A day after the passing of Chris Cornell (currently being reported as a suicide), his wife, Vicky, delivered a public statement that disputed Cornell’s cause of death. According to Vicky Cornell, the singer was taking Ativan (lorazepam) at the time of his death. Furthermore, Cornell had told his wife that he had taken “one or two extra” pills shortly before he died after a show in Detroit. “I noticed he was slurring his words; he was different,” Vicky Cornell said in her statement.
While Cornell’s death is both a tragedy and a great loss to the music world, Vicky Cornell’s statement will also, no doubt, give rise to questions about Ativan, a benzodiazepine often used for the treatment of anxiety, sleep disorders, and chemotherapy-induced nausea, among others. If you’re unfamiliar with the drug, here’s what you need to know:
What is Ativan?
Ativan is the brand name of lorazepam, a benzodiazepine that was first brought to market in 1977 by Wyeth pharmaceuticals (now Pfizer). While experts don’t fully know how benzodiazepines work, research indicates that Ativan increases the activity of gamma-Aminobutyric acid (GABA), a neurotransmitter responsible for suppressing nerve activity. When GABA activity increases, nerve activity in the brain and spinal cord decrease — leading to feelings of calm, relaxation, and (usually) sleepiness. While the drug can be very helpful in the treatment of short-term anxiety problems — it’s often administered during a panic attack — it also carries a high potential for addiction. Due to this fact (as well as the fact that Ativan withdrawal can be dangerous), benzodiazepines are generally not recommended for long-term use.
It’s important to note that while Ativan is a mild anxiolytic/tranquilizer that it is also a central nervous system depressant, meaning that it can slow down respiration. Therefore, it is imperative that the person taking it does not mix the drug with alcohol or other CNS depressants (opiates including Percocet and Vicodin) unless closely monitored by a doctor.
The drug is currently featured on the “List of Essential Medicines” published by The World Health Organization.
What is Ativan prescribed for?
Ativan is primarily employed in the treatment of anxiety disorders. The drug has been approved by the FDA in the treatment of all seizures, can be prescribed for sleep disorders, and is indicated when treating severe alcohol withdrawal. In addition, Ativan can be used to treat the nausea that often accompanies cancer treatment (chemotherapy and radiation). The drug can be swallowed, dissolved under the tongue, or injected.
What are the side effects of Ativan?
The most common side effects associated with Ativan include drowsiness, sedation, and dizziness. Some people report feeling tired, not being able to concentrate, and becoming forgetful. Because Ativan is sedating, it is especially important to note that the drug will alter the user’s coordination and balance, making them clumsy and likely unable to complete activities that require fine motor skills. This means that driving and operating heavy machinery (yes, your car is heavy machinery) is absolutely forbidden during the 6-10 hours the drug is coursing through the user’s system.
Unfortunately, paradoxical side effects can also occur. While the medication is used to treat anxiety, it can trigger angry outbursts and aggression in some users. In some cases, the drug can bring about hallucinations, although it’s reported that this reaction is more common among the elderly.
The drug is contraindicated for those who suffer from substance abuse (unless otherwise indicated by a doctor), those who suffer from severe depression (due to the risk of suicidal ideation, as mentioned in a statement by Vicky Cornell’s lawyer), and individuals who have experienced stroke or liver failure, among other disorders.
How likely is an overdose?
According to Priyanka Wali, a San Francisco-based physician we spoke to about overdose risk, it’s very difficult to overdose on Ativan unless it’s been mixed with another CNS depressant. And while there are no clear and fast rules on how many milligrams of Ativan will make up a fatal dose, it’s recommended that users don’t go above 10mg of the drug (spread out over the day) per 24 hours. The initial dose for most people, however, is between 0.5 and 2 mg two to three times a day. Any more and the user runs the risk of respiratory problems (and possible respiratory failure).