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The Ativan Withdrawal Timeline Chart

TABLE OF CONTENTS


ARTICLE SUMMARY: Never attempt to withdraw Ativan on your own. It can be dangeous and lead to multiple complications. Continue reading for more on how to safely manage coming off this strong benzodiazepine.


Overall Duration

It can take weeks to months to completely withdraw from Ativan. This is because with repeated daily dosing, accumulation occurs and high concentrations can build up in the body (mainly in fatty tissues). The symptoms of Ativan withdrawal may appear as soon as 4 to 8 hours after the last dose, and withdrawal symptoms usually manifest within 48 hours. However, some signs of withdrawal may not manifest for up to 7 to 10 days after stopping chronic use.

On the other hand, physical dependence develops relatively quickly. This is because Ativan is a benzodiazepine, a strong central nervous system depressant. It affects the brain.In fact, anyone who has taken a benzodiazepine like Ativan for longer than 3–4 weeks is likely to have withdrawal symptoms if the drug is ceased abruptly. These symptoms require time in order to resolve.

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NOTE HERE: It is important that you seek medical supervision when you are ready to stop taking Ativan. Symptoms can be serious and include seizures. Mild withdrawal symptoms include a depressed mood and trouble sleeping. However, these symptoms can persist for weeks or months. 

What’s Withdrawal Like?

What can you expect during Ativan withdrawal?

Whether you’re taking Ativan prescribed by a physician or bought on the black market, know that anyone who is physically dependent on Ativan is at risk for an acute withdrawal syndrome that is clinically indistinguishable from alcohol withdrawal. Risk factors for severe withdrawal include:

  • comorbid medical or psychiatric problems
  • longer time of use
  • older age
  • taking larger doses of Ativan chronically

Further, this type of benzodiazepine withdrawal is characterized by many signs that are opposite to the therapeutic effects of the drug. So, you can expect rebound anxiety or insomnia. In more severe cases, some people may experience seizures. We explain a week-by-week picture of the details in the following schedule.

The Safest Way to Withdraw 

The safest way to manage withdrawal from Ativan is under medical supervision where you can get all support you need. Because lorazepam has a medium-term onset of action, sometimes doctors will transfer you to longer-acting drugs such as diazepam or nitrazepam. The Australian Prescriber, an Australian medical journal, outlined these possible dosing substitutions in 2015. For others, the transfer may be problematic and the drug may have to be substituted in a stepwise manner. This is why medical help is essential.

Still other medical authorities have outlined protocol for Ativan withdrawal and been practicing it from the 1980’s. The Ashton Manual is considered the current authority on the correct protocol for tapering off a medication like Ativan. In fact, withdrawal syndrome from benzos is treated by tapering the sedative and may require hospitalization. Long-term treatment of sedative addiction requires counseling, often with the help of an addiction-treatment professional.

24-72 hours after the last dose

The initial indication of withdrawal from Ativan is an elevation of vital signs such as heart rate, blood pressure, and temperature. Tremors develop next, first a fine tremor of the hands and fasciculation of the tongue, sometimes followed by gross tremors of the extremities. Disorientation and mild hallucinations (often auditory, occasionally visual) may develop as the syndrome progresses, accompanied by sweating. Seizures can also occur during this time.

  • Confusion
  • Headache
  • Increased blood pressure
  • Increased heart rate
  • Rebound anxiety
  • Rebound insomnia
  • Sleep disorder
  • Sweating
  • Tremors

4-7 Days after last dose

  • Abdominal cramps
  • Concentration difficulties
  • Heart palpitations
  • Nausea
  • Vomiting
  • Weight loss

2 Weeks After Last Dose

  • Anxiety
  • Cravings
  • Depression
  • General malaise
  • Headache
  • Irritability
  • Nausea
  • Vomiting

3 Weeks After Last Dose

  • Cravings stabilization
  • Feeling better
  • Lack of motivation
  • Mood swings

Factors that Influence Duration

Know that the length of Ativan withdrawal is different from each individual; in face, the length of time you spend in withdrawal depends on various factors such as:

  • individual’s general health
  • individual’s metabolism and system
  • Ativan dosage
  • frequency of Ativan use

Long-term Ativan users may experience protracted acute withdrawal syndrome (PAWS) which may last for a longer period of time. Some symptoms of Ativan PAWS include:

  • Depression
  • General malaise
  • Lack of motivation
  • Mood swings

A Realistic Timeline

Withdrawal from Ativan may last from several days to few weeks, and even months after the last drug intake. The first Ativan withdrawal symptoms happen when the last dose of Ativan fades away, and usually peak between 48 – 72 hours after the dose. Still, there are some withdrawal protocols that can help affect the severity or intensity of symptoms.

