Season three of “The White Lotus” has a new scene-stealer beyond its messy rich people: lorazepam.
In the TV series, this anti-anxiety medication is front and center thanks to loony Southern mom Victoria Ratliff (played by Parker Posey), who treats it more like a breath mint than a prescription drug.
While the show is a satire, it raises real questions about how lorazepam works and whether it’s safe to be taking the drug regularly.
Lorazepam should only be used for an intense episode of anxiety, according to Jason Kellogg, MD, a psychiatrist and chief of staff at Newport Bay Hospital. It should be prescribed for short-term use, ideally less than a month.
While lorazepam can ease anxiety quickly, it comes with side effects such as drowsiness, lethargy, and slurred or slow speech.
High doses and long-term use of lorazepam may increase the risk of developing physical dependence on the drug.
“With repeated use, individuals may develop tolerance and require higher doses to achieve the same effects,” Kellogg told Verywell.
Some people can also develop benzodiazepine-induced neurological dysfunction, a condition where withdrawal symptoms persist for months or years.
How Does Lorazepam Work?
Sold under the brand name Ativan, lorazepam belongs to a class of anti-anxiety medication called benzodiazepine.
Benzodiazepines work by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that slows brain activity. By increasing GABA’s calming effects, lorazepam reduces anxiety, relaxes muscles, and promotes sedation.
“It works quickly and is relatively short-acting, making it useful for acute symptoms such as panic attacks or severe anxiety,” Josef Witt-Doerring, MD, an assistant professor of psychiatry at Drexel University College of Medicine, told Verywell.
Can You Take Lorazepam With Alcohol?
In “The White Lotus,” Victoria is often seen with a glass of wine at dinner after taking lorazepam. However, combining lorazepam with alcohol is dangerous. It can lead to excessive sedation, dangerously slow breathing, blackouts, and overdose.
“Both substances depress the central nervous system,” Kellogg said. “Because alcohol and benzodiazepines both increase GABA activity, their combined effects can be unpredictable and life-threatening.”
It’s safest to hold off on alcohol until about 24 hours after taking lorazepam, Witt-Doerring explained.
Are There Safer Alternatives?
Lorazepam may offer quick anxiety relief, but for a long-term solution, you may need medications like selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) for anxiety management, Kellogg said.
“Cognitive behavioral therapy, in addition to medication, has been shown to provide the most benefits,” he added.
If you simply need a good night’s sleep or something to combat jet lag while you’re on vacation, melatonin supplements may help. “Take it 30 to 60 minutes before bedtime rather than right at bedtime.”
What This Means For You
Lorazepam can quickly relieve anxiety, but it should only be used short-term due to the risk of dependence and withdrawal. Taking it with alcohol can be dangerous, leading to excessive sedation and even overdose.
The Impact of Lorazepam: Insights from The White Lotus
In the latest season of HBO’s “The White Lotus,” the character Victoria Ratliff, portrayed by Parker Posey, brings an unexpected focus to lorazepam, a common anti-anxiety medication. While the show depicts a satirical take on wealth and privilege, it also sheds light on the serious implications of using this drug.
Understanding Lorazepam
Lorazepam, commonly recognized by its brand name Ativan, is classified as a benzodiazepine, a type of medication primarily prescribed for anxiety relief. It acts by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter responsible for reducing brain activity. As a result, lorazepam can quickly alleviate acute anxiety symptoms, making it suitable for managing situations like panic attacks.
Recommended Usage and Risks
Experts, including Dr. Jason Kellogg, a psychiatrist at Newport Bay Hospital, indicate that lorazepam should be reserved for short-term situations, typically less than a month, due to potential dependence risks. While it offers rapid anxiety relief, users may experience side effects such as drowsiness, sluggishness, and impaired speech.
Prolonged use or high dosages can lead to tolerance, requiring larger amounts for the same effects, and increasing the risk of physical dependence.
Additionally, some individuals may face benzodiazepine-induced neurological dysfunction, where withdrawal symptoms could linger for extended periods, even after cessation.
Interactions with Alcohol
In “The White Lotus,” Victoria is often depicted enjoying a glass of wine after taking lorazepam. However, this combination is concerning. Mixing lorazepam with alcohol can dangerously amplify the medication’s sedative effects, potentially resulting in severe respiratory depression, blackouts, and overdose. Dr. Kellogg emphasizes that both substances depress the central nervous system, leading to unpredictable and hazardous outcomes.
To maintain safety, health professionals recommend abstaining from alcohol for at least 24 hours following the ingestion of lorazepam.
Exploring Safer Alternatives
While lorazepam offers quick relief from anxiety, it is not a long-term solution. Alternative treatments may include selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), which have been found effective for ongoing anxiety management. For those needing occasional sleep aid or to adjust to time zone changes, melatonin supplements may serve as a natural option—recommended to be taken 30 to 60 minutes before bedtime.
Conclusion: Responsible Use of Lorazepam
What This Means for You
While lorazepam can effectively manage acute anxiety, it is crucial to use it cautiously due to the risk of dependency and withdrawal. Its combination with alcohol poses severe health risks, reinforcing the need for collective awareness and responsible medication practices.
