Is Ativan (lorazepam) effective for treating an alcohol hangover?

Lorazepam (Ativan) is Not Effective for Treating Alcohol Hangover

Lorazepam (Ativan) is not recommended for treating alcohol hangover symptoms and should be avoided for this purpose. While benzodiazepines like lorazepam are considered the gold standard for treating alcohol withdrawal syndrome, there is no evidence supporting their use for simple alcohol hangover 1.

Understanding Alcohol Hangover vs. Alcohol Withdrawal

It's critical to distinguish between:

• Alcohol hangover: A collection of symptoms (headache, nausea, fatigue, etc.) that occur after a single episode of alcohol consumption, typically resolving within 24 hours
• Alcohol withdrawal syndrome: A potentially serious medical condition occurring in alcohol-dependent individuals who suddenly reduce or stop alcohol consumption

Why Lorazepam Should Not Be Used for Hangover

1. No evidence of efficacy: No clinical studies support using benzodiazepines for hangover symptoms 2
2. Risk of medication misuse: Benzodiazepines carry potential for abuse, especially in individuals with alcohol use disorders 1
3. Inappropriate medical use: Benzodiazepines should be reserved for their approved indications, primarily alcohol withdrawal syndrome and anxiety disorders
4. Potential for respiratory depression: Combining benzodiazepines with residual alcohol can increase risk of respiratory depression
5. Risk of developing dependence: Even short-term benzodiazepine use can lead to dependence in susceptible individuals

Appropriate Use of Lorazepam in Alcohol-Related Conditions

Lorazepam is appropriately used for:

• Alcohol withdrawal syndrome: Particularly in patients with hepatic dysfunction, as it's metabolized differently than long-acting benzodiazepines 1
• Dosing for withdrawal: Typically 1-4 mg every 4-8 hours as needed for withdrawal symptoms 1

Evidence-Based Approaches for Hangover Management

Instead of benzodiazepines, hangover management should focus on:

• Rehydration: Replenishing fluids lost through alcohol's diuretic effect
• Prostaglandin inhibitors: NSAIDs like ibuprofen may help with headache symptoms (avoid acetaminophen due to potential liver toxicity when combined with alcohol) 3
• Rest: Allowing the body time to metabolize and clear alcohol
• Vitamin B6: May provide some symptom relief 3

Cautions and Considerations

• Many marketed hangover treatments lack scientific evidence for efficacy and safety 4
• Some hangover remedies contain ingredients exceeding recommended daily intake levels 4
• No hangover treatment has been proven to reduce overall hangover severity in rigorous clinical trials 2

Prevention Strategies

The most effective approach to hangover is prevention:

• Moderate alcohol consumption
• Drinking water between alcoholic beverages
• Avoiding drinking on an empty stomach
• Choosing beverages with fewer congeners (clear liquors vs. dark)

In conclusion, while benzodiazepines like lorazepam are valuable medications for treating alcohol withdrawal syndrome, they have no role in treating simple alcohol hangover and should not be used for this purpose.