Ativan is the brand name for lorazepam, a benzodiazepine medication used to treat anxiety and seizure disorders.[1] The U.S. Drug Enforcement Administration (DEA) classifies Ativan as a Schedule IV drug because it has a moderate potential for misuse and physical dependence.[2]
Physical dependence occurs when the body adapts to the presence of a drug and relies on it to function properly. People who are physically dependent on Ativan will experience uncomfortable, sometimes serious withdrawal symptoms if they stop taking it cold turkey.
This article discusses Ativan withdrawal. You will learn:
- What causes Ativan withdrawal
- How long Ativan withdrawal lasts
- What symptoms to expect while detoxing
- How a medical detox program can help
If you or someone you love are struggling with Ativan addiction, please contact First Step Behavioral Health today to learn about our detox and treatment programs.
Understanding Ativan Withdrawal
Ativan works by increasing the production of gamma-aminobutyric acid (GABA) in the brain, a major inhibitory neurotransmitter. By increasing GABA levels, there is suppression of neuron firing which leads to reduced excitation in the brain.[3]
Like other benzodiazepines, Ativan is physically habit-forming. Physical dependence occurs after the body adjusts to having the drug around and relies on it to function normally. The body adapts by regulating its own release of chemicals like neurotransmitters and hormones to match the drug’s presence. If the person suddenly stops using the drug, their body becomes imbalanced, leading to a range of physical symptoms known as withdrawal symptoms.
In the case of Ativan, withdrawal symptoms can be particularly challenging due to its impact on GABA levels in the brain. When Ativan is abruptly discontinued, the sudden decrease in GABA can trigger a surge in neuron activity, resulting in heightened brain excitability. This imbalance often manifests in symptoms such as anxiety, insomnia, tremors, sweating, and even seizures in severe cases.[4]
Symptoms of Withdrawal
Ativan (lorazepam) withdrawal may cause physical and psychological symptoms.
Physical withdrawal symptoms:
- Increased heart rate
- Increased blood pressure
- Heart palpitations
- Nausea
- Vomiting
- Abdominal cramps
- Muscle aches
- Body pain
- Fatigue
- Headaches
- Sweating
- Tremors
- Seizures
Psychological withdrawal symptoms:
- Anxiety
- Panic attacks
- Drug cravings
- Depression
- Irritability
- Agitation
- Mood swings
- Confusion
- Memory loss
- Difficulty concentrating
- Sleep difficulties
- Insomnia
Detoxing from benzodiazepines like Ativan cold turkey is dangerous and potentially life-threatening. Always speak with your doctor or seek help from a medical detox center before you stop taking Ativan.
How Long Does Ativan Withdrawal Last?
Ativan has a half-life of about 10-12 hours, so after this period, levels of the drug begin to decrease in the body, and withdrawal symptoms can appear. Ativan withdrawal usually begins within 24 hours after the last dose and lasts around 10-14 days.
The duration of withdrawal varies depending on:
- Frequency of use
- Length of use
- Dosage taken
- Age, weight, and gender
- Overall health and metabolism
- Genetics
- Co-occurring disorders
People with a history of long-term or heavy use are more likely to experience longer withdrawal periods. Those who take high doses of Ativan build up a tolerance quickly and begin taking even higher doses which can contribute to potentially life-threatening withdrawal symptoms.
Additionally, certain co-occurring disorders, such as anxiety or depression, can influence the severity of withdrawal. For example, those with an anxiety or panic disorder may experience “rebound anxiety.”
In severe cases, such as those in which someone was taking higher doses for extended periods, protracted withdrawal may occur. Also known as post-acute withdrawal syndrome (PAWS), protracted withdrawal can last for several weeks or months.
Ativan Withdrawal Timeline
- 1-3 days – Early withdrawal begins within the first 24 hours after the last dose and may continue to increase for the next few days. Some of the first withdrawal symptoms are headache, nausea, anxiety, and cravings.
- 4-7 days – Ativan withdrawal peaks between days four and seven. Side effects include tremors, irritability, cravings, sweating, and muscle aches.
- 8-14 days – After the first week symptoms should begin to subside. Some discomfort, anxiety, and sleeplessness may persist.
- 15+ days – Acute withdrawal should be over after two weeks. However, some people may experience PAWS. PAWS can be managed with addiction treatment and lifestyle changes.
Ativan Detox Programs
Benzodiazepine withdrawal should always be treated by medical professionals. In a detox program, a physician can oversee the withdrawal process and slowly reduce the dose of lorazepam given. By slowly reducing the dose over time (tapering), symptoms of Ativan withdrawal can be reduced significantly.[5]
Additional symptom-specific medications can be administered to further reduce discomfort. For example, studies have found that melatonin, a supplement used for sleep, can be helpful in alleviating the insomnia that is so common while detoxing from benzodiazepines.[6] Individuals who develop seizures or are at risk of them may be prescribed anticonvulsants.
In addition to medications, treatment centers offer behavioral therapies and support groups to help individuals navigate recovery. After detoxing, treatment should continue with inpatient or outpatient care.
Start Your Recovery at an Ativan Detox Center in Florida Today
Getting treatment for Ativan dependence is the first step toward recovery. 1st Step Behavioral Health is a licensed dual-diagnosis long-term addiction treatment facility that is accredited by the Joint Commission. We focus on the physiological rebalancing of the individual through medical, physical, emotional, mental, and spiritual care.
To learn more about our medical detox and substance abuse treatment programs, or to get started with a confidential, risk-free assessment, please contact us today.
References:
- U.S. Food and Drug Administration (FDA): Ativan (lorazepam)
- U.S. Drug Enforcement Administration (DEA): Drug Scheduling
- National Institute of Health: Benzodiazepine modulation of GABAA receptor opening frequency depends on activation context: A patch clamp and simulation study
- Wiley Online Library: The benzodiazepine withdrawal syndrome
- Sage Journals: Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey
- JAMA Network: Facilitation of Benzodiazepine Discontinuation by Melatonin
