Ativan Withdrawal Timeline

Ativan withdrawal timeline typically starts with withdrawal symptoms occurring 1 to 4 days after the last dose of the medication was taken and ends within 14 days. However, for more severe cases withdrawal symptoms can linger for years.

How Long Does Withdrawal From Ativan Last

Ativan (lorazepam) is a brand name prescription medication that is used to treat anxiety, insomnia, continuous seizures, and as a medication used right before anesthesia. The active ingredient in Ativan is benzodiazepines.

The street names for benzodiazepines are benzos, downers, nerve pills, and tranks. Benzodiazepines are central nervous system depressants that have a tranquilizing effect. Benzodiazepines can be addictive and for that reason, Ativan is only intended for short-term relief of anxiety or depressive symptoms. Prolonged use of benzodiazepines like Ativan can lead to psychological and physical dependence.

Overview

According to the Drug Enforcement Administration (DEA), Ativan is one of the five most prescribed and most commonly seen benzos on the illegal market. In 2017, 26.4 million Ativan prescriptions were dispensed to patients by doctors all throughout the United States.

According to a report by the Substance Use Disorder and Mental Health Services Administration (SAMHSA), as of 2018, among people 12 and older, the second most common type of illicit drug used in the United States was the misuse of prescription pain relievers. An estimated 5.4 million people misused prescription benzodiazepines like Ativan in the last year. To break that number down into age groups, about 399,000 adolescents aged 12 to 17; 1.5 million young adults aged 18 to 25; and 3.5 million adults aged 26 and older misused prescription benzos in the past year.

It does not take long to become addicted to Ativan. A person who used the prescription as prescribed by their doctor can become addicted. It only takes a few weeks to develop a dependence on the medication and experience withdrawal symptoms.

Signs and Symptoms

A recent article published in the British Journal of Clinical Pharmacology stated that benzodiazepines like Ativan are intended for short term use such as for 3 to 6 weeks. Even when taking the prescription as prescribed it can result in dependence. Between 15 to 44 percent of chronic benzodiazepine users experience moderate to severe withdrawal symptoms when they attempt to stop using the medication. Around 40 percent of people who used Ativan for prolonged periods of time such as more than 6 months will have moderate to severe withdrawal symptoms. The other 60 percent will only experience mild withdrawal symptoms.

The severity and duration of withdrawal symptoms will depend on a few factors. These factors include a person’s age, how long they have been on the medication, what dose they take, and other factors such as medical history and co-occurring substance use disorder problems.

Signs and symptoms of Ativan withdrawal include anxiety, panic attacks, hyperventilation, tremors, sleep disturbances, muscle spasms, anorexia, weight loss, visual disturbances, sweating, and feeling unwell. Withdrawal from lorazepam can also include perceptual distortions such as abnormal bodily sensations and other sensitivities to stimulus. Ativan withdrawal symptoms can even include major events like grand mal seizures, hallucinations, delusions, and delirium.

Additional lorazepam withdrawal symptoms include nausea, headaches, rebound anxiety and insomnia, dizziness, blurred vision, confusion, delusions, paranoia, diarrhea, nightmares, poor memory, appetite loss, irritability, restlessness, depressed mood, muscle aches, tiredness, blood pressure changes, and rapid heart rate.

The Ativan withdrawal timeline starts with acute withdrawal symptoms starting 1 to 4 days after the last dose of the medication was taken and ends within 14 days. However, 10 to 15 percent of people will experience symptoms that can last years. This phase is known as protracted withdrawal and involves a slow reversal of the changes the medication made to the brain. Withdrawal symptoms in this stage include anxiety, insomnia, muscle spasms, cognitive impairment, tingling or numbness in limbs, and depression.

Coping & Relief

Do not attempt to quit “cold turkey” or abruptly. During acute withdrawal, there is a high risk of relapse. According to the Journal of Clinical Medicine, in people who quit benzos abruptly, relapse is as high as 50 percent. Relapse is most often only seen in people who abruptly stop taking Ativan and do not taper. When combining a slow taper with cognitive-behavioral therapy success rates for stopping benzodiazepines are about 90 percent with most people feeling much better after withdrawal.

