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Ativan Withdrawal and Dangers of Use

Ativan is the brand name for lorazepam, a benzodiazepine medication prescribed to treat anxiety disorders and epilepsy. It is also sometimes used prior to surgery, before anesthesia is administered, to help relax the individual.

How Does Someone Become Addicted to Ativan?

Like other benzodiazepines, Ativan works on the GABA receptors, influencing how rapidly gamma-aminobutyric acid (GABA) binds to these neurons. GABA is a neurotransmitter that, when absorbed rapidly, can cause feelings of anxiety, panic attacks, and even seizures. When it is not absorbed rapidly, however, neuron firing slows down, inducing a feeling of relaxation. At prescription doses, used over a short period, Ativan can help a person relax and feel less panicked. It can also reduce the frequency of seizures or their severity.

Ativan has become a popular prescription benzodiazepine because its effects can be felt within 1-6 hours after ingestion. It does not affect the liver as much as other benzodiazepine medications, and it does not interact with as many drugs.

However, like other benzodiazepines, there is a potential for Ativan to become addictive or habit-forming. Benzodiazepines are very habit-forming, and the body can quickly develop both a dependence on and tolerance to these drugs. This is why benzodiazepines like Ativan are rarely prescribed for more than two weeks. Unfortunately, many people abuse Ativan. With continued abuse, or even extended standard use, dependence can quickly form.

What Is Ativan Withdrawal?

Withdrawal occurs once Ativan begins to leave the body once dependence has formed. Withdrawal symptoms occur because the body needs the medication to operate normally, and it can take some time for brain chemistry to return to normal without the continual presence of Ativan.

Withdrawal from benzodiazepines requires medical supervision, even if the person has been taking this medication as prescribed. Symptoms of Ativan withdrawal can include seizures, especially if the person received a large dose of the drug or struggled with addiction to Ativan for an extended period of time. This can be physically dangerous and even result in death.

The Ativan Withdrawal Process

Withdrawal from benzodiazepines like Ativan can vary, depending on the drug’s half-life, how large the dose is, and how long the person has struggled with Ativan abuse. Ativan’s half-life is about 12 hours, so withdrawal symptoms typically begin within two days after the final dose. For many people, the most intense symptoms peak at four days, but some people develop protracted withdrawal, or benzodiazepine withdrawal syndrome, which can last for several weeks or even months and be physically dangerous.

Ativan withdrawal can take about two weeks, depending on individual factors related to dose size and frequency. However, acute withdrawal follows a typical pattern.

  • Days 1-2Ativan’s half-life is 12 hours, so within the first 48 hours after the final dose, the person will begin to experience withdrawal symptoms. Most of these symptoms are similar to symptoms of the initial anxiety or panic disorder being treated. They can include:
    • Agoraphobia
    • Anxiety or panic attacks
    • Insomnia
    • Nightmares
    • Restlessness or excitability
    • Muscle pain or stiffness

During the first two days, physical symptoms may feel more like a cold or the flu. However, during the next 10 days, these can become more intense.

  • Days 3-14Both physical and psychological symptoms hit their peak during this time. These can include:
    • Reduced cognitive ability
    • Difficulty concentrating
    • Depression and/or anxiety
    • Increased panic attacks
    • Lightheadedness or dizziness
    • Fatigue and exhaustion
    • Muscle aches and pains
    • Tremors
    • Heart palpitations
    • Increased breathing and blood pressure
    • Muscle stiffness, especially in the neck, back, and jaw
    • Sweating, especially night sweats
    • Cravings and anxiety around taking the medication

After two weeks, these symptoms will begin to clear up.

  • Day 14 and beyondSymptoms of Ativan withdrawal will dissipate, although there can be lingering muscle aches, fatigue, and cravings for the benzodiazepine. If symptoms do not clear up, however, the person may be experiencing protracted withdrawal, which can be a serious condition.

Medically Supervised Detox

Benzodiazepine withdrawal symptoms can be dangerous in some instances. This includes the potential for seizures. While rare, seizures can be life-threatening so medical detox is always recommended for benzodiazepine withdrawal.

For benzodiazepines like Ativan, there are no medication replacement therapies as there are with other drugs, such as for opioid addiction. However, a physician will typically work with their patient on a tapering schedule, reducing the dose over several weeks to slowly wean the body off dependence on Ativan. Although this draws out the experience of detox for several weeks or month, it is much more successful. There is less chance that the person will relapse back into Ativan use because withdrawal symptoms should feel mild, if they are even felt at all. Clients also receive social support during medically supervised detox; when they attempt to withdraw without help, the lack of encouragement and support can lead to relapse.

People who have struggled with Ativan addiction for a long time may also receive a long-acting benzodiazepine, such as diazepam (Valium), as a replacement. This helps the person break the habit of taking several doses per day, while still working with dosage reduction and reducing the intensity of withdrawal symptoms. Either way, working with medical professionals to gradually withdraw from Ativan dependence is the most effective, and safest, process.

The Need for Additional Treatment

Once a person has successfully detoxed from Ativan, or another drug of addiction, they should enter a rehabilitation program. Detox is a very important step in recovery, but it is only the first step. Attending a rehabilitation program, either on an inpatient or outpatient basis, is the best way to understand the root causes of the addiction and to develop better coping mechanisms for stress or triggers in the person’s environment. With comprehensive care, addiction can be effectively managed for life.