Yahoo Lifestyle 'White Lotus' Characters Pop Lorazepam Pills Like Candy. Here's What The Drug Can (And Can't) Be Used For
Season 3 of The White Lotus has already served up a ton memorable moments, from robberies to bougie boat rides and poisonous snakes. But southern mom Victoria Ratliff, played by Parker Posey, takes the cake with her drawling accent and pill-popping repertoire.
Lorazepam, the medication her character seems to constantly take, is name-checked and featured a lot in the series, starting from the very first episode. Victoria is seen taking the pills before a massage and downing them with wine at dinner. Her husband, Tim, eventually takes one himself to calm down after dealing with stressful news at work. And at one point, Victoria's daughter Piper questions why her mom even needs to use the anti-anxiety medication during a week at a wellness spa.
With all the on-screen chatter around lorazepam, it’s fair to wonder what this medication is and what it’s actually used for. And, if you suspect that Victoria’s habits aren’t exactly healthy... ding ding ding! You're correct. Mental health experts break down how lorazepam is actually designed to be used, and what else you should know about the drug.
Meet the experts: W. Christopher Winter, MD, is a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine and host of the Sleep Unplugged podcast; Erin Kelly, PhD, is a psychologist and assistant professor in the Division of Pain Medicine at Vanderbilt University Medical Center; Megan Maroney, PharmD, is a clinical associate professor at the Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey; David Merrill, MD, PhD, is a board certified psychiatrist at Providence Saint John’s Health Center in Santa Monica, CA, and Singleton Endowed Chair in Integrative Brain Health; Gail Saltz, MD, is an associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine; Hillary Ammon, PsyD, is a clinical psychologist at the Center for Anxiety & Women’s Emotional Wellness
What is lorazepam?
Lorazepam is the generic term for the prescription medication called Ativan. It’s in the benzodiazepine class of medications, which also includes Valium, Xanax, and Klonopin, explains Megan Maroney, PharmD, clinical associate professor at the Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey.
“Lorazepam is a nervous system sedative,” says David Merrill, MD, PhD, board certified psychiatrist at Providence Saint John’s Health Center in Santa Monica, CA, and Singleton Endowed Chair in Integrative Brain Health. “It takes the edge off or reduces the level of alertness.”
Lorazepam works by increasing levels of the relaxing chemical GABA, which can cause someone to feel calmer, says Hillary Ammon, PsyD, a clinical psychologist at the Center for Anxiety & Women’s Emotional Wellness. "Those who take it will report a sense of relaxation in their body, with physical symptoms of anxiety subsiding, as well as the anxious thoughts," she says.
What can it be used for?
As you’ve probably guessed by now, lorazepam is used to treat anxiety. But it can also help with insomnia, agitation, or to treat or prevent seizures, Dr. Maroney says. Still, Ammon says it's most commonly used for treatming anxiety or panic disorders.
Victoria specifically talks about using lorazepam to help her sleep (along with lowering her general social anxiety), but that’s not a good long-term strategy, according to W. Christopher Winter, MD, a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine and host of the Sleep Unplugged podcast. “It's a terrible, outdated treatment” for insomnia, he says. “These meds often do not improve sleep quality and may ironically worsen sleep, even though they often create the impression of better sleep via chemical sedation,” he adds.
Ammon calls lorazepam and fellow benzodiazepines “Band-aids” for anxiety. While they may temporarily relieve anxiety and make you feel more relaxed, "ultimately, they are not supportive in getting to the root problem and addressing it," she says.
Are there any side effects?
There are a few potential side effects of taking lorazepam, according to the Food and Drug Administration (FDA). The biggest side effects included feeling sedated, dizzy, weak, or unsteady. But you may also experience drowsiness, amnesia, confusion, seizures, blurred vision, depression, and euphoria, per the FDA.
How long can you be on lorazepam?
While there are several medications that can help with anxiety over the long-term, including selective serotonin re-uptake inhibitors, lorazepam is designed to be used when someone is actively struggling with a moment of intense anxiety. This is partly because it takes effect very quickly.
“It's typically intended for short-term or situational use,” says Erin Kelly, PhD, psychologist and assistant professor in the Division of Pain Medicine at Vanderbilt University Medical Center. That might mean taking the medication when you’re in the middle of a panic attack or to help you sleep after going through a trauma, like the loss of a loved one, Dr. Merrill says.
“We may use it as a ‘bridging treatment’ while we are starting psychotherapy and other medications, such as antidepressants, to treat an anxiety disorder,” Dr. Maroney says. “These other safer forms of treatment take longer to take effect, so a fast-acting medication like lorazepam can be really helpful in managing severe anxiety symptoms as needed while waiting for the primary treatments to kick in.”
Dr. Maroney says that lorazepam can also be “really helpful” for anxiety brought on by a particular situation, like flying in an airplane (for those with flight anxiety) or getting an MRI (for those with claustrophobia). “They can take one dose for that specific situation and it works pretty well, but only in the short term,” she says.
Is it addictive?
Yes, lorazepam is potentially addictive.
"It is physiologically addictive, meaning once you develop dependence—not from a few doses—and then try to stop, your body will experience symptoms of withdrawal like [a] rise in blood pressure, rapid heartbeat, nausea, sweating, and achiness," say Gail Saltz, MD, associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine. "In fact, abrupt withdrawal can be medically dangerous."
That’s why Merrill says that people need to be “cautious” when using the drug. And, if you've been taking it for a while and want to stop, Merrill says that "you need to try a slow, tapered approach" in order to safely wean yourself off.
Can you drink alcohol while taking lorazepam?
That scene where Victoria is drinking wine while taking her pill? This is a really, really bad idea, according to experts. “This is a common recipe for overdosing,” Winter says. “People should never mix benzodiazepines with alcohol.”
Both lorazepam and alcohol depress the central nervous system, Kelly explains. When you take them together, it increases the risk you’ll be sedated and that you’ll even stop breathing, she says. “This risk is especially dangerous, and can even be deadly, if the patient takes more than is prescribed,” Dr. Maroney says.
Given how much lorazepam is mentioned on White Lotus, and the fact that there seems to be a shortage at the resort, things are not looking great for Victoria.
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