The Ativan Withdrawal Timeline Chart

Rebound anxiety, sleep disorders, and mood swings are only few symptom that occur when you are withdrawing from Ativan. What are the other Ativan withdraw symptoms? Explore our complete VISUAL GUIDE here:

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Reviewed by: Dr. Manish Mishra, MBBS

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?

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
  • Sleep disorder
  • Sweating
  • Tremors

4-7 Days after last dose

  • Abdominal cramps
  • Concentration difficulties
  • Heart palpitations
  • Insomnia, anxiety and nausea are at their peak
  • Risk of seizures
  • Vomiting

2 Weeks After Last Dose

  • Anxiety
  • Cravings
  • Depression
  • General malaise
  • Headache
  • Irritability
  • Nausea
  • Rebound anxiety
  • Rebound insomnia
  • Vomiting

3 Weeks After Last Dose

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

NOTE HERE: PAWS, post acute withdrawal symptoms, such as drug craving, depression, or irritability may appear at any time during the withdrawal times for Ativan.

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.

 

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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
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
Medical Reviewers
Dr. Manish Mishra, MBBS serves as the Chief Medical Officer of the Texas Healt...

All of the information on this page has been reviewed and verified by a licensed medical professional.

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