Ativan Withdrawal

Last updated: 06/7/2021
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Reading Time: 5 minutes

Ativan, which is the brand name for lorazepam, is most commonly prescribed to manage the symptoms of anxiety or anxiety associated with depression. Ativan is classified as a benzodiazepine, a class of sedative drugs. Typically, Ativan is only used for short-term management of these conditions, because chronic Ativan use can lead to physiological dependence. Once you are dependent on Ativan, you will experience unpleasant and possibly life-threatening withdrawal symptoms when you attempt to quit.1 Luckily, Ativan withdrawal can be managed in a professional detox program.

Who is at Risk for Withdrawal from Ativan?

Anyone who is prescribed Ativan is at risk of developing a dependence and subsequent withdrawal symptoms, but people who misuse Ativan are at a greater risk for lorazepam withdrawal than those who take it exactly as directed. Ativan can be misused in a number of ways, including:

  • Taking more Ativan than prescribed
  • Taking more frequent doses than prescribed
  • Mixing Ativan with other substances, like alcohol or opioids
  • Using Ativan in a way other than intended (e.g. crushing and snorting or injecting)

Other risk factors that increase the chance of Ativan withdrawal include:

Ativan Withdrawal Symptoms

If you are dependent on Ativan, you will experience withdrawal symptoms when you suddenly quit using it. Like withdrawal from other substances, Ativan withdrawal symptoms can range from mild to severe and may include:1,2,3

  • Anxiety
  • Panic attacks
  • Restlessness
  • Irritability
  • Depression
  • Headache
  • Insomnia
  • Agitation
  • Heart palpitations and rapid heart rate
  • Hyperthermia
  • Confusion
  • Excessive sweating
  • Tremors
  • Dizziness
  • Depersonalization and derealization
  • Numbness in extremities
  • Hypersensitivity to stimuli
  • Loss of appetite
  • Nausea, vomiting, and diarrhea
  • Short-term memory loss
  • Seizures

If you are taking Ativan for a condition, such as anxiety or insomnia, you are likely to experience what’s known as “rebound anxiety” or “rebound insomnia” when you suddenly quit taking this benzodiazepine. That means that the symptoms you were using Ativan to manage will temporarily return.1

Is Ativan Withdrawal Life-Threatening?

Unlike withdrawal from many other drugs, Ativan withdrawal can be life-threatening.1,2,3 This is due to the potential seizures that may occur once you suddenly quit using Ativan. Seizures are more likely to occur in individuals who have pre-existing seizure disorders or who are taking medications that lower the seizure threshold.1 That said, it’s still possible to experience a withdrawal-induced seizure even if you’ve never had a seizure before. This is an extremely severe Ativan withdrawal symptom and the risk is higher if you’ve been taking high doses of Ativan for an extended period of time.

Additionally, if you frequently mix Ativan and alcohol and also have an alcohol dependence, this could increase the risk of experiencing a life-threatening seizure. That’s because alcohol withdrawal, which resembles Ativan withdrawal, is also characterized by potential seizures (delirium tremens).2

Because benzodiazepine withdrawal could be life-threatening, it’s important to seek medical attention before quitting Ativan. If you are prescribed this medication for a condition, consult with your doctor. Your doctor will create a tapering schedule for you in which your Ativan dose is gradually reduced over a period of time.1

Conversely, if you misuse Ativan and/or struggle with an Ativan addiction, you’ll want to seek professional Ativan detox treatment to keep you safe during withdrawal. Medical detox programs include 24/7 supervision and medical care and withdrawal medications.

Ativan Withdrawal Timeline

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), withdrawal from sedative medications, such as Ativan, may emerge within several hours to a few days after you quit using the sedative.2

Ativan is an intermediate-acting benzodiazepine and has a half-life of between eight hours and 15 hours. Half-life is the amount of time it takes for the amount of a substance to be reduced by 50% in the body.3 As such, the half-life of a drug like Ativan determines the onset and duration of Ativan withdrawal. Withdrawal from shorter-acting benzos will result in an earlier onset of symptoms, whereas withdrawal from long-acting benzos may be delayed by a couple of days. Since Ativan is intermediate-acting, you can expect withdrawal symptoms to emerge within 24 hours of the last dose.

Not everyone’s Ativan withdrawal timeline will look the same. The timeline may be affected by factors, such as:

  • Method of administration (oral use vs. intranasal vs. intravenous)
  • Whether you are using other drugs
  • Your individual physiology
  • Whether you had previous withdrawal experiences

Ativan Withdrawal Treatment: Detox Programs

Because Ativan withdrawal could be potentially fatal, you should not undergo Ativan withdrawal on your own. If you are taking Ativan and want to quit, contact your doctor, who will create a tapering schedule for you. Gradually lowering the dose will prevent the emergence of Ativan withdrawal symptoms.

For people whose Ativan use has progressed into an addiction or dependence, it is recommended to seek a 24/7 medical detox program in which you are treated by a team of doctors and nurses. These programs include around-the-clock medical oversight, treatment, and medications.3

While there are no medications approved by the Food and Drug Administration (FDA) for the management of benzodiazepine withdrawal, several medications may be used to manage symptoms and keep you safe. In these programs, you may be put on a taper or your doctor may switch you from Ativan to a long-acting benzodiazepine, such as Klonopin. Some anticonvulsants, such as valproate and carbamazepine, may be used as well to treat seizures.3

Once you are medically stabilized, it’s important to transition into an Ativan addiction treatment program. These benzodiazepine addiction treatment programs may include interventions, such as:

  • Behavioral therapies
  • Group counseling
  • Family therapy
  • Drug education
  • Support groups
  • Therapy for co-occurring disorders
  • Holistic treatment, such as meditation, yoga, or equine therapy
  • Aftercare planning

Since everyone’s Ativan addiction is different, it’s important to find a treatment program that offers individualized treatment plans based on your evaluation. These programs also tend to change your treatment plan if it needs adjustments at any time during your program.

If you are dependent on Ativan and want to quit, seek medical care or detox. Call our helpline at (800) 662-HELP (4357) to speak to a rehab specialist about finding a detox program or addiction treatment program.


Resources

  1. The Food and Drug Administration. (2016). Ativan Label.
  2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
  3. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.

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