Ativan (Lorazepam) Withdrawal Symptoms — Ativan Withdrawal Timeline
Medically reviewed by
Dr. Anna PickeringApril 3, 2019
Ativan (lorazepam) withdrawal can come with an array of symptoms. Generally, it takes three to four weeks for physical withdrawal symptoms to wear off and months or years for psychological symptoms to stop.
Many people may start to take benzodiazepine medications such as Ativan (lorazepam) for a medical purpose. However, when it comes time to stop taking the drug, they struggle to do so because they encounter unpleasant withdrawal symptoms. In general, benzodiazepine withdrawal symptoms have three classifications:
Anxiety and related symptoms:
- anxiety, panic attacks, hyperventilation, tremors
- sleep disturbance, muscle spasms, anorexia, weight loss
- altered vision, excessive sweating
- abrupt mood swings
Perceptual disorders:
- hypersensitivity to sound, light, and touch
- abnormal body sensations
- depersonalization (a state in which one’s thoughts and feelings seem unreal or not to belong to oneself, or in which one loses all sense of identity)
- derealization (a feeling that one’s surroundings are not real)
Major events:
- generalized seizures
- precipitation of delirium or psychotic symptoms
It is important to note that every person will have their own experience when they withdraw from Ativan. Someone may experience all of the above symptoms, while others may only experience a few.
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Ativan (Lorazepam) Withdrawal And Rebound Anxiety
When someone goes through Ativan (lorazepam) withdrawal, he or she can also experience rebound phenomena. Rebound symptoms are the return of the sleep or anxiety issues for which someone started taking Ativan in the first place. The original symptoms can seem much more severe once an individual has stopped taking Ativan.
The chances of someone experiencing rebound symptoms is increased when someone suddenly stops taking Ativan, which is why most people are recommended to taper off use of the drug gradually.
Ativan (Lorazepam) Withdrawal Timeline
Lorazepam has a half-life of 12 to 18 hours, meaning that every 12 to 18 hours half of the drug is processed and eliminated from the body. When someone stops taking Ativan or misses a dose, they will likely begin to feel withdrawal symptoms 12 to 24 hours after their last dose.
People who have developed a tolerance to higher doses of the drug may not feel withdrawal symptoms for longer than 12 to 24 hours because they have more of the substance accumulated in their bodies.
Although these individuals may experience a delayed onset of withdrawal symptoms, they are more likely to experience more severe withdrawal symptoms than others who are not as tolerant to the drug.
Ativan Withdrawal: How Long Does It Take?
The amount of time it takes to withdraw from Ativan depends on the individual and their unique circumstances. Several things influence the way the body withdraws from Ativan. These factors can include:
- the length of time they have abused Ativan (lorazepam)
- the method of administration (snorting, smoking, injecting)
- how much Ativan they have become tolerant to
- underlying mental health or other medical issues
- abusing other substances with Ativan (polydrug abuse)
Ativan withdrawal is more likely to be severe if an individual stops taking the medication suddenly, or is tolerant to a very large dose. The longer someone has been abusing Ativan, the more time it will take to eliminate the drug from the body, as excess Ativan is stored in fat cells throughout the body.
Usually, to completely withdraw from Ativan takes about three to four weeks. Depending on the situation, someone could experience post-acute withdrawal symptoms for months or years afterward.
Stages Of Ativan (Lorazepam) Withdrawal
Two significant stages commonly characterize benzodiazepine withdrawal: acute (immediate) withdrawal and post-acute (prolonged) withdrawal. Acute withdrawal is what is most widely associated with Ativan withdrawal. This phase is when a majority of physical withdrawal symptoms occur and typically lasts for seven to 14 days.
Post-acute withdrawal symptoms, also referred to as PAWS, begin after acute withdrawal is finished. This phase is tricky to estimate, because some people may only experience post-acute withdrawal for a month or two, and others could experience these symptoms for years.
Generally, post-acute withdrawal consists of mainly psychological symptoms, which can encourage people to start using Ativan again. This is why many people may find formal addiction treatment programs helpful, as they can teach participants how to recognize and deal with their triggers to prevent future relapse.
Medication-Assisted Ativan (Lorazepam) Detox
Detoxing from benzodiazepine medications like Ativan can be dangerous to do alone. Suddenly stopping the drug can cause the body to go into a type of shock. Medically supervised detox programs can be used to decrease the likelihood of experiencing uncomfortable Ativan withdrawal symptoms.
These programs are supervised by physicians who can recommend individual tapering schedules to ensure comfort and safety throughout the detox process. Ativan (lorazepam) withdrawal can produce potentially life-threatening symptoms, so it is best to detox in a safe and controlled environment.
Although withdrawal symptoms are minimized by slowly reducing the daily dose of Ativan, other medications may be prescribed to help with symptoms that cannot be avoided. Antidepressants or other sleep aids may be given to individuals who experience rebound symptoms, for example.
Medically supervised detox programs are also equipped to deal with unforeseen withdrawal symptoms, such as seizures or psychosis, in a more timely manner than someone attempting to detox on their own.
Treatment For Ativan Withdrawal And Addiction
Treatment for Ativan (lorazepam) withdrawal is only the first stepping stone on the path to recovery. Addiction is a chronic, life-long disease and formal addiction treatment is often the best way to come off benzodiazepines safely.
With comprehensive treatment that addresses the person as a whole—mind, body, and spirit—individuals are much more likely to stop their Ativan abuse and regain control of their lives.
Addiction treatment options such as an inpatient program make all the difference to someone who wishes to successfully withdraw from Ativan. Inpatient programs are best suited for individuals who have tried and failed to quit Ativan and individuals who may need a little extra support when first coming off the drug.
Article SourcesGovernment of South Australia: SA Health - Benzodiazepine withdrawal management
National Center for Biotechnology Information: Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings - Withdrawal Management
U.S. Food And Drug Administration (FDA) - Ativan® C-IV (lorazepam) Tablets Rx only