Table of ContentsView AllTable of ContentsAtivan DependenceWithdrawal OverviewWithdrawal TimelineSigns and SymptomsCoping & ReliefWarningsLong-Term TreatmentBefore Stopping Use
Table of ContentsView All
View All
Table of Contents
Ativan Dependence
Withdrawal Overview
Withdrawal Timeline
Signs and Symptoms
Coping & Relief
Warnings
Long-Term Treatment
Before Stopping Use
What is the most important information I need to know about Ativan withdrawal?Ativan withdrawal can be dangerous, so it is not safe to stop taking this medication or reduce your dose on your own.Tapering your dose gradually can help minimize withdrawal symptoms. Work with your care provider to develop a tapering schedule that is right for you.
What is the most important information I need to know about Ativan withdrawal?
Ativan withdrawal can be dangerous, so it is not safe to stop taking this medication or reduce your dose on your own.Tapering your dose gradually can help minimize withdrawal symptoms. Work with your care provider to develop a tapering schedule that is right for you.
Ativan (lorazepam) is a prescription drug used totreat anxiety disorders, seizures, and insomnia. As a benzodiazepine, discontinuing Ativan use can result in withdrawal symptoms such as headache, heart palpitations, sweating, muscle pain and stiffness, and more.
If you’re concerned about Ativan withdrawal, here’s what you need to know about its signs and symptoms, warnings, and long-term treatment. We also share ways to cope with Ativan withdrawal symptoms, providing some relief.
Verywell / Emily Roberts
How Long Does Ativan (Lorazepam) Stay in Your System?
About Ativan Dependence
Ativan belongs to a class of drugs called benzodiazepines. Benzodiazepines are central nervous system depressants that have a sedating and relaxing effect.These medications can also lead to tolerance and dependence, even when taken at therapeutic doses.
Ativan is one of themost widely prescribed benzodiazepines. In 2017, doctors wrote almost 26.5 million prescriptions for Ativan alone.As of 2018, an estimated 5.4 million people over the age of 12 misused prescription benzodiazepines like Ativan.Ativan can lead to dependence even if you take it exactly as prescribed.
Dependence vs. AddictionIt is important to note thatdependence is not the same as addiction. If you become physically dependent on a substance, it means that you will experience withdrawal symptoms if you stop taking the medication. Addiction, on the other hand, involves repeated use despite negative consequences.
Dependence vs. Addiction
It is important to note thatdependence is not the same as addiction. If you become physically dependent on a substance, it means that you will experience withdrawal symptoms if you stop taking the medication. Addiction, on the other hand, involves repeated use despite negative consequences.
Many people take Ativan regularly for years without realizing how dependent they have become. It is only when withdrawal symptoms emerge after they try to stop taking the medication that this dependence becomes clear.
Overview of Ativan Withdrawal
Benzodiazepines like Ativan were originally intended for short-term use, but their long-term use for anxiety and insomnia has become more commonplace.The issue is that taking Ativan for as little as three to six weeks, even at therapeutic doses, can cause physical dependence and mild withdrawal symptoms.
Ativan withdrawal can be a challenging, uncomfortable experience. Around 40% of people on benzodiazepines for more than six months have moderate to severewithdrawal symptomsif they stop taking the drug abruptly. The other 60% have mild symptoms.
The severity of withdrawal symptoms is also associated with your current dose. If you are on a high dose of Ativan or if you mix Ativan with other benzodiazepines, your withdrawal symptoms may be more severe.
Ativan Withdrawal Timeline
When your daily dose of Ativan is suddenly stopped or significantly reduced, withdrawal symptoms can appear in as little as eight to 12 hours. Acute symptoms or lorazepam withdrawal typically last between one and four weeks.
Research indicates that the severity andduration of withdrawal symptomsdepend on the medication’s half-life, how long it was taken, and the daily dose used.Although, you can expect to feel extremely anxious and irritable for several weeks.
The anxiety you feel during Ativan withdrawal will probably be worse than the level of anxiety you were experiencing before you started taking it, a phenomenon known asthe rebound effect.Insomnia can compound the effects of anxiety and it can feel like your sleep patterns will never return to normal.
It has been estimated that anywhere from 10 to 25% of people who take benzodiazepines for long periods experience what’s known as protracted withdrawal. Protracted withdrawal involves milder symptoms that come and go for several months.It’s not easy, but it typically resolves on its own within one year.
Signs and Symptoms of Ativan Withdrawal
Some of the most common benzodiazepine withdrawal symptoms include:
In severe cases of high-dose withdrawal, some people experience serious side effects such as hallucinations, delirium, and grand mal seizures.
