Ativan withdrawal symptoms (generic lorazepam) are extremely problematic for many persons. According to published medical research by Ashton, Brett, and Lader, benzodiazepines such as Ativan should, in the vast majority of cases, be prescribed for short-term use only. However, even after short-term use, Ativan withdrawal can still be problematic. 7-9
Medical regulators around the world have reduced the recommended window for a lorazepam prescription to extend no longer than 2-4 weeks. This is due to the well-recognized, severe risk of becoming drug-dependent, most notably when used longer than this time frame.1,10
However, the FDA drug label states that lorazepam withdrawals such as rebound insomnia can occur even after a single week’s use of lorazepam. In general, the more rapid the rate of Ativan withdrawal, and the greater the dosage and duration of medication use, the more severe the withdrawal symptoms will likely be. Below is a summary of the most common Ativan withdrawal symptoms.5,11,12
Ativan withdrawal symptoms can include:
Rebound insomnia — often worsened compared to pre-treatment levels
Rebound anxiety — often worsened
Rebound depression — often worsened
Confusion, cognitive impairment, memory loss
Derealization/depersonalization — the feeling of being detached from one’s surroundings, or from one’s own identity
Tingling or numbness in the extremities
Sensitivity to light (photophobia), touch (hyperreflexia), and noise (hyperacusis)
Tachycardia, heart palpitations
Increased breathing rate
Delusions, hallucinations, perception changes
Tremors, especially in the hands, shaking, involuntary movements
Nausea, vomiting, dry-retching
Muscle cramping, abdominal cramps
Loss of appetite, weight loss
Hyperthermia (overheating, fever)
Unless medically directed by a hospital, never abruptly stop benzodiazepines that have been in regular use, but do a gradual gentle Ativan withdrawal under medical supervision.14 Abruptly stopping Ativan or other benzodiazepines may result in seizure or death, especially if they have acclimated to using it over a longer duration. It is much safer and easier for the body and mind to approach a gradual lorazepam withdrawal.
Benzodiazepines are also known to have a number of PAWS13 or post-acute withdrawal symptoms that can linger long after the drug has been stopped.
PAWS for Ativan or lorazepam:
Return of anxiety and/or depression
Return of sleep difficulties — also called rebound insomnia
Mood swings, crying spells, irritability
Lack of focus, cognitive impairments
Movement disorders such as dystonia– repetitive twisting or contortion of feet, hands, and other muscle groups
Physicians dedicate years to their medical training, yet the horrible truth is that med school does not instruct how to help someone through lorazepam or Ativan withdrawal.1,2 Doctors are forced into the default position of continuing to prescribe a drug that masks symptoms for a short time, if at all.
Yet, considerable harm can ensue. Like all benzodiazepines, the health risks associated with Ativan are extremely worrisome, and the physiological reactions during Ativan or lorazepam withdrawal can be so hard to bear that a person may feel it’s a hopeless situation, leading to going back on medication.
Do Your Symptoms Require Lorazepam?
Alternative to Meds has been able to help thousands of clients struggling with benzodiazepine withdrawal to get better. Over the past nearly 20 years, we have accumulated a wealth of published evidence regarding our success. Some people seem to be able to miraculously slide off of benzodiazepines, whereas others have a dreadful time trying. It could be that some persons have sensitivity issues related to damaged neurochemistry.6 Dysfunctional neurochemistry can be remedied without pain or discomfort by cleaning out accumulated toxins, drug residues, etc., and at the same time rebuilding healthy neurotransmitters via corrected diet and supplementation. This makes a huge difference. Each person is beautifully unique, however, and must receive an individualized lorazepam withdrawal program that reflects that fact well.
This video is of a woman who withdrew from benzodiazepines and antidepressants while at Alternative to Meds Center. She came to us for help after having lost her ability to work, take care of herself, and was barely able to walk.
We invite you to watch and listen to her incredible story of recovery. She now practices as a licensed counselor and has a very robust life!
