Introduction to Lorazepam

Lorazepam, commercially known as Ativan, is a medication frequently depicted in popular media, like the show “The White Lotus.” In the series, one character, Victoria Ratliff, played by Parker Posey, frequently uses lorazepam, presenting it in a casual light. Though the series offers a satirical take on wealth and privilege, it raises essential questions regarding the medication’s use and safety in managing anxiety.

Understanding Its Functionality

As a member of the benzodiazepine class, lorazepam operates by enhancing the effects of gamma-aminobutyric acid (GABA), which is a neurotransmitter responsible for slowing down brain activity. This mechanism helps in reducing anxiety, relaxing muscles, and promoting a state of sedation. “It works quickly and is relatively short-acting, making it useful for acute symptoms such as panic attacks or severe anxiety,” noted Dr. Josef Witt-Doerring, an assistant professor of psychiatry.

Guidelines for Use

Short-term Administration

Experts recommend that lorazepam be utilized primarily for intense episodes of anxiety and for short durations, typically less than a month. According to Dr. Jason Kellogg, a psychiatrist and chief of staff at Newport Bay Hospital, prolonged use can lead to issues such as dependency and the need for increased dosages over time.

Potential Side Effects

While lorazepam provides rapid relief from anxiety, it carries potential side effects, including:

• Drowsiness
• Lethargy
• Slurred or slow speech

Long-term use can lead to complications such as benzodiazepine-induced neurological dysfunction, where withdrawal symptoms may persist for months or years.

Interactions with Alcohol

In “The White Lotus,” the character Victoria often indulges in wine after taking lorazepam, which is a dangerous practice in reality. The combination of alcohol and lorazepam can lead to severe sedative effects, potentially resulting in slow breathing, blackouts, or overdose. Dr. Kellogg emphasizes that both substances depress the central nervous system and warns against their concurrent use, suggesting a minimum waiting period of 24 hours after taking lorazepam before consuming alcohol.

Exploring Safer Alternatives

For long-term anxiety management, alternatives like selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) may be more suitable. Dr. Kellogg recommends a combination of these medications with cognitive-behavioral therapy for optimal results. Furthermore, melatonin supplements can provide assistance for disrupted sleep patterns, particularly when taken 30 to 60 minutes before bedtime.

Conclusion

Lorazepam can be a valuable tool for alleviating acute anxiety; however, its use should be strictly short-term due to the risks of dependency and withdrawal. Awareness of its effects, interactions, especially with alcohol, and the availability of safer alternatives, is crucial for those considering its use.