Ativan (Lorazepam) is a benzodiazepine drug that is most commonly used for the treatment of anxiety disorders. It is among the most potent benzodiazepines on the market and is used for the short-term treatment of anxiety, panic attacks, insomnia, acute seizures, and to sedate aggressive hospital patients. In some cases it is also used in surgery prior to the administration of anaesthesia to reduce the amount of anaesthesia required. It is widely regarded as one of the best benzodiazepines to decrease feelings of agitation and is utilized to help reduce the probability of seizures among individuals that overdose on stimulants.
Due to the potent nature of this particular drug, it is not advised to be used in excess of one month. It is considered very fast-acting, which is why most people that take it find it extremely helpful for treating anxiety. Although it is an effective drug, it is extremely easy to build up a tolerance and become dependent on this drug for functioning. This drug is thought to work by increasing the effects of GABA neurotransmitters – leading to effects of psychological and physical relaxation.
Even though this drug works wonders to help treat anxiety, long term use could lead to the development of dementia as well as an array of other problems. This drug along with other benzodiazepines have extremely high potential for tolerance, addiction, and dependence. Additionally many people that are on this drug for an extended period of time develop benzodiazepine-induced depression. Therefore eventually it will be necessary to withdraw from the drug.
Factors that influence Ativan withdrawal
There are many factors that play a role in the withdrawal of benzodiazepine drugs. The two most influential factors are time span and dosage. The longer you take a drug at a high dosage, the more difficult it will be to withdraw from. Additionally individual factors and how quickly you taper off the drug will play a role in influencing your withdrawal symptoms.
1. Time Span
How long were you taking Ativan? If you took it for an extended period of time, you will likely have significantly more difficult and severe withdrawal symptoms compared to someone who took it for a short duration. People that take this medication for a few short weeks at a relatively low dose will likely still have withdrawals, but they will not be nearly as severe as someone with a high tolerance who has been on it for an extended term.
2. Dosage (0.5 mg to 10 mg)
The typical dose of Ativan is between 2 mg and 6 mg for anxiety and insomnia. However most doctors start patients at smaller doses due to the potency of this drug as well as the fact that most people quickly develop a tolerance. The higher end of the dosage range per day is 10 mg, but there are likely plenty of individuals taking more than 10 mg due to the fact that they have become highly tolerant and dependent upon this drug for functioning. In general the lengthier the period over which you have taken a higher dosage, the more difficult the withdrawal.
3. Individual Factors
Other individual factors have an influence over the intensity of withdrawal. People that are naturally sensitive to drug withdrawals may have more symptoms and more intense symptoms than less sensitive individuals. Additionally whether you are on any other drugs, have a therapist, have a supportive environment can all have influences on withdrawal. Your individual physiology plays a huge role in determining how quickly you recover (both physically and mentally) after quitting this particular drug.
4. Cold Turkey vs. Tapering
It is never advised to quit this medication cold turkey unless you were on the lowest possible dose for a short-term. If you were taking this drug daily for longer than a month, you should take the time to properly conduct a gradual taper. Many people quit cold turkey and do not realize that not only can this be dangerous, it will yield significantly more severe and longer-lasting withdrawal symptoms.
It is best to drop the dose every 2 weeks by a pretty small increment to ensure withdrawal success. Some recommend dropping by 1/8 of your current dose every two weeks for the most gradual taper. Others suggest dropping by 1/4 of your current dose every 2 weeks. By gradually tapering over a period of weeks, it gives your body and brain time to gradually adapt to small changes.
If you suddenly quit cold turkey, it will serve as more of a shock to your system – and thus taking you longer to recover and producing more extreme symptoms.
Note: The half life is approximately 12 hours, therefore it may take up to 3 days before the Ativan is cleared from your system. However, even after it is “cleared” you will still experience withdrawals from your body attempting to readjust to homeostatic functioning.
Ativan Withdrawal Symptoms: List of Possibilities
Below is a list of symptoms that you may experience when you discontinue Ativan. Keep in mind that since your experience will be unique, you may not experience every symptom listed below. Additionally the severity of the symptoms will vary based on individual factors.
- Anxiety: Perhaps the most prevalent withdrawal symptom associated with Ativan is severe anxiety. Most individuals report significant spikes in anxiety symptoms when they discontinue this medication. The increased anxiety is largely due to the fact that GABA neurotransmitters are rebounding from being under the influence of a benzodiazepine.
- Concentration problems: Many people report concentration problems while taking this drug, but they also report difficulties concentrating during withdrawal. If you have found that you have trouble focusing after you have discontinued Ativan, you are not alone. Typically your focus should return as your brain readjusts itself – this could take weeks or months.
- Confusion: This is a bit of a general symptom that people report feelings of confusion when they stop taking this drug. This typically goes hand-in-hand with concentration issues as well as memory problems – producing a general state of confusion.
- Depression: Benzodiazepines are known to lead to increased depression while taking them. However, coming off of them can also lead a person to feel more depressed than average. If you feel extremely depressed after you quit taking Ativan, it’s likely no coincidence – it’s likely a result of withdrawal.