If you experience mild side effects, talk to your healthcare provider about your options. If you experience severe side effects, seek immediate medical attention or call911.
Coping and Relief for Ativan Withdrawal
Quitting Ativan takes time and planning. Before tapering begins, your physician may switch you to a longer-acting benzodiazepine such as diazepam.A long-acting drug helps stabilize you and can make your taper go more smoothly.
There is no single tapering schedule that works best for everyone. The higher your dose, the more significant your first dose reduction will likely be.
If you have been using Ativan for longer than six months, tapering is the only safe way to stop taking the drug. While tapering will help reduce your withdrawal symptoms, it won’t get rid of them entirely. You may still have symptoms each time your dose is reduced.
To help you cope with these symptoms, consider the following options:
Warnings About Ativan Withdrawal
Some drugs are safe to quit on your own; benzodiazepines are not. Do not stop taking Ativan on your own without discussing it with your healthcare provider.
Quitting Ativan cold turkey can be dangerous. While it may not feel like a serious drug, especially if you only take it as directed, it has powerful effects on your brain.
However, most people don’t need to undergoinpatient detoxification. Instead, consulting with your primary care physician or psychiatrist on an outpatient level is often sufficient.Your physician can monitor your tapering progress through frequent visits and phone calls.
An inpatient setting may be a better approach if you have a history of complicated withdrawal, seizures, or severe mental illness. This can involveliving at a detoxification or rehabilitation facilityfor several weeks, where you can be monitored for complications.
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Return of Psychiatric Symptoms
Ativan withdrawal can coincide with the re-emergence of psychiatric symptoms that may have been dormant while you were using the drug. This can include symptoms associated withsevere anxiety,post-traumatic stress disorder (PTSD),obsessive-compulsive disorder (OCD), andclinical depression.
Inpatient treatment may be required if severe psychiatric symptoms begin to return. Talk to your psychiatrist or psychologist about helping you work with your insurance company to get treatment. If you are uninsured, certain inpatient facilities may still be an option.
Pregnancy
The FDA prescribing label for Ativan warns that there are potential risks to taking Ativan during pregnancy.As a result, it is recommended that the decision to continue or discontinue its use be made with the help of a medical professional.
If you are pregnant, talk to your psychiatrist or obstetrician about both the risks of continuing the drug and the risks of quitting while pregnant. If you do want to quit while pregnant, a medically supervised taper is the safest way to do so.
Long-Term Treatment for Ativan Withdrawal
Ativan withdrawal can feel long and arduous because it tends to come and go during the course of your taper. Some people finish tapering their dose within three to four weeks, while others may stretch their taper out for as long as 12 months.
Longer tapers are not associated with better outcomes but may be more comfortable for some people.Either way, it is very important to complete your taper without reversing direction. An Ativan taper should move continuously forward with decreasing doses.
If withdrawal symptoms arise during the taper, the taper can be paused to allow the body time to adjust, but the dose should not be increased.
For those who have been misusing Ativan, tapering alone may not be enough to maintain abstinence.Cognitive behavioral therapyandother psychotherapiescan help you understand why you feel the need to use Ativan and can help you make healthier decisions.
If total abstinence is causing psychological distress, some people may aim for a reduced dose. Tapering toward a reduced dose can reset your tolerance level and help you avoid the negative side effects of high doses.
If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
Before Stopping Ativan Use
To make your dose taper easier on yourself, plan to work with a healthcare provider who is conveniently located and easily accessible. The reason for this is that you may need to make a number of office visits when discontinuing Ativan use.
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11 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152–155. doi:10.18773/austprescr.2015.055Guina J, Merrill B.Benzodiazepines I: upping the care on downers: the evidence of risks, benefits and alternatives.J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017U.S. Department of Justice, Drug Enforcement Administration, Drug & Chemical Evaluation Section.Benzodiazepines.Substance Abuse and Mental Health Services Administration.2018 NSDUH Annual National Report.Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285–294. doi:10.1111/bcp.12023Edinoff AN, Nix CA, Hollier J, et al.Benzodiazepines: Uses, dangers, and clinical considerations.Neurol Int. 2021;13(4):594-607. doi:10.3390/neurolint13040059Lerner A, Klein M.Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025Darker CD, Sweeney BP, Barry JM, Farrell MF, Donnelly-Swift E.Psychosocial interventions for benzodiazepine harmful use, abuse or dependence.Cochrane Database Syst Rev. 2015;(5):CD009652. doi:10.1002/14651858.CD009652.pub2Guina J, Merrill B.Benzodiazepines II: waking up on sedatives: providing optimal care when inheriting benzodiazepine prescriptions in transfer patients.J Clin Med. 2018;7(2):20. doi:10.3390/jcm7020020U.S. Food and Drug Administration.Ativan (lorazepam) tablets.Chinyere I, Ogbonna MD.Tapering people off of benzodiazepines.Am Fam Physician. 2017;96(9):606-608.