15 Years Experience by Professionals Who Understand Your Journey.
You probably already know the dark side of this drug. Benzodiazepines are notoriously more difficult to withdraw from than heroin.
And, trying to live life on benzos can create a catastrophe. Please watch the videos you see here or call us to get hope for your situation.
Did your doctor cover these items BEFORE prescribing lorazepam?
Lorazepam, sold under the brand name Ativan, is a potent, tranquilizer that induces sedation and muscle relaxation. Ativan, like all benzo drugs, is recommended for short-term use only, to avoid dependence, which can develop quickly. Despite the recommendations, many doctors continue to prescribe Ativan or lorazepam far longer than the recommended time frame without advising of the potential consequences of Ativan withdrawal, which can have disastrous consequences for their patients. Benzo prescriptions have continued to soar, despite cautions given by drug regulators and clinical researchers.38
Before prescribing, physicians are encouraged to employ guidelines that they have been directed to follow, which include the following prescribing best practices: 1,15
Take full history including alcohol or other drug use, licit and illicit.
The patient must be informed of the potential adverse effects of benzodiazepines.
Search for and treat underlying causes before prescribing.
Explore and discuss referrals to other therapies or types of services.
Explore and discuss alternative types of therapies or treatments.
Explore, discuss, and consider the possibility of the patient delaying the prescription until the next visit.
Benzodiazepines should not be prescribed for more than a few weeks.
What Is Ativan (lorazepam) Used For?
Ativan is used as a potent short-term tranquilizer for a variety of purposes. The drug is fast-acting and produces a drowsy, calming, and mildly euphoric effect as a result of depression of the central nervous system.
Ativan is short-acting benzo. If someone takes it at night, it can be that by morning they are no longer feeling the sedating effects. Especially for people who experience daytime anxiety, this can create a rollercoastering effect of inter-dosing lorazepam withdrawal manifestations. Should this be occurring, the tendency may be for the practitioner to include daytime dosing. It is for this reason that Ativan is a poor choice for long-standing pre-existing anxiety. The person with pre-existing anxiety could quickly find themselves in a spot where they are taking the medication 3 or 4 times a day, and no clear way out of this situation.16
Off-label uses for lorazepam include avoiding seizures during alcohol detox, reducing discomfort during opiate withdrawal, as a muscle relaxant, pre-surgical or dental anesthesia, and treating insomnia.17
Ativan is also sometimes prescribed off-label to help with nausea, a common side effect of chemotherapy, and for a condition called psychogenic catatonia. Catatonia is a broad term used in diagnosing up to 20% of psychotic persons in inpatient treatment settings who exhibit multiple symptoms such as mutism, stupor, grimacing, posturing, and other unusual symptoms. In this set of persons, benzodiazepines do not have a sedative effect, but paradoxically, 60-80% given benzodiazepines through IV become more alert, and more interactive.18,19
Lorazepam is sometimes abused by opiate users because combining these two drugs augments the euphoric effects, although the practice is dangerous and often leads to overdose, coma, or death.
Another form of abuse is using lorazepam or Ativan on a victim of “date rape” or even robbery, due to the drug’s ability to induce a trance-like state of non-resistance and amnesia.20,21
What is a Natural Substitute for Ativan?
There are many natural nutritional and herbal remedies that have been found to have similar properties to Ativan, which improve sleep and provide relief from stress, depression, and anxiety, but without negative characteristics or harsh reactions. Some examples of these aids can include:
Nutritional GABA 28
Amino acids such as taurine, glycine, L-lysine, L-theanine, 5-HTP, etc. 29,30
Diet modification includes fermented foods, probiotics, and prebiotics to support microbiome health, which in turn supports mental and physical health.32
Ativan is classified by the DEA as a Schedule IV drug, described as having a lower risk for abuse than Schedule II or III drugs such as opioids or ketamine, but more addictive than cough syrup with codeine, or antidiarrhea drugs.34
However, it is well-established that benzodiazepines are highly addictive and according to clinical research published in the Journal of Addiction Medicine, benzodiazepines should not be prescribed to anyone who has a history of drug or alcohol use disorder.33
Additional research out of Germany showed that between 35% and 40% of chronic benzodiazepine users become drug-dependent. As underscored in the DEA schedule, populations that have a history of turning to drugs or alcohol are at high risk if taking lorazepam and similar benzos.35
Ativan Alternative Names and Slang
Lorazepam is a generic drug that is sold under the brand name Ativan. It is often referred to in street slang 22 where the drug is used in non-clinical settings for getting high or for self-medicating. Here are some of the drug’s nicknames:
Strategies to Quit Ativan (lorazepam)
Withdrawal from Ativan is safest when done slowly; giving the body a chance to stabilize and adjust to incremental reductions over adequate time.
