Comedown From Ativan

For most people, Ativan withdrawal lasts between 5 to 28 days. For some people who suffer from severe dependence, Ativan withdrawal can take months or even years.

How Long Does Ativan Withdrawal Last?

How long does Ativan withdrawal last? Ativan also is known as Lorazepam, has a half-life of about 12 to 18 hours. This means that after a person takes their last dose of the medication it will take about 2 to 3 days for the medication to leave a person’s system. According to a study published in the British Journal of Anaesthesia, about 90 percent of lorazepam leaves the body in 4 days. Therefore, the most acute side effects will typically start 3 to 4 days after a person takes their last dose.

Ativan’s active ingredient is benzodiazepines. Benzodiazepines are one of the most commonly prescribed depressant medications in the United States. Benzodiazepines have sedative properties that are used to treat both psychological and physical illnesses. The drug is most commonly used for anxiety relief, as a muscle relaxant, and amnesiac. Benzodiazepines affect the major neurotransmitter in the body known as gamma-aminobutyric acid (GABA). This neurotransmitter is responsible for regulating bodily functions such as feelings of calm, drowsiness, and sleep. The activity of GABA is enhanced by benzodiazepines, resulting in slowing nerve impulses throughout the body, which calms the brain.

Benzodiazepines such as Ativan are classified as Schedule IV in the Controlled Substance Act meaning they have a low risk for abuse and dependence. However, taking Ativan for longer than prescribed can result in physical dependence that has the potential to cause withdrawal symptoms in people attempting to reduce their dosage or abruptly quit taking the medication.

Ativan Withdrawal

Addiction and physical dependence can occur when a person takes Ativan for prolonged periods of time. Over time, a person’s body will become accustomed to having the drug and will adjust its own release of chemicals to account for the drug. If a person does not constantly maintain a continuous supply of the drug in their system, they will not feel normal without. This chronic use or abuse of the medication can lead to painful Ativan withdrawal symptoms when a person attempts to stop using the medication. Withdrawal symptoms occur because the body has learned to not supply the chemicals it needs to function properly. Therefore, the body relies on the drug function as it should.

For some people who chronically abuse benzodiazepines withdrawal can be a long and slow process. According to the Comprehensive Handbook of Drug & Alcohol Addiction 2004, there are two stages of benzodiazepine withdrawal. The first stage is the acute withdrawal stage. This stage can last anywhere from 5 to 28 days. People typically see a peak in the severity of symptoms around 2 weeks after they had their last dose of the medication. Lorazepam withdrawal symptoms in the acute phase can include nausea, headaches, sweating, dizziness, blurred vision, confusion, delusions, paranoia, hallucinations, diarrhea, nightmares, poor memory, appetite loss, irritability, tremors, restlessness, depressed mood, trouble sleeping, muscle aches, tiredness, blood pressure changes, rapid heart rate, anxiety, and seizures.

The last stage is known as Post-Withdrawal syndrome.  Only about 10 to 15 percent of people will develop this syndrome and it can last months to years. This phase involves a slow reversal of the receptor changes that happened in the brain from the medication use. Ativan withdrawal symptoms in this stage include psychological symptoms that resulted from long-term benzodiazepine use such as anxiety, insomnia, muscle spasms, cognitive impairment, tingling or numbness in limbs, and depression.

Factors Affecting Withdrawal

There are many different factors that affect the duration and intensity in which a person experiences withdrawal from Ativan. The Department of Health listed several factors that affect withdrawal.

First, a person’s expectation of what they believe their withdrawal looks like. If someone believes they are going to experience severe withdrawal symptoms they will be more likely to have them.

Second, a person’s general physical health can affect the withdrawal process. A person who is healthy will experience less severe withdrawal symptoms than someone who is not. This is because a person who eats healthy, exercises, and drinks plenty of water will be better able to flush the toxins out and recover faster.

Third, a person’s overall psychological health can make the withdrawal process better or worse. People who are prone to anxiety or depression tend to have more severe withdrawal symptoms.

Fourth, a person’s social support can determine whether or not a person successfully withdraws. Social support plays a major role in keeping people motivated to continue treatment and overcome their addiction.

