in a multifactorial constipation picture 4. However, this is likely not a direct pharmacological effect but rather part of a complex medication regimen where other agents (particularly antipsychotics) are the primary culprits.