- Depersonalization: Many individuals report feeling “depersonalized” or unlike their natural selves. This could be feelings of numbness, feeling like a zombie, and/or like an alien from another planet – you feel different from your normal functioning. This is usually caused by neurotransmitter changes and increasing anxiety. You will return to your normal functioning over time.
- Dizziness: It is extremely common to feel dizziness upon discontinuation of Ativan. The dizziness may range in severity from being somewhat minor and short-lasting to very powerful and long lasting. Typically when a person quits “cold turkey” the dizziness is more pronounced and longer lasting.
- Fatigue: Many people have reported feeling extremely tired and lethargic when they quit their Ativan. Your energy level may be lower than average for a couple of weeks, but you will eventually experience a rebound.
- Headaches: Another very common symptom to experience is that of headaches. These are usually caused by the withdrawal itself, but can be intensified by the increased anxiety that is also experienced during withdrawals. If headaches are severe, consider taking some sort of headache relief.
- Hallucinations: In some rare cases, withdrawal can lead a person to experience hallucinations. If you experience hallucinations, it could be due to the fact that you withdrew too quickly and had built up a high tolerance. Keep in mind that although hallucinations could be a symptom of a greater problem (such as schizophrenia), they are also linked to benzodiazepine withdrawal.
- Insomnia: This is a drug that is used to treat insomnia, so it is no wonder that when you stop it, you may experience rebound insomnia. Additionally the fact that your anxiety levels are likely to spike, it may be difficult to fall asleep. As your nervous system readjusts itself, you should gradually notice your sleep improving.
- Irritability: Since Ativan helps people keep calm and reduces anxiety, withdrawals may lead to increases in irritability as well as aggression. If you notice yourself becoming highly irritable, take the time to calm yourself and realize that you may not have control over this feeling, but you can control how you express it.
- Memory problems: It is well documented that benzodiazepines (like Ativan) can lead to the development of dementia and a decline in memory. If you notice decreased memory function following your usage of this drug, just know that it’s relatively common. I would expect memory to improve though after 6 to 12 months following your last dose.
- Mood swings: Many people experience changes in mood when they withdraw from benzodiazepines. One moment you may feel anxious, another extremely tired, etc.
- Nausea: If you feel nauseated, just keep in mind that this is common during withdrawal. The nausea should not persist for longer than a week or so.
- Palpitations: Some people notice changes in heart beat and/or sensations that their heart is beating loudly. These are common to experience during withdrawal and are associated with an increased sympathetic nervous system response.
- Panic attacks: Since this medication is primarily geared towards treating anxiety and panic attacks, experiencing panic attacks upon discontinuation is common. These panic attacks experienced during withdrawal may be more extreme than before you began this drug.
- Psychosis: In rare cases, people have reported experiencing psychotic symptoms such as hallucinations and delusions upon withdrawal. If you have never experienced these symptoms prior to your withdrawal and they are relatively short-lived, they could be a result of withdrawal.
- Seizures: Individuals that quit cold turkey from a relatively high dose may experience seizures. For this reason it is very important to conduct a slow taper off of this drug.
- Sleep problems: You may have problems falling asleep, staying asleep, and you may not be able to sleep long enough to wake up feeling refreshed. It is pretty common to experience sleep changes when you initially quit taking Ativan.
- Suicidal thinking: Some people report feeling especially suicidal when they withdraw from Ativan. This may be due to the fact that benzodiazepines triggered depression, but it could also be a result of the withdrawal process.
- Sweating: If you notice yourself profusely sweating throughout the day and wake up from sleep drenched in sweats, it’s a result of drug withdrawal. It is thought that this may be your body’s natural way of detoxifying itself.
- Vomiting: It isn’t very common to vomit while withdrawing from Ativan unless you taper too quickly and/or have been on it for a long term. If you end up vomiting during withdrawal, just know that you are not alone.
Ativan Withdrawal Duration: How long does it last?
It is important to understand that there is no set withdrawal “timeline” or set period of time that the withdrawal is going to take. For some people, symptoms may last for several weeks and subside. For others, it may take months before some of the symptoms subside and their normal functioning returns. It really all depends on individual factors and scenarios when trying to determine how long the withdrawal will take.
Just keep in mind that the symptoms that you experience are a result of your body trying to successfully function without the influence of the drug. It may take some time before your GABA neurotransmitters stabilize and recover from the Ativan usage. If you conducted a proper, gradual taper, you may feel better within the first month after your last dose. If you didn’t gradually taper and quit “cold turkey” – it may take several months before you start to feel somewhat normal again.
Just know that your withdrawal will be completely unique based on your individual circumstances. Benzodiazepines like Ativan are some of the most difficult drugs to withdraw from. If you need help coping with your withdrawal symptoms, be sure to seek out some sort of help (e.g. online support from people going through the same thing and/or a licensed professional). Despite the fact that this is among the toughest class of drugs to withdraw from, people have still successfully made it through the withdrawal process and experienced a full recovery.