The best way to avoid Ativan’s side effect withdrawal is by speaking with your doctor to create a taper schedule. Tapering off medications is the act of slowly reducing the dosage over a period of time until you no longer need to take the medication.

The National Center for PTSD published a few taper recommendations for weaning off benzodiazepines. Your doctor might create a taper schedule that includes substituting Ativan for a longer-acting benzodiazepine like diazepam to help you stabilize. After you are stabilized, your doctor might initially reduce your dose by 25 to 30 percent. Then, reduce your dose by 5 to 10 percent daily to weekly depending on the severity of your dependence. The last phase of withdrawal is likely to be difficult. So make sure you have additional psychological support during the taper.

If you are severely dependent on Ativan, tapering is the only safe way to come down from the medication. Tapering will reduce withdrawal symptoms but won’t get rid of them completely. Therefore, a person can increase their comfort levels by using non-drug therapies such as engaging in cognitive-behavioral therapies, relaxation through meditation, listening to music, increasing liquid intake to ensure proper hydration, eating regular nutritious meals, exercising, taking deep breaths, engaging in relaxing activities, and using positive self-talk.

Warnings

Quitting Ativan abruptly can be extremely dangerous on your own. If you have only been taking this drug for a few weeks and are on low doses, consulting your family doctor to create a taper plan should be sufficient. However, if you have been taking Ativan for prolonged periods of time and are on higher doses, your best chances of experiencing a successful withdrawal will be at a rehabilitation clinic. Also, if you have a history of seizures, mental illnesses, or other substance use disorder you might run into complications when withdrawing. Therefore, an inpatient clinic will best be suited to monitor your vitals and ensure your safety.

Psychiatric Symptoms

Psychiatric symptoms can sometimes be exacerbated when withdrawing from Ativan. If a person has underlying mental health problems such as  PTSD, OCD, panic attacks, or psychotic symptoms their symptoms can sometimes get worse when withdrawing.  Also, symptoms of depression, anxiety, and insomnia tend to get worse when detoxing as well.

Long-Term Treatment

For those who are lucky enough to only experience mild withdrawal symptoms, an outpatient rehabilitation clinic can best support your needs. For those who experience moderate to severe withdrawal symptoms, the best way to overcome an Ativan addiction is at an inpatient rehabilitation clinic.

Long-term treatment will incorporate several components, including slow detoxification, counseling, and medications. A slow detoxification process is necessary to slowly reduce a person’s dosage and wean them off the medication. This will help reduce a person’s likelihood of experiencing withdrawal symptoms. However, tapering off Ativan alone is not enough to produce long term abstinence. Cognitive-behavioral therapy can help you learn the underlying reasons behind why you abuse Ativan and can teach you coping strategies to avoid Ativan use in the future. Medications can also be supplied to target specific withdrawal symptoms such as melatonin for insomnia.

Getting Help

No one should have to suffer alone. Addiction to Ativan is a very treatable condition. If you or someone you love has an Ativan addiction, finding a high-quality rehab can help. Treatment can provide comfort through easing painful withdrawal symptoms as well as therapy to better understand your addiction. This can help a person get back to living a drug-free, healthier life.

References

• Addiction Treatment Options. Sunshine Behavioral Health.
• Benzodiazepines. Drug Enforcement Administration.
• Benzodiazepines II: Waking up on sedatives: Providing optimal care when inheriting benzodiazepine prescriptions in transfer patients. Journal of Clinical Medicine.
• Benzodiazepine dependence and its treatment with low dose flumazenil. British Journal of Clinical Pharmacology.
• Benzodiazepine withdrawal.Verywellmind.com
• Effective treatment for PTSD: Helping patients taper from benzodiazepines. National Center for PTSD.
• Key substance use and mental health indicators in the united states: Results from the 2018 national survey on drug use and health. SAMHSA.
• Lorazepam (Ativan). National Alliance on Mental Illness.
• Management of benzodiazepine misuse and dependence. Australian Prescriber.
• Protracted withdrawal symptoms from benzodiazepines. Comprehensive Handbook of Drug & Alcohol Addiction 2004.
• Weaning off your pain medication. UW Health.