Ativan Withdrawal: Symptoms, Timeline and Detox

Ativan withdrawal symptoms can depend on many factors, such as your age, kidney and liver function, the dose of Ativan you’ve been taking and more.

Ativan is the brand name for the benzodiazepine drug lorazepam. The drug is an intermediate-acting benzo. It carries the risk of misuse and abuse. Dependence can develop after a short time, even when used as prescribed. There are dangers with quitting Ativan cold turkey. However, medically-assisted detox can help you quit Ativan safely and effectively.

Ativan Withdrawal at a Glance

• Ativan withdrawal typically begins within 1 to 2 days after the last dose
• Ativan withdrawal can last anywhere from 2 to 4 weeks, although symptoms can persist for months
• Ativan withdrawal symptoms are unpredictable. The severity of withdrawal symptoms can fluctuate dramatically during the withdrawal process
• Common Ativan withdrawal symptoms include anxiety, sleep problems, restlessness, agitation, irritation, memory and concentration problems and muscle pain

What Is Ativan Withdrawal?

Withdrawal occurs when the body lacks a familiar substance, as in the case of Ativan dependence or abuse. Seeking professional help during Ativan detox is common due to unpleasant withdrawal symptoms.

Drug tolerance happens when you need more of a drug to get the same effect, and it can lead to dependence and addiction. Ativan is a medication that can cause tolerance to build up quickly. That’s why doctors should only prescribe it for a short time. 

Ativan works by affecting special parts of the brain called GABA (gamma-aminobutyric acid) receptors. These receptors help slow down brain activity. This is why Ativan is good at preventing seizures and reducing anxiety and panic attacks.

GABA inhibition affects dopamine regulation. Dopamine controls the “reward circuit” in our brains. This circuit is activated by drugs, causing euphoria in addicted people. Researchers are studying how GABA can make it harder for the brain to feel good on drugs, which may help those struggling with addiction.

When someone stops taking Ativan too quickly or reduces their dosage without medical supervision, it can lead to withdrawal symptoms. This is because brain activity suddenly increases, causing symptoms like anxiety, restlessness and trouble sleeping. In severe cases, it can even lead to seizures or death. 

Remember to always follow your doctor’s instructions and never stop taking medication without talking to them first.

Factors Impacting Ativan Withdrawal

Several factors can influence the Ativan withdrawal process. The most significant factor is Ativan tolerance. Benzodiazepine tolerance, in general, will impact Ativan withdrawal because all benzodiazepines act similarly within the brain. Therefore, if you have been using Ativan for a long time, your withdrawal experience will differ from someone who only took Ativan a few times. Your overall health, including your kidney and liver function, can also determine how quickly withdrawal lasts.

Additionally, misusing drugs such as alcohol can impact Ativan withdrawal because alcohol also acts on the GABA within your brain. If you are already prone to anxiety or have an anxiety disorder, Ativan withdrawal effects may be more profound than those without anxiety.

Can Ativan Withdrawal Kill You?

Benzodiazepine withdrawal (including Ativan) can be lethal. When an Ativan user stops using the drug “cold turkey,” significant changes in brain chemistry rapidly occur. For individuals who have used Ativan for a long time, suddenly depriving the brain of the drug can cause a hyperexcitable state. This can lead to elevated body temperature, hypertension, seizures and death.

A different type of risk associated with Ativan withdrawal can be suicidal tendencies. A recent meta-analysis of 17 studies found that benzodiazepines (including Ativan) are associated with an increased risk of attempting or completing suicide.

It is strongly recommended that anyone who develops an Ativan addiction undergo detox and withdrawal in a rehab facility that can treat medical complications. Before quitting, it’s best to consult a doctor for a scheduled taper that can increase the chances of a safe and successful rehab process.

Ativan Withdrawal Symptoms

Once detox is over, Ativan withdrawal generally has two stages: acute and protracted. Acute symptoms typically last for two to four weeks. Protracted symptoms can persist for months, even years. Symptom duration reflects the length and amount of use.