As mentioned earlier, benzodiazepines should be prescribed for 2-4 weeks maximum, but long-term use is still prevalent. Long-term use of benzodiazepines may require inpatient treatment for withdrawal. When the time comes to begin the detox process, a clinic or setting that can provide close and careful medical monitoring is recommended.
Lorazepam or Ativan discontinuation may manifest a certain complication; due to the drug’s short half-life. This means a person can go into withdrawal quite rapidly. A pragmatic approach might be to spread the dosing out so that it is being administered three or four times over a day, to limit withdrawal effects between dosing. Then, using a stair-step-down dosing strategy, attempting to maintain a somewhat consistent level. An example of this approach you can discuss with your prescriber might be:
1mg Ativan daily, split into 4x.25mg dosings throughout the day. Dropping one of the doses to .125 (half) would be a reasonable approach to discuss with your doctor.
Once stabilized, continue to drop each of the dosings to .125mg, one step at a time.
Over the course of four reductions, the person would be at .5mg total daily.
Once stabilized, then consider dropping the mid-day dose.
For the next doseage adjustment, pick another dose to eliminate, and continue this process until medication-free.
In some cases, temporary bridge drugs like Trileptal or Gabapentin may be used to soften the Ativan discontinuation process.
Another much different approach might be switching to Valium, as it is longer acting. Not everyone reacts to these two drugs equally, and there may be a crossover reaction so requires attentive monitoring.
These suggestions are all options to discuss with your treating physician. This is not intended to represent what you should do in your case, but merely talking points for your doctor and you to discuss. Each person’s situation is highly specific to them and truly requires the guidance of an experienced and trusted medical professional to determine the correct strategy.
These problems may be challenging for your entire family. Consider residential treatment for Ativan withdrawal, as it may significantly ease what you and your family may go through during this difficult time.
Ativan Withdrawal (lorazepam) FAQs
The following topics relate to the most searched-for and frequently asked questions about Ativan and Ativan withdrawal
For more information contact your primary or prescribing physician, or contact us for more information which we can supply on request.
How Do Benzodiazepines Work?
Lorazepam, like all benzodiazepines, is thought to enhance the effects of a natural neurotransmitter called GABA. The effect that is produced is a slowing of the sensory message relay system resident in the central nervous system and brain.9-11,17
This slowing-down effect produces a calm trance-like mental state.
Ativan induces an artificial feeling of well-being, mild euphoria, drowsiness, and relaxation of muscle tension.
Is Ativan a Narcotic?
Lorazepam is classified as a benzodiazepine, and is a controlled substance medication. A narcotic is a substance that induces a sleep-inducing effect. However, in legal terms, a narcotic is the term used where illegality is implied.23
Therefore a controlled substance can have narcotic effects, but because it is legal to prescribe, it is not generally referred to as a narcotic drug. Whether obtained legally or otherwise, Ativan withdrawal requires specialized treatment for success.
There are similarities and differences between Ativan and Xanax. They are both benzodiazepines, and both are classified as controlled substance medications used in the treatment of psychiatric conditions, insomnia, prescribed as muscle relaxants, etc.
Both drugs affect the GABA neurotransmitters, inducing a slowing or calming of the CNS.
