HBO’s ‘The White Lotus’ features anti-anxiety drug Lorazepam. How safe is it? – Firstpost

HBO’s hit show The White Lotus is back and since its release has served up several memorable watching moments, from robberies to bougie boat rides and poisonous snakes. But beyond the cast and the storyline, there’s a scene-stealer — the anti-anxiety medication, lorazepam.

The drug almost plays a character of its own in the show as kooky Southern mom Victoria Ratliff, played by actor Parker Posey, can’t seem to go anywhere — not even dinner — without popping one of the anti-anxiety pills and stashing the prescription in her purse. She even freely offers some to her husband, Timothy, who’s visibly stressed out about being caught in a money laundering scheme.

At one point in the show, Posey also utters the memorable quote: “I don’t even have my lorazepam. I’m going to have to drink myself to sleep.”

If the show has got you curious about the drug, you’re not alone. In fact, searches for the drug have spiked, reveals Google Trends. So what actually is this drug and what’s the right way to use it?

What is lorazepam?

Sold under the brand name of Ativan, lorazepam belongs to the class of medications called benzodiazepines, which work to calm the central nervous system by slowing activity in the brain. Other famous benzodiazepines in the market are Valium, Xanax and Klonopin.

As David Merrill, MD, PhD, board certified psychiatrist at Providence Saint John’s Health Center in Santa Monica, California, told Women’s Health Mag, “Lorazepam is a nervous system sedative. It takes the edge off or reduces the level of alertness.”

Lorazepam works by increasing a calming chemical in your brain called gamma-aminobutyric acid (GABA). Low levels of GABA can lead to overactive brain circuitry that contributes to anxiety.

So, what is lorazepam used for?

As Victoria in The White Lotus suggests lorazepam is used mainly to treat anxiety. It is, however, also helpful for someone who struggles with insomnia, agitation, or to treat or prevent seizures.

Ryan Marino, MD, an assistant professor in the departments of emergency medicine and psychiatry at Case Western Reserve University School of Medicine, told SELF, “Lorazepam is most commonly used in very short-term situations for treatment of things like anxiety, panic attacks, and alcohol withdrawal.”

Sue Varma, a Distinguished Fellow of the American Psychiatric Association, holds a similar view. Speaking to Cosmopolitan, she says, “Its accessibility and effectiveness in acute settings makes it a go-to for health care providers looking to alleviate immediate distress. It is most commonly used for short-term treatment, often while the patient works on long-term strategies like cognitive behavioural therapy (CBT) or lifestyle changes that address the root causes of anxiety or insomnia.”

However, all medical experts and even the Food and Drug Administration (FDA) note that lorazepam should only be prescribed for periods of two to four weeks — unlike how Victoria keeps popping them in the HBO hit series.

“It’s not something that you should be consistently on, for life,” Thea Gallagher, PsyD, clinical associate professor at NYU Langone Health, tells SELF, adding, “It’s supposed to be used for situations when you’re feeling especially anxious and activated as a ‘bridge’ medication to help you manage that.”

Are there any dangers to taking lorazepam?

There are certain physical side effects to taking lorazepam. Some people, as doctors note, will complain of dizziness, confusion, memory issues and slowed breathing when they ingest the drug. In addition, the US Drug Enforcement Agency (DEA) states that lorazepam could cause amnesia, vivid or disturbing dreams, irritability, or hostility.

But besides the physical side effects, lorazepam is highly addictive, contrary to what Victoria claims in The White Lotus when she hands a lorazepam to her husband and says, “Take this, they’re not addicting, I just take one when I need it.”

Medical studies have found that this anti-anxiety drug is very habit-forming. Chelsie Rohrscheib, a neuroscientist and sleep specialist at Wesper in New York in a Fox News report said, “This class of drug is extremely habit-forming, which means a patient taking it may become dependent and experience withdrawal symptoms once it’s discontinued.”

Dr Joseph Squitieri at Northwell Zucker Hillside Hospital in Queens, New York, also issued a similar word of caution to the use of lorazepam. “If you stop taking it suddenly, you can also develop a withdrawal from the medication, which actually could be very dangerous, could result in high blood pressure, seizures; that’s a life-threatening situation. A lot of people don’t realise that you can’t just stop it if you’re taking it regularly for a very long time,” he told People magazine.

This is the reason that in 2020, the US FDA released a new warning label for benzodiazepine boxes, which addresses the heightened risks of abuse, addiction, physical dependence, and withdrawal reactions that can come with using the drugs.

Medical research has also shown that lorazepam can affect an individual’s mood and even raise a patient’s risk of depression. But that’s not all; studies have also revealed that long-term use of benzodiazepines such as lorazepam is linked to neurodegenerative disorders, such as dementia.

Can you consume alcohol with lorazepam?

In The White Lotus, Victoria often downs her lorazepam with alcohol; in fact, she consumes copious amounts of liquor while being on the drug. This, experts, note is a huge red flag in the medical world and is indicative of abuse.

As Dr Gail Saltz, who serves as a clinical associate professor of psychiatry at New York-Presbyterian Weill Cornell Medical Centre, said in a CNN report, “Alcohol specifically interacts with benzodiazepines. They both affect the GABA system. They both can cause, on their own, respiratory depression and death – meaning you stop breathing and die. But together, they are what’s called synergistic, meaning it makes each of them have more of that effect than the two of them on their own. So it’s dangerous. That’s why they tell you not to drink when you’re taking lorazepam.”

Who shouldn’t take lorazepam?

There are certain individuals who should steer clear of lorazepam, say doctors. These include women who are pregnant or breastfeeding, elderly patients who are more sensitive to sedation, and individuals with certain medical conditions that may react to the medication (like severe liver disease and acute narrow-angle glaucoma).

Also, those who have a history of substance abuse shouldn’t be prescribed lorazepam. As it is highly addictive, individuals who have struggled with alcohol, prescription drugs, or other substances should generally avoid the anti-anxiety medicine.

With inputs from agencies