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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.

The Ativan Withdrawal Timeline Chart

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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.

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?

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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

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24 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.

Carol
5:47 am February 24th, 2018

My mom was on Ativan for at least 20 years .05 mg. She is 89 and has been off of this horrible drug for about a month. How long can withdrawal symptoms last? Thank you!

Lydia @ Addiction Blog
1:15 pm February 27th, 2018

Hi Carol. The withdrawal is different for each individual. Its length depends from various factors such as person’s health, metabolism, frequency and dosage of use, level of dependence, body weight, etc.

Linda
3:53 pm February 27th, 2018

Hello it’s me again and as of today I am 44 days lorazepam free!! I’ve commented before when I was just 8 days weaning off and that was November 26th. It has been a roller coaster ride but I am doing it! 44 days ago (early January) when I totally went off I thought that it would only take 2 or 3 weeks but 6 weeks later I am still having withdrawal symptoms, however they are slowly getting better. I am not waking up at 3 a.m. any longer and instead waking up around 5 a.m. and for the last 2 days have been able to fall back asleep until 7:30 a.m. Vertigo is still a bit of a problem but my Doctor who has been on this journey with me tells me that this should fix itself up and some days it is not as bad as others. My mood swings are also starting to not be as severe unless I have had a sleepless night, which is only about once a week, sometimes twice. My thoughts are also not as fogged up as they were even a week ago. I do still get body sweats quite a few times a day and night. One thing I want to mention because no one goes into this detail but I did not drive for the first month that I was completely weaned off of lorazepam because of the dizziness (vertigo) and lack of concentration and I think it is a good idea to know that when you are going through this as it can be very dangerous driving in this condition. The best advice my Doctor gave me before I totally went off was not to make any plans for at least 3 weeks and to stay close to home. I do agree Lydia that this is different for everyone. I had been on 1 mg of lorazepam at night for 17 years so it has been challenging but it also has been doable going into it with the right information and attitude and lots of patience with yourself. Also I talked to my husband before I ever started in order to make sure he too was on the same page and was cognitive of the process. Thank you for this site as it too has helped me by reading the information and the stories that your readers share. I will post again in a month or so and update my progress.

Carol
6:12 pm March 1st, 2018

Thank you Linda for your latest post! It really helped me to understand what is going on with my mom. I am so happy for you and how well you are doing. All the best to you. Carol

