- In its third season, HBO’s “The White Lotus” frequently features lorazepam, a widely used anti-anxiety drug.
- This benzodiazepine is prescribed for managing anxiety, panic disorders, and specific sleep disturbances.
- By decelerating brain activity, the drug aids in physical relaxation and diminishes feelings of anxiety.
- However, lorazepam can lead to dependency and poses severe risks when combined with opioids, alcohol, or illegal substances.
The latest installment of HBO’s “The White Lotus” takes place in Koh Samui, Thailand, where a fresh batch of guests arrives at the upscale spa and wellness resort. The series continues to blend elements of spirituality with a suspenseful murder mystery, capturing the audience’s attention.
The season kicks off in a typical mysterious fashion, introducing us to the death of an unknown individual, marked by gunshots and a body seen floating in a lotus pond.
This season, a notable plot element is the recurrent references to lorazepam, a medication prescribed for anxiety and some types of insomnia.
Parker Posey’s character, Victoria Ratliff, with her notable Southern accent, frequently uses lorazepam, often consuming the pills with wine at dinner. Her dependency significantly impairs her, causing her to slur her speech, become distant, and even fall asleep during meals.
In an episode that aired on March 9, Victoria’s excessive reliance on lorazepam is highlighted when her daughter, Piper, comments on her inability to cope at a wellness spa without a substantial supply of the medication.
Furthermore, Victoria’s husband, Timothy, portrayed by Jason Isaacs, also misuses lorazepam in a bid to handle a career-threatening scandal. At a yacht party, he takes lorazepam from Victoria’s purse, drinks excessively, and his behavior becomes erratic.
If you’re curious about lorazepam’s application for anxiety and its safety, continue reading as we explore its proper use, associated risks, and alternative anxiety management strategies.
Understanding Lorazepam
Lorazepam, sold under the brand name Ativan, is part of the benzodiazepine family, which also includes drugs like Valium, Xanax, Halcion, and Klonopin.
- Valium
- Xanax
- Halcion
- Klonopin
“Lorazepam is frequently prescribed for anxiety, as well as panic attacks and certain sleep issues,” explains Dr. David Merrill, a geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, CA.
The medication works by slowing down brain functions, helping the body to relax and reducing anxious thoughts.
However, Dr. Merrill notes that the primary treatment for anxiety typically involves antidepressants like SSRIs and therapies such as cognitive behavioral therapy or mindfulness-based stress reduction, which help patients understand and manage their anxiety more effectively than medication alone.
In some cases, like with anxiety in cancer patients or those receiving hospice care, benzodiazepines might be used as a first option, states Dr. Victoria L. Leigh, an internal medicine specialist at Providence St. Joseph Hospital in Orange, CA.
Lorazepam might also be prescribed temporarily for anxiety due to specific medical procedures, such as those involving MRI machines, according to Dr. Leigh.
A 2024 meta-analysis indicated that benzodiazepines are more effective than SSRIs at reducing the physical symptoms of anxiety, although both are similarly effective at relieving psychological symptoms. However, due to the severe side effects and risk of dependency associated with benzodiazepines, SSRIs are often the first choice for treating generalized anxiety disorder.
Therapeutic methods also help individuals recognize and manage physiological responses to stress, such as a rapid heartbeat or shortness of breath, which are normal but often interpreted as threatening, according to Dr. Merrill.
For more severe cases of anxiety, a combination of medication and therapy typically offers the best outcomes, at least in the short term, with the possibility of gradually reducing medication as the patient’s condition improves, adds Dr. Merrill.
Risks of Dependency on Lorazepam
Lorazepam is generally safe when taken as directed but can cause side effects such as:
- drowsiness
- dizziness
- tiredness
- weakness
- unsteadiness
- nausea
- diarrhea or constipation
- appetite changes
- restlessness
- blurred vision
- changes in sexual function
More severe complications, including potentially fatal breathing issues, sedation, or coma, may occur if lorazepam is combined with opioids, alcohol, or certain illegal substances.
“While generally safe if used correctly, lorazepam can be habit-forming, leading to physical or psychological dependence,” Dr. Merrill warns.
Individuals with a history of substance misuse or alcohol dependency should avoid lorazepam, unless under strict medical supervision.
Dr. Leigh emphasizes that lorazepam’s quick action increases its addiction potential, and withdrawal can be particularly abrupt compared to other benzodiazepines.
Discontinuing lorazepam suddenly after developing dependence can lead to severe withdrawal symptoms, including seizures and altered mental states, which can be life-threatening, she adds.
Identifying Lorazepam Dependency
Physical dependence on lorazepam and other benzodiazepines can occur even when the medication is used as prescribed.
The intensity of withdrawal symptoms can vary based on the dosage, duration of use, concurrent use of other sedatives, and individual factors.
Symptoms of withdrawal might include:
- agitation
- poor memory
- insomnia
- anxiety
- panic attacks
- irritability
- headache
- muscle fatigue
- weakness
- tremor
- seizures
Dr. Merrill points out additional signs of dependency, such as:
- needing to refill prescriptions early
- using the medication more frequently or in larger amounts than prescribed
- resorting to someone else’s medication due to running out
- using the medication with alcohol to manage anxiety
- neglecting work or personal responsibilities
If you experience physical dependence or withdrawal symptoms when attempting to stop lorazepam, consult your doctor about gradually decreasing your dosage to safely discontinue use.
Seeking Help for Substance Misuse
To locate a psychiatrist or psychologist specializing in substance misuse, utilize the Substance Abuse and Mental Health Services Administration (SAMHSA) database or call their helpline at 1-800-662-HELP (4357).