Lorazepam (Ativan) is a commonly prescribed benzodiazepine. When someone abuses large doses of lorazepam for more than two or three weeks, they can become addicted to or dependent on the medication. Once addicted, if someone suddenly stops taking Ativan, they will experience withdrawal symptoms.
Benzodiazepine withdrawal can be very dangerous and uncomfortable. There are two stages of lorazepam withdrawal: acute and prolonged withdrawal.
Acute withdrawal symptoms of lorazepam (Ativan) can include:
- sleep disturbance
- increased tension and anxiety
- panic attacks
- hand tremors
- excessive sweating
- difficulty concentrating
- dry heaving and nausea
- a headache
- muscular pain and stiffness
Prolonged withdrawal symptoms from lorazepam (Ativan) can include:
- rebound insomnia
- anxiety and restlessness
- changes in mood
Problems with short-term memory and lack of coordination are rare but may also occur during lorazepam withdrawal. The psychological impact of prolonged lorazepam withdrawal can sometimes cause severe anxiety which may lead to hallucinations and psychosis.
How Long Does Lorazepam (Ativan) Withdrawal Last?
In general, the more intense the lorazepam abuse, the more severe the withdrawal. The severity of the symptoms felt during lorazepam (Ativan) withdrawal depends on the severity of the individual’s abuse. This is especially true if lorazepam is mixed with other substances such as opioids or alcohol.
One to three days after the last dose, acute lorazepam withdrawal symptoms, such as headaches and nausea, are usually at their worst. Rebound symptoms, or symptoms that occurred before starting lorazepam, may begin during this time and cause severe anxiety, rapid heartbeat and insomnia.
Lorazepam withdrawal symptoms typically peak in severity four to seven days after the last dose. The signs and severity of withdrawal will vary from one person to the next but can include tremors, cravings, and irritability.
After reaching peak severity, withdrawal symptoms from lorazepam usually begin to taper off about two weeks after the last dose. By this time, any rebound symptoms that an individual experiences should also subside.
The worst part of withdrawal is over after the first two weeks without lorazepam (Ativan), as acute withdrawal symptoms should be resolved. At this point, prolonged withdrawal symptoms may start to occur.
Potential Dangers Of Lorazepam (Ativan) Withdrawal
Withdrawing from high doses of lorazepam (Ativan) can increase the risk for severe and even life-threatening symptoms. Benzodiazepine withdrawal can lead to blackouts and memory loss. Missing a single dose can be devastating. Because Ativan is a short-acting benzo, it is eliminated from the body at a faster rate than other longer-acting benzodiazepines.
Because lorazepam is short-acting when it is suddenly removed from the body, withdrawal symptoms can onset more quickly. Individuals who have abused lorazepam (Ativan) for more than six months are more likely to experience more intense withdrawal symptoms, which can make it more difficult for them to come off it safely.
Factors That Influence Lorazepam (Ativan) Withdrawal
Benzodiazepines like lorazepam are fat soluble, so the longer someone abuses the drug, the more it builds up in the fatty tissues throughout their body. Individuals who continually take lorazepam will need larger doses of the drug. People who snort or inject Ativan may increase the rate at which they develop a tolerance to the drug’s effects, compared to taking it by mouth.
Individuals who struggle with co-occurring mental health disorders may also experience more severe lorazepam withdrawal. Abusing other substances in addition to lorazepam can increase dependency and may lead to longer than average withdrawal.
Research also indicates that some people naturally produce more of the enzymes used to metabolize medications such as lorazepam. This increased enzyme level can cause them to process the drug at a faster rate which can make it easier to develop a tolerance to them.
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Treatment For Lorazepam (Ativan) Withdrawal And Addiction
The first step to treating lorazepam (Ativan) withdrawal is to detox from the substance. During lorazepam (Ativan) detox, individuals slowly taper off their dose over the course of a month or more until they are no longer dependent on the substance.
Some withdrawal treatment programs may also provide a less potent and longer-acting benzodiazepine for individuals with severe lorazepam addiction. Once detox is complete, treatment usually continues in an inpatient or outpatient setting, depending on the individual’s needs.