Linda
7:33 pm April 4th, 2018

As of today I am 80 days lorazepam free!! I’ve written before in this post and I wanted to share again. It is not easy getting off of any Benzodiazepine as it is more addictive than many other prescriptions drugs. Having said that it is doable if you research and get yourself ready for what you will go through for a few months. When I first began this journey I was frightened as over the years I have tried unsuccessfully to get off of Lorazepam. My doctor prescribed this drug to me in 2001 without any warning of it’s addictiveness. I only took 1mg at night to help me sleep as my mind seems to speed up when I lay down! In 2007 when my doctor retired I went off Lorazepam “cold turkey’ only to end up in a walk-in clinic several days later in bad withdrawals. Since then I had tried unsuccessfully on my own to wean off of it. In October of 2017 my family doctor and I devised a plan to completely wean off with her supervision but no alternative drugs (this doctor is very knowledgable on addictions and you should make sure that your doctor is too as it’s very important to have the assistance from a knowledgable doctor).
I started by taking 1/4 off my little tablet every 2 to 3 weeks. It sound like very little but it is important to do it slowly and even then you will get withdrawals that are named in the article before the posts. For me it was insomnia in a really bad way … I could fall asleep but after 2 or 3 hours I would wake up and not be able to sleep for the remainder of the night. This is when I used breathing exercises and meditation and did not get up from bed. My main objective was to stay relaxed and to retrain my brain to sleep without the assistance of Lorazepam. This was slow but steady. After a couple of weeks I would start sleeping more hours but never a full night. Usually about 5 to 6 hours which to me was much better than 2 or 3 hours. Every time I cut the medication back by 1/4 tablet I would again go through this for a couple of weeks but it eventually would start to even out and I would sleep longer.
Another withdrawal that was difficult was the vertigo I got and still sometimes get on a daily basis. Some days it’s quite bad and other days it’s just there. Vertigo though is not pleasant as it makes you quite nauseated and lacking energy. However this too subsides with time but is very difficult to have every single day … if you are ready for it, it does make a difference. To this day I still get vertigo here and there for a couple days at a time.
Heart palpitations are also worrisome as they leave you breathless at times and they too subside in time. Breathing exercises help a lot. The days that I had my worst hearth palpitations I also felt shaky. Almost like I was having small tremors.
You will also feel very spaced out as if you are stoned all the time. It’s like smoking a joint without smoking a joint but not quite as pleasant! And some days with that comes a euphoria which was the best withdrawal symptom but it does not last long.
My ears seemed to vibrate with sound and I did not like to listen to anything loud … and my eye sight was a little off … my eyes seemed to shake at times if that makes any sense.
Your moods will be up and down every single minute of the day. For this reason if you have a partner in life it is critical to speak with them before heading into this journey as you will need their support and if you don’t have it you likely will not succeed. Even with my husband who is a great person I had to remind him a couple of times that I had to look after me and that I needed his full support. This is not the time to make any major decisions or sometimes even small decisions. Just think of yourself and how to help yourself in what you are experiencing.
When the day came that I was weaning off to 0 Lorazepam I was scared. But I went ahead. The first couple of days were not that bad. And then came the 3rd and 4th day … Could not sleep more than a couple of hours at night … nausea was always with me … my hands shook constantly … my vertigo was bad … confusion set in … I could not do much, not even simple housework some days. I love to write and sketch but could not during this time. It was a big effort just to get out of bed and drag myself to the couch some days. Headaches set in which I normally do not experience. It felt like I had a very tight elastic wrapped around my head from my neck to my forehead … if I turned my head to quickly I felt like I would vomit … I didn’t want to speak with anyone or have anyone see me this way. Most days I stayed in my pj’s and for about a month I only showered about every 3rd to 4th day as I didn’t care and didn’t have the energy. It lasted quite badly for approximately 6 weeks … this is a time where you may be tempted to go back to the Lorazepam as you know that it will make you feel much better but you also know that you’ve done a lot of hard work just to get to this point … over 3 to 4 months of hard work and I was not going to go backwards.
Cold sweats are another symptom that can hit you when you least expect it … fast and furious … especially at night but even during the day.
Determined I carried on and NEVER went backwards.
So here I am today at 80 days. Yes I do still have some withdrawal symptoms. I still do not sleep through a whole night. Normally I wake up after 5 or 6 hours but now when I am laying in bed using my relaxing techniques I do go back to sleep for another hour or two … I do not have vertigo every single day but I still do get it for a day or two here and there … I still get heart palpitations but they are not as often … and the cold sweats still come every night … just not as many.
I do believe that in another month or two most of the residual withdrawal symptoms will have left me … Only one thing I know for sure though and that is that I will never go backwards. You too can do it … Prepare yourself first … get help from your doctor or a doctor knowledgeable on addictions and withdrawals … have support at home … don’t make any long term plans for at least 3 to 4 months … practice meditation or yoga … and be kind, gentle and patient with yourself.
I truly hope that this helps someone either going through this or preparing to go through it. Peace & Love

Lydia @ Addiction Blog
5:56 pm April 25th, 2018

Hi Linda. Congrats! Keep up with the great work. I hope that your message will inspire and help the others…

Kerry
12:22 pm April 20th, 2018

I only had been taking ..5 mg Lorazepem every third day or so, Now I am trying to get off of it. I reduced to .25 mg/day, but I want to just stop altogether now. Do you think I can do this?

Lydia @ Addiction Blog
1:21 pm April 24th, 2018

Hi Kerry. The safest way is by slowly reducing the daily dose. The Ashton Manual provides simple tapering schedule for Lorazepem here: https://www.benzo.org.uk/manual/bzsched.htm#s3

BUT, alwaus consult with your doctor before reducing your dose.

Sandra
6:51 am April 21st, 2018

I am 77 years old and I have been on Ativan for 30 years for anxiety. I only take one each night at bedtime and currently take 0.5 mg. I took 1.0 mg for most of those years. My physician recommends stop taking it. He was going to have me take 0.25 for 2 weeks, then stop taking. I knew that a psychologist years ago had told me it would take me months to wean myself off. So he reluctantly gave me a RX for 4 weeks of 0,25, then stop taking. Do you think this is how I should stop taking.

Lydia @ Addiction Blog
2:17 pm April 24th, 2018

Hi Sandra. You may need a slower taper. Take a look into the Ashton Manual here: https://www.benzo.org.uk/manual/
It provides with simple tapering schedules. BUT, do not taper by yourself, always consult with your doctor.