11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152–155. doi:10.18773/austprescr.2015.055Guina J, Merrill B.Benzodiazepines I: upping the care on downers: the evidence of risks, benefits and alternatives.J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017U.S. Department of Justice, Drug Enforcement Administration, Drug & Chemical Evaluation Section.Benzodiazepines.Substance Abuse and Mental Health Services Administration.2018 NSDUH Annual National Report.Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285–294. doi:10.1111/bcp.12023Edinoff AN, Nix CA, Hollier J, et al.Benzodiazepines: Uses, dangers, and clinical considerations.Neurol Int. 2021;13(4):594-607. doi:10.3390/neurolint13040059Lerner A, Klein M.Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025Darker CD, Sweeney BP, Barry JM, Farrell MF, Donnelly-Swift E.Psychosocial interventions for benzodiazepine harmful use, abuse or dependence.Cochrane Database Syst Rev. 2015;(5):CD009652. doi:10.1002/14651858.CD009652.pub2Guina J, Merrill B.Benzodiazepines II: waking up on sedatives: providing optimal care when inheriting benzodiazepine prescriptions in transfer patients.J Clin Med. 2018;7(2):20. doi:10.3390/jcm7020020U.S. Food and Drug Administration.Ativan (lorazepam) tablets.Chinyere I, Ogbonna MD.Tapering people off of benzodiazepines.Am Fam Physician. 2017;96(9):606-608.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152–155. doi:10.18773/austprescr.2015.055Guina J, Merrill B.Benzodiazepines I: upping the care on downers: the evidence of risks, benefits and alternatives.J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017U.S. Department of Justice, Drug Enforcement Administration, Drug & Chemical Evaluation Section.Benzodiazepines.Substance Abuse and Mental Health Services Administration.2018 NSDUH Annual National Report.Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285–294. doi:10.1111/bcp.12023Edinoff AN, Nix CA, Hollier J, et al.Benzodiazepines: Uses, dangers, and clinical considerations.Neurol Int. 2021;13(4):594-607. doi:10.3390/neurolint13040059Lerner A, Klein M.Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025Darker CD, Sweeney BP, Barry JM, Farrell MF, Donnelly-Swift E.Psychosocial interventions for benzodiazepine harmful use, abuse or dependence.Cochrane Database Syst Rev. 2015;(5):CD009652. doi:10.1002/14651858.CD009652.pub2Guina J, Merrill B.Benzodiazepines II: waking up on sedatives: providing optimal care when inheriting benzodiazepine prescriptions in transfer patients.J Clin Med. 2018;7(2):20. doi:10.3390/jcm7020020U.S. Food and Drug Administration.Ativan (lorazepam) tablets.Chinyere I, Ogbonna MD.Tapering people off of benzodiazepines.Am Fam Physician. 2017;96(9):606-608.
Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152–155. doi:10.18773/austprescr.2015.055
Guina J, Merrill B.Benzodiazepines I: upping the care on downers: the evidence of risks, benefits and alternatives.J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017
U.S. Department of Justice, Drug Enforcement Administration, Drug & Chemical Evaluation Section.Benzodiazepines.
Substance Abuse and Mental Health Services Administration.2018 NSDUH Annual National Report.
Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285–294. doi:10.1111/bcp.12023
Edinoff AN, Nix CA, Hollier J, et al.Benzodiazepines: Uses, dangers, and clinical considerations.Neurol Int. 2021;13(4):594-607. doi:10.3390/neurolint13040059
Lerner A, Klein M.Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025
Darker CD, Sweeney BP, Barry JM, Farrell MF, Donnelly-Swift E.Psychosocial interventions for benzodiazepine harmful use, abuse or dependence.Cochrane Database Syst Rev. 2015;(5):CD009652. doi:10.1002/14651858.CD009652.pub2
Guina J, Merrill B.Benzodiazepines II: waking up on sedatives: providing optimal care when inheriting benzodiazepine prescriptions in transfer patients.J Clin Med. 2018;7(2):20. doi:10.3390/jcm7020020
U.S. Food and Drug Administration.Ativan (lorazepam) tablets.
Chinyere I, Ogbonna MD.Tapering people off of benzodiazepines.Am Fam Physician. 2017;96(9):606-608.
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