If you've been tuning in to season 3 of The White Lotus on HBO, chances are you've heard one particular medication mentioned repeatedly: lorazepam. The anti-anxiety drug has become a recurring character this season, thanks to its role in the lives of Victoria and Timothy Ratliff, a wealthy Southern couple played by Parker Posey and Jason Isaacs. It has quite the dramatic portrayal in the show, where it's popped before a massage, mixed with alcohol and even stolen. But what is lorazepam? And more importantly, how should it be used safely? We spoke to healthcare professionals to find out.
What is lorazepam?
"Lorazepam is a prescription drug that falls under the benzodiazepine family," explains Nzinga Harrison, MD, co-founder and chief medical officer at Eleanor Health. Similar to Xanax, "it's often used to help with anxiety, insomnia, seizures and even to relax patients before medical procedures." You may recognize it by its brand name Ativan.
Lorazepam works by "enhancing the effects of GABA, a neurotransmitter that calms the nervous system, helping to reduce feelings of tension and restlessness," adds Pamela Tambini, MD, medical director at Engage Wellness.
When taken as prescribed, lorazepam can promote relaxation. "While it can be highly effective, it is typically meant for short-term use, generally two to four weeks, due to its potential for dependence and withdrawal symptoms," notes Dr. Tambini. Meaning if you take it regularly for a long period of time, it could potentially become habit-forming, as shown in The White Lotus.
Potential side effects
Especially when taken for an extended period, Dr. Tambini explains that lorazepam can cause a range of side effects. These include:
In more severe cases or with misuse, Dr. Tambini notes individuals may also experience the following less common side effects:
"Because it works in the same parts of the brain as alcohol, a person taking too much lorazepam can appear very similarly to someone who has had too much to drink, including blackouts," adds Dr. Harrison.
Can you drink alcohol while taking lorazepam?
In The White Lotus, Victoria and Timothy Ratliff take lorazepam with alcohol on more than one occasion, a combination that is strongly warned against.
"Life can be stressful, and sometimes, a drink seems like an easy way to unwind. But if you're taking lorazepam (or any benzodiazepine), adding alcohol to the mix isn't just a bad idea -- it's a potentially deadly one," emphasizes Dr. Harrison. "Both lorazepam and alcohol slow down your central nervous system." This can lead to more intensified side effects.
But beyond feeling what Dr. Harrison describes as "loopy," this combination can also slow your breathing to a dangerously low level. This can put you at risk for "respiratory failure, coma and even death," she says.
Another big concern? Memory loss. "Lorazepam can already affect your ability to remember things clearly, and alcohol takes that to the next level," says Dr. Harrison. You may, as a result, blackout, make riskier choices and entirely forget what happened the next day.
What happens if you take too much lorazepam?
As seen in episode four, Timothy begins taking lorazepam more frequently, even sneaking extra pills from Victoria's bag while on board a yacht for the day.
"Taking multiple doses beyond what is prescribed can quickly lead to dependence and addiction," says Dr. Tambini. "Over time, the body builds a tolerance, meaning a person may feel the need to take higher doses to achieve the same calming effect, which significantly raises the risk of overdose."
If someone becomes reliant on lorazepam, quitting suddenly can lead to serious withdrawal effects, including seizures, severe anxiety and agitation.In severe cases, a potentially fatal overdose can occur.
How to take lorazepam safely
The medication is available in tablet, extended-release capsule, and liquid concentrate forms. The capsules are typically taken once daily, while the tablets and liquid concentrate are often taken two to three times daily. When taken as prescribed by your doctor, lorazepam can be an effective, short-term tool to manage anxiety and other conditions. But only if you use it safely.
"Avoid alcohol entirely while on this medication, and if you feel you need to increase your dose, speak with a doctor instead of adjusting it yourself," says Dr. Tambini. "If stopping lorazepam, work with a healthcare provider to taper off the medication gradually to prevent withdrawal symptoms."
While The White Lotus is known for its exaggerated drama, lorazepam deserves more serious attention beyond the small screen. "If someone is struggling with lorazepam dependence or withdrawal, seeking medical help is the safest way to reduce and eventually stop use while exploring alternative anxiety treatments," says Dr. Tambini.