From the Guidelines
The recommended dose of Ativan (lorazepam) for anxiety or agitation is 0.5-1 mg orally four times a day as required, with a maximum of 4 mg in 24 hours, as per the latest guidelines 1. When considering the dose of Ativan, it's crucial to take into account the patient's age and health status.
- For elderly or debilitated patients, the dose should be reduced to 0.25-0.5 mg, with a maximum of 2 mg in 24 hours, to minimize the risk of adverse effects 1.
- The medication can be administered orally, and in some cases, oral tablets can be used sublingually, although this is considered an off-label use 1.
- It's essential to monitor patients closely and adjust the dose as needed to achieve the desired therapeutic effect while minimizing the risk of dependence and withdrawal symptoms.
- The dose of Ativan may vary depending on the specific clinical context, but the guidelines provide a clear framework for dosing in patients with anxiety or agitation, as seen in the study published in the BMJ in 2020 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... The usual range is 2 mg/day to 6 mg/day given in divided doses, the largest dose being taken before bedtime, but the daily dosage may vary from 1 mg/day to 10 mg/day For anxiety, most patients require an initial dose of 2 mg/day to 3 mg/day given twice daily or three times daily. For insomnia due to anxiety or transient situational stress, a single daily dose of 2 mg to 4 mg may be given, usually at bedtime. For elderly or debilitated patients, an initial dosage of 1 mg/day to 2 mg/day in divided doses is recommended, to be adjusted as needed and tolerated
The dose of Ativan (lorazepam) is:
- Usual range: 2 mg/day to 6 mg/day given in divided doses
- Anxiety: 2 mg/day to 3 mg/day given twice daily or three times daily
- Insomnia: 2 mg to 4 mg given once daily, usually at bedtime
- Elderly or debilitated patients: 1 mg/day to 2 mg/day in divided doses 2
From the Research
Dose of Ativan
The provided studies do not directly mention the dose of Ativan (lorazepam). However, they discuss the use of benzodiazepines, including lorazepam, in various medical conditions.
Benzodiazepine Use
- Benzodiazepines are commonly prescribed as anxiolytics, sedatives, and anticonvulsants 3.
- They are used to treat status epilepticus, with non-intravenous routes of midazolam considered an alternative to intravenous lorazepam 3.
- Clonazepam is used to treat acute mania and is more effective than lithium in controlling symptoms of mania 4.
- Benzodiazepines can have adverse effects, including sedation, tolerance, and potential for addiction and misuse 3.
Sleep Architecture
- Benzodiazepines can affect sleep architecture, increasing stage 2 of NREM sleep and decreasing stages 3 and 4 of NREM sleep, as well as reducing REM sleep 5.
- This can lead to deficits in concentration and working memory, as well as weight gain 5.