Ativan Withdrawal: Symptoms, Timeline & Detox

Ativan Withdrawal Guide

Ativan, also known by its generic name lorazepam, is a type of prescription benzodiazepine. The medication is prescribed for the treatment of acute anxiety and panic attacks. Although most benzodiazepine drugs are used to treat severe anxiety and sleep disorders, Ativan is used mainly for sudden onset of anxiety. The drug enhances the effects of a certain natural chemical in the body (GABA). This has a calming effect on the central nervous system functions, which become exaggerated during a panic attack or an acute stress response. Although the medication is amazingly valuable and has improved the quality of life of many people worldwide, it must be used with caution and controlled dosages because it can be addictive and requires withdrawal treatment.

Ativan is often used in combination with opioids or alcohol. The use of Ativan in combination with these substances greatly increases the risk of overdose because all three of these drugs suppress vital functions like blood pressure and breathing. Ativan is often abused because it gives users an addictive feeling of euphoria, and benzodiazepines can create quick dependence. When clients develop dependence, they will probably experience dangerous, painful withdrawal symptoms.

Luckily, there are safe, effective treatment options available for Ativan dependence. Rehab centers and medical detox facilities have professionals trained to assist Ativan clients in overcoming this dependence and recovering from the withdrawal symptoms. Some treatments offer withdrawal tools so clients can lessen their physical pain from detox.

Ativan Withdrawal

Ativan Withdrawal Symptoms

People who abruptly stop taking Ativan without gradually weaning off the drug may experience intense withdrawal symptoms, such as psychotic reactions, hallucinations, and seizures. Medical practitioners advocate tapering off of the drug rather than quitting “cold turkey” because this approach can be dangerous.

Essentially, benzodiazepine withdrawal entails two stages known as acute withdrawal and protracted withdrawal. The first stage, acute withdrawal, includes both psychological and physical symptoms. The main Ativan acute withdrawal symptoms include:

• Insomnia
• Anxiety
• Mood swings
• Panic attacks
• Rapid heart rate
• Weight loss
• Stiffness or muscle pain
• Blood pressure change
• Vomiting or nausea
• Confusion
• Irritability
• Difficulty concentrating

The second stage, protracted withdrawal, is also referred to as post-acute withdrawal syndrome. It is characterized by the presence of withdrawal symptoms, specifically psychological, after the first stage is over. Notably, not all people experience protracted withdrawal. The main Ativan protracted withdrawal symptoms include:

• Dysphoria or depression
• Memory problems
• Anxiety
• Difficulty concentrating
• Cravings
• Sleep difficulties
• Obsessive-compulsive tendencies
• Inability to feel pressure
• Reduced interest
• Constantly feeling tired

Clients need to participate in medically supervised detox during withdrawal to decrease the chances of rare and adverse side effects and to prevent severe withdrawal symptoms.

Ativan Withdrawal Timeline

Technically, the duration of Ativan withdrawal varies from one individual to another, depending on many factors like the severity of the addiction and how long the substance was used. The duration of this process is usually measured in days, weeks, and months. Some clients may be highly dependent on Ativan and thus need more time to withdraw from the drug. People who use Ativan more frequently and for longer periods may experience stronger withdrawal symptoms and longer withdrawal durations.

Duration of Withdrawal

The drug Ativan has a half-life of 10 to 12 hours. This means that it takes 10 to 12 hours for half a dose to leave the body. For this reason, some more time is needed for withdrawal to complete. Withdrawal symptoms can take place within 24 hours of discontinuation. However, the average onset of withdrawal symptoms is between three and four days after the last dose.

Normally, symptoms are mild during the onset of withdrawal symptoms. However, they become more severe within the first week, and the severity generally peaks within the first two weeks after cessation of drug use. Full-blown withdrawal symptoms lessen over the following weeks. However, in more severe cases, symptoms can persist for months.

Withdrawal Symptoms Timeline

Generally, the drug’s withdrawal symptoms timeline, from the onset of symptoms to the peak, is measured in days. However, it’s important to remember that the timeline varies from one individual to another.

Days 1-3

Involves acute withdrawal symptoms characterized by nausea and headache. These are usually experienced within the first 24 hours after the last dose of Ativan.

Days 4-7

The severity of withdrawal symptoms peaks during this period. The common symptoms experienced include irritability, cravings, and tremors. The severity and symptoms vary from person to person.

Days 8-14

Withdrawal symptoms should start to lessen during this period. At the end of this period, the symptoms should have essentially, if not completely, disappeared. However, rebound symptoms tend to start two to three days after Ativan acute withdrawal ends. The rebound symptoms may include rapid heart rate, insomnia, severe anxiety, and increased blood pressure.

Days 15+

Usually, the difficult part is over at this time. The client should not be experiencing acute withdrawal symptoms. Any persisting withdrawal symptoms should not be severe by now. However, protracted withdrawal symptoms can start at this time for some clients.