June
9:13 pm May 26th, 2018

I have been on 1mg for 3 weeks for insomnia, though mistakenly played with lowering the dose a few times to see if I could get by with less, not knowing that that can cause kindling. The last few days I took a full dose at night, and by the third day it was noticeably less effective. That’s when I decided I needed to start tapering. The nurse on call at my doctor doesn’t seem to think 3 weeks is long enough to cause withdrawal, but now on the 2nd day of just 0.5mg at night, I have night sweats, a dull headache and some mild anxiety, but otherwise am fine. Since I’ve only been on this for 3 weeks, what is a realistic time frame for getting off of it fully? I don’t want to rush, but I don’t want to prolong it more than I need to. Thanks!

Lydia @ Addiction Blog
11:53 am May 29th, 2018

Hi June. Some people may develop dependence only after using Ativan for 2 weeks. You may need a slower tapering schedule. Consult with your doctor to adjust your quitting time.

Linda
2:37 pm May 29th, 2018

Hi Lydia … Today has been 135 days Lorazepam free for me!! I am feeling MUCH better. Am sleeping 6 to 7 hours a night before I wake up and can manage to get back to sleep for another couple of hours after waking up. This is such a great improvement. My vertigo is almost completely gone and when I do “occasionally” get vertigo it is no where as bad as it was and my Doctor tells me that this too shall pass. I wrote again because I do want people to know that this can be done. No easy task but doable and it feels so good not to have the dependency on Lorazepam. If anyone is reading this I hope they have read my 3 previous replies, first one starting in November 2017. Lydia please keep encouraging people as there are so many reasons to get off of benzoids and it does improve your quality of life. And please people do this with a knowledgable doctor who knows this process. It’s very important!

Lydia @ Addiction Blog
10:26 am May 30th, 2018

Hi Linda. Congratulation on your 135 Lorazepam-free days! There are more to come! Thank you for sharing your story, and update us, because you inspire others to quit… Keep strong!

Jackie
3:24 am June 4th, 2018

I have been taking antidepressants for 27 years and have had little difficulty, taking only two different ones in all that time. I am now 71 years old and my husband died year before last. My antidepressant finally stopped working and I went downhill badly. In the meantime I had been taking Ativan all those years as needed but it was never more than 1.5 mg a day. I had managed to go to .75 mg when I attempted suicide and went into a psychiatric hospital. I was put on 7.5 mg of Buspirone twice a day and Cymbalta 20 mg along with the Ativan. Since leaving the hospital, I was taken off Cymbalta because it made me so sick. Three weeks ago my doctor upped my Buspirone to 30mg a day, put me on Zoloft 25 mg, put me on Klonopin twice a day .5 mg and stopped the Ativan. I am so nauseous, exhausted and sleep most of the day. When might I see a glimmer of feeling better. Am I withdrawing from Ativan or adjusting to Klonopin or both. I feel so bad.

Lydia @ Addiction Blog
12:58 pm June 4th, 2018

Hi Jackie. It may be both. You’ve experienced many changes in your medications. I suggest that you consult with your doctor about your issues.

Sarah
6:16 am June 9th, 2018

I’ve been taking 2mg of ativan for 9yrs. I cut my pill in half and take 1mg in the am and 1mg in the pm. Today my psychiatrist told me she wants to start weaning me next month. I knew this was coming but it’s still terrifying for me! Not only has it been my security blanket but I’m scared to death of the withdrawals. I have a phobia of dying especially by heart attack so palpitations are a huge fear. Just the thought is causing me extreme anxiety. I feel like this is a life and death experience and no one understands or cares much. If you could please give me advice on how to prepare myself or set myself at ease of appreciate it. I really think I’ll give myself a heart attack before I make it to the end.

Kristin
6:14 am June 12th, 2018

Hi I’m Kristin I have been taking ativan1mg once a day around 6 in the evening for about 2 and a half or 3 weeks now for anxiety I want to get off because I don’t want to become addicted I am going to try to go back to my vistiril. Should i taper? I have only been taking for 3 weeks will I still have withdrawals?

Lydia @ Addiction Blog
10:38 am June 13th, 2018

Hi Kristin. The safest way to quit any benzo no matter the time period you have taken is by slowly reducing the daily dose.

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