Additional factors that affect withdrawal are the dose and frequency that a person was taking the prescription, the length of time a person was on the medication for, and using the medication with other drugs.

Medications to Assist with Ativan Withdrawal

Medical detox can provide a person with medications to ease the painful withdrawal symptoms. While there are no Food and Drug Administration (FDA) approved medications to treat a benzodiazepine addiction, physicians during a medical detox can provide a patient with medications to treat certain withdrawal symptoms.

According to Therapeutic Advances in Psychopharmacology, carbamazepine, trazodone, buspirone, and melatonin are safe and can be used to assist with Ativan (benzodiazepine) withdrawal.

The medication carbamazepine is an anticonvulsant that can be used to treat seizures. Seizures are a less common, but dangerous symptom of Ativan withdrawal.

Doctors can prescribe trazodone to treat depression. Trazodone also improves a person’s mood, appetite, and energy levels. This medication is also known to reduce anxiety and insomnia and works by restoring the balance of certain natural chemicals in the brain.

Anxiety, irritability, trouble sleeping, rapid heart rate, and sweating are all commonly seen when a person withdraws from Ativan. The medication buspirone is a medication used to treat anxiety that affects certain natural substances in the brain. Therefore, this medication can be prescribed to treat certain symptoms of withdrawal.

Rebound insomnia is often seen in people who are withdrawing from Ativan. Therefore, melatonin can be prescribed to help people sleep. Melatonin is a hormone that is naturally produced in a person’s body to induce and regulate sleep.

Ativan detox

How to get off Ativan? Two essential pillars of successful withdrawal from Ativan are a gradual dosage reduction and psychological support. When combined with medications to specifically target symptoms a person can experience enhanced comfort during the withdrawal process as well.

The rate at which a person should withdraw from Ativan depends on the person’s lifestyle, personality, environmental stresses, the reason for taking this medication, and the amount of support they have. In any case, withdrawal from Ativan should start with a slow taper. A slow taper is a gradual reduction in dosage until a person no longer needs to take the medication to prevent withdrawal symptoms. For a lot of people, a successful withdrawal from ativan can be accomplished at an outpatient clinic. For more severe cases, an inpatient clinic will better suit their needs.

The detox process will combine medications to treat specific withdrawal symptoms with behavioral therapy. One form of behavioral therapy that is often used to treat benzodiazepine addiction is cognitive-behavioral therapy. Cognitive-behavioral therapy is widely used to assist in the addiction treatment process. This form of therapy helps people address problematic thoughts associated with drug use, helps a person develop coping strategies to deal with stressful situations that might cause a person to engage in drugs, and helps them overcome addiction.

According to a study published in Behavioral Research and Therapy Journal, cognitive-behavioral therapy was found to significantly increase rates of successful benzodiazepines discontinuation compared to tapering off the mediation alone by the end of the 6-month follow up. The study also found that patients who received cognitive-behavioral therapy tapered despite the presence of withdrawal symptoms. Patients who only tapered and did not receive therapy did not successfully taper and relapsed.

Finding Help

Attempting to come down from Ativan on your own can be extremely difficult and even painful. If you or someone you love has an addiction to this medication, finding a high-quality rehab can help. Rehabilitation clinics can provide support, education, and a safe environment to help you withdraw from Ativan and overcome your addiction.

References

• Addiction Treatment Options. Sunshine Behavioral Health.
• Benzodiazepines. Centers for Substance Use Disorder Research.
• Challenges of pharmacological management of benzodiazepine withdrawal, dependence, and discontinuation. Therapeutic Advances in Psychopharmacology.
• Efficacy of cbt for benzodiazepine discontinuation in patients with panic disorder: Further evaluation. Behavioral Research and Therapy Journal.
• Facilitation of benzodiazepine discontinuation by melatonin. Archives of Internal Medicine.
• Management of benzodiazepine misuse and dependence. Australian Prescriber.
• Metabolism of lorazepam. British Journal of Anaesthesia.
• Protracted withdrawal symptoms from benzodiazepines. Comprehensive Handbook of Drug & Alcohol Addiction 2004.
• Withdrawal symptoms and the rebound effect. The Department of Health.