Factors Affecting Withdrawal

The duration and severity are dependent on several factors that vary from one individual to another.

Individual Differences in Psychological, Emotional, and Physical Makeup

Personal factors, including the client’s co-occurring mental health issues, history of addiction, and body composition, can significantly affect the length and intensity of a client’s withdrawal symptoms linked with Ativan.

The Dose and Frequency of Ativan Use

Chronic drug users tend to develop a more physical and psychological dependence on it, thus developing strong tolerance. The severity and length of the withdrawal symptoms a client experiences vary based on their tolerance to the drug. People with high tolerance levels to Ativan may experience more severe and longer withdrawal symptoms than those with lower tolerance levels.

How Long a User Was Taking Ativan

The length of time that a person used Ativan will contribute to the severity and length of the withdrawal symptoms. The longer the client uses Ativan, the more severe and longer their withdrawal may be.

Addiction to Other Drugs

Ativan is commonly used in combination with other drugs. Addiction to other substances, like opioids, alcohol, and other types of psychotropics, combined with Ativan can affect its withdrawal timeline. People dependent on multiple substances are likely to experience a more difficult withdrawal process.

The Individual’s Life Circumstances

No two people have the same lives. A client’s life circumstances can affect the withdrawal timeline and severity of withdrawal symptoms he or she experiences. Clients who are homeless, separated from their families, and undergoing legal battles have a higher chance of experiencing stronger, longer, and more severe withdrawal symptoms than those who have jobs or who live close to their family members.

Ativan Detox

Medically assisted detox offers the safest option for recovering from Ativan dependence. This is a crucial step in the withdrawal process and should not be taken lightly. Because of the severity of withdrawal symptoms, clients who have been out for more than 24 hours can and should obtain medical assistance.

Medications help make the detox process more comfortable and safer for the client. Detoxing under the supervision of a physician is safer and more effective than detoxing independently. This is because the physician can monitor the client and ensure they are safe during the withdrawal process.

Usually, in detox, clients taper off of the drug in a gradual manner and on schedule. This is usually done by reducing Ativan doses to zero over time. Alternatively, a physician can prescribe a less potent benzodiazepine to wean clients off Ativan. Tapering helps reduce the risk of relapse by slowly reducing Ativan doses until they are completely off of the drug. This process can last anywhere from several weeks to months.

The common approach to detox is a slow taper. A slow taper prevents clients from experiencing withdrawal symptoms that might be severe and that will help them adjust and manage the process without too much discomfort or relapse risk.

Medications to Assist With Withdrawal

Various substances or drugs can be administered to clients struggling with withdrawal. This is because many people experience multiple withdrawal symptoms that could be difficult to handle and manage on their own. A physician should supervise the use of medication to minimize withdrawal symptoms.

For instance, Ativan clients who develop seizure-like activity during detoxification are given medications to reduce the activity or to lessen its intensity. A common class of drugs that are used is called anticonvulsants. These medications are given to clients to reduce withdrawal-induced seizure activity.

Although physicians may utilize various drugs to treat certain withdrawal symptoms during detox, it is important to note that there are no medications that can treat all withdrawal symptoms. Additionally, a meta-analysis study pointed out that the most effective strategy of addressing withdrawal symptoms does not involve the use of medication but rather involves the use of tapering approach, especially in the case of benzodiazepines such as Ativan.

The following is a list of drugs or substances that may be administered in Ativan medical detox.

Melatonin

One of the medications that can be used for this purpose is melatonin. The drug is sometimes used in detox because it is made from a hormone that induces sleep. There is research evidence showing that melatonin has a positive effect in addressing insomnia in clients who are undergoing benzodiazepine withdrawal, including those withdrawing from Ativan. However, the research study is mixed and does not primarily focus on Ativan.

Paxil

Another drug used in Ativan medical detox is Paxil (paroxetine). The drug has some research evidence suggesting it can address withdrawal symptoms linked with Ativan detox. Paxil is positively correlated with increased success rates in benzodiazepine (including Ativan) withdrawal.

Treatment for Ativan Addiction

Treatment in an outpatient or inpatient program that allows clients to effectively recover from their Ativan addictions. Both programs are ideal and significantly help with the detox process, ensuring that it is comfortable and safe.

Inpatient treatment is helpful for clients who have possible complications that could cause harm, such as seizures or other symptoms. The client is completely supervised and can be monitored and treated in a hospital by doctors.

On the other hand, outpatient treatment is a more cost-effective option for clients. It is also suitable for clients who do not have severe withdrawal symptoms. However, the withdrawal symptoms of Ativan can still be severe for some clients and should be monitored carefully.

Getting Ativan treatment can help clients acquire the needed support that is essential to achieving full recovery. They learn the skills needed to prevent relapse and can continue to practice those skills after they leave rehab.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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