We Welcome Your Questions

Are you or a loved one facing Ativan withdrawal?  If you have ny questions, feel free to write to us in the comments section at the end. We love to hear from our readers! And we will try to respond promptly and personally to all real life inquiries.

Reference sources: Management of benzodiazepine misuse and dependence
Aust Prescr. 2015 Oct; 38(5): 152–155.
Published online 2015 Oct 1. doi: 10.18773/austprescr.2015.055
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/
Medline plus: When you feel like changing your medicine
NCBI: Using medication: What can help when trying to stop taking sleeping pills and sedatives?
NCBI: A physician’s guide to discontinuing benzodiazepine therapy
NCBI: The benzodiazepine withdrawal syndrome
The Ativan Withdrawal Timeline Chart

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5 Responses to “The Ativan Withdrawal Timeline Chart
Michele
7:08 pm July 8th, 2017

I had been on some sort of benzo such as xanax, ativan, clonazepam for 17 years. Went to a detox center a month ago. They gave me hydroxyzine and phenobarbitol for 2 days. On the third day I was released. Had an extremely difficult time with my mind and heart racing, tremors, not sleeping, rapid eye movement, oversensitive senses such as hearing, smelling, tasting and touch, fatigue. I literally felt like I was going crazy. Currently in counseling and have recently started the hydroxyzine 25mg 3-4 times a day. It helps slightly with the anxiety but am still experiencing the shakes, trembling or quivering sensation in the body, insomnia, nonfocused mind, lack of energy or motivation, depression and fear to go anywhere. I struggle to make it daily to counseling. It has been a month since I have had any benzo’s. Shouldn’t my symptoms be better?

Lydia @ Addiction Blog
5:58 pm July 11th, 2017

Hi Michele. The length of benzo withdrawal depends from various factors such as frequency of use, dosage, length of use, general health, metabolism, etc. You may want to take a look into the Ashton Manual: http://www.benzo.org.uk/manual/
It is a manual that can help you with dealing benzodiazepine dependence and withdrawal.

Suzanne
2:06 pm August 7th, 2017

I’m so afraid for my son. He is 17 years old and has low functioning autism. His psychiatrist prescribed ativan a year ago and now I’m trying to wean him off of it. He can’t tell me how he feels and he gets aggressive. Ive been giving him benedryl and ibuprofen to help with his aggression and discomfort. I tried to get in touch with a rehab center and was on hold for an hour and a half, left a message but no one called me back. Any suggestions would be appreciated.

Lydia @ Addiction Blog
5:02 pm August 11th, 2017

Hi Suzanne. First, consult with your son’s doctor on quitting Ritalin. Then, call the helpline you see on the website to get in touch with a trusted treatment consultant.

Linda
6:40 pm November 26th, 2017

This is day 8 for me having gone from 1 mg of lorazepam for 16 years at bedtime. I’ve been trying to get off this drug by weaning myself off for the last 7 to 8 years and have always failed and gone back to my 1mg dosage after about a week or two. The reason being the withdrawals. This time I’ve gone into it reading and googling so much on the withdrawals that I feel I am ready to face them. I weaned down to 1/2 the dosage but by the 3rd night took 3/4 dosage but went right back to 1/2 dosage on night 4. It’s been difficult although I had a very good day yesterday and did not feel the withdrawals symptoms until well on into the evening. Today I’m quite anxious and I keep telling myself that this needs to be done in order to reach the light at the end of the tunnel. I’ve been walking every morning and doing yoga throughout the day and some meditation too. It helps very much. Believe me in 2001 when my doctor put me on lorazepam he did not tell me how physically dependent I would become to it. If he had have I am sure I would have asked for something else that was not as I was going through the roughest part of my life back then. Now my life is so good and yet my body is addicted to this awful drug but I am determined. When my symptoms feel at their worst I take 8 slow, deep breaths and then drink a full glass of water. It helps me a lot so I will keep doing this. If you have any advice to offer me I am very open to it as I would like to be off lorazepam by late February to early March. I have read that once you are down to .05mg which is half the dose of 1mg you can go cold turkey but this scares me. Please tell me your thoughts on this as I was planning that after Christmas I would go down to 1/4 dose for a few weeks and then go off of it completely. Thank You.

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