Physical withdrawal symptoms include:

• Tingling in extremities
• Dizziness
• Loss of appetite
• Numbness
• Heart palpitations
• Tremors
• Muscle aches
• Cramps
• Hypertension
• Nausea
• Vomiting
• Seizures

Psychological withdrawal symptoms include:

• Anxiety
• Panic
• Paranoia
• Restlessness
• Confusion
• Anhedonia, or the inability to feel pleasure
• Depression
• Suicidal ideation
• Attempts to self-harm

Symptoms of Post Acute Withdrawal Syndrome

Many believe their addiction symptoms should be over once the drug is out of their system. Unfortunately, post-acute withdrawal syndrome (PAWS) affects recovery for many people. PAWS can cause physical and psychological effects that are similar to the symptoms of acute withdrawal. However, the severity of these symptoms may vary over time.

Protracted Withdrawal Symptoms

PAWS and protracted withdrawal symptoms are synonyms. Protracted withdrawal is defined as “…the presence of substance-specific signs and symptoms common to acute withdrawal but persisting beyond the generally expected acute withdrawal timeframes” by the Substance Abuse and Mental Health Services Administration (SAMHSA).

How Long Does Ativan Withdrawal Last?

Every individual’s Ativan withdrawal timeline will differ depending on factors such as metabolism, Ativan dosage, how long Ativan was taken and the Ativan taper schedule used.

Ativan Withdrawal Timeline

However, the withdrawal will generally occur in two phases:

• Acute withdrawal starts approximately three days after quitting and lasts about two weeks. This is the most dangerous phase of the withdrawal process, as the acute phase is when seizures are most likely to occur.
• Prolonged withdrawal emerges later and can last for a long time (upwards of a year).

Ativan Tapering Schedule

The safest way to stop taking a benzo like Ativan is to taper or slowly decrease your dose. This process usually takes many weeks. However, the time it takes to stop safely will depend on your starting dose of Ativan. An example of a taper schedule might look like this:

Week 1	Dose might be reduced slightly, if at all
Week 2	Reduce your total daily dose by 25%
Week 3	Similar to week one, your dose may be reduced slightly or not at all.
Week 4	Reduce your total daily dose by another 25% (which will now be 50% of your starting dose).
Weeks 5–8	Make no change to allow your body time to adjust to this lower dose.
Week 9 and after	Every two weeks, reduce your total daily dose by 25% until you can safely stop taking Ativan.

Can You Stop Taking Ativan Cold Turkey?

Ativan slows down the communication between your brain and body. Over time, your brain gets used to it, leading to tolerance.

But if you suddenly stop taking Ativan or reduce your dose too quickly, your brain doesn’t have time to adapt. This can cause withdrawal symptoms, which can range from mild to severe. In some cases, symptoms can become life-threatening, resulting in coma or death.

To make sure you stop taking Ativan safely, it’s crucial to talk to your healthcare provider about wanting to quit. They can help you come up with a plan to do it the right way.

How To Cope With Ativan Withdrawal Symptoms

The side effects of Ativan withdrawal are not pleasant, but there are treatment methods you can utilize to help cope with withdrawal symptoms, such as:

• Tapering your dose of Ativan: You can avoid the worst withdrawal symptoms by tapering your dose. Tapering is when you take progressively smaller amounts of Ativan over a long period (weeks to months).
• Exercise: Exercise can be therapeutic and reduces stress and anxiety.
• Practice mindfulness or meditation: Focusing on and accepting the present moment through mindfulness techniques or meditation can be beneficial. This method can help you cope with cravings and urges that occur during withdrawal.

These methods may help someone treat withdrawal at home, but professional detox is the safest way to go through the withdrawal process.

Medically Supervised Ativan Detox

Managing Ativan withdrawal symptoms can be tough on your own. Fortunately, rehab centers with medical supervision offer a safe place to detox. You’ll receive constant care from medical experts. Plus, you’ll get medication when needed to ease symptoms.

For many people, this support in a drug-free setting helps them avoid going back to Ativan during withdrawal. It allows them to start their recovery journey on the right track.

If you or someone you care about is struggling with Ativan addiction, we’re here to assist you. Our knowledgeable and compassionate professionals provide medical detox to new patients. This ensures a safe and comfortable withdrawal process.

The Recovery Village Palm Beach at Baptist Health Drug and Alcohol Rehab accepts most insurance plans. We also offer 24-hour admission coordination, even on holidays and weekends. Contact our Recovery Advocates today to begin your path to recovery.