They are also both easy to get addicted to and create similar adverse effects, including cravings.
The main difference between Ativan and Xanax is that the time it takes for Ativan to leave the system is quicker than Xanax, although the half-life of both of these drugs is considered short-acting within the benzodiazepine class.
Certain other medications react with Xanax but do not react with lorazepam, and possibly vice versa.5,24
Always inform your prescribing physician if other medications or substances are used simultaneously with a benzodiazepine.2
Can You Overdose on Ativan?
Yes. Ativan is a powerful sedating drug that has a depressant effect on the CNS. The CNS controls breathing, and heart rate, which are necessary to live. When these become overly sedated, coma or death can occur.5,17
Taking too much Ativan or mixing it with alcohol or other CNS depressants can result in an overdose, requiring medical intervention to prevent a fatality. Since lorazepam impairs memory, there is a greater chance of accidental overdose or missing doses that may lead to Ativan withdrawal reactions.27
Risks of Ativan / Lorazepam
Benzodiazepines are one of the most frequently prescribed drugs, and are considered highly addictive, and subject to dependence. Ativan withdrawal requires careful and precise monitoring. We can see in statistics that there is a significant rise in people seeking help after benzodiazepine use in the US and around the world.25
Lorazepam withdrawal management (as for all benzodiazepines) requires careful medical oversight, as the withdrawals can be coupled with intense cravings for the drug. The risk is high for adverse withdrawal symptoms which can be overwhelming and even deadly, especially where support is not adequately provided to soften the process.5
Always seek medical attention and guidance for managing Ativan withdrawals.
Lorazepam Withdrawal and Removal of Toxins
There has been success regarding the extraction of excitotoxins, like heavy metals, chemicals, and pesticides that we have been commonly exposed to.
One type of pesticide, called organophosphates, kills pests by putting their nervous system into overdrive via overstimulation of its acetylcholine receptors.
There may be a similar action in the human body as well. Like the fate of the chemically poisoned pest, this may lead to over-stimulating acetylcholine receptors in the human brain and CNS.3
A poison, or pesticide, is designed to kill pests by attacking the pest’s nervous system and leaving it in a state of twitches and uncontrolled movements as it begins to die. There may be a parallel for this possibility in humans, because, like the pest, we also have acetylcholine receptors. As we humans have livers for clearing some of this toxic burden, we typically experience a different outcome than a grasshopper or other pest. Yet, if our genetic dispositions become somehow compromised, we may be at risk of similar effects as are seen in the spasmodic movements and twitches or a poisoned, dying pest.
According to one research group studying the over-firing phenomena,
“This is because aspartic acid (from aspartame) and glutamic acid (from MSG) can both stimulate a receptor in the brain called the NMDA receptor (n-Methyl-d-aspartate). Chronic overstimulation of the NMDA receptor over time is neurotoxic.”4
The cumulative real effects of organophosphates and other environmental toxins are truly understudied as most of the instances of toxicity involve acute poisoning. For some, clearing a body burden of neurotoxins may be the only way to find relief from anxiety and nervous system over-stimulation. These patients typically present as those who enjoyed a lifetime of balance and then slowly began to degenerate into anxiety and/or insomnia. These are important and useful facts that can contribute to engineering a successful Ativan withdrawal and recovery.
Recovery from Ativan Withdrawal is Different at Alternative to Meds Center
Ativan withdrawal doesn’t have to be painful, torturous, or unsustainable. Clinical studies show that psychological and other non-medication-based interventions are more effective in the Ativan withdrawal process than merely substituting one drug for another. Perhaps in desperation, some rehab programs opt for a drug like flumazenil that shuts down benzo receptors within minutes, much like Narcan shuts down opioid receptors in reversing an opioid overdose. But doing so can result in seizures, convulsions, panic attacks, and other harsh withdrawal symptoms, according to the drug’s label.36,37
Even the FDA advises against using such drug interventions for benzodiazepine withdrawal in patients who have developed dependence. And we agree that this is not the path to successful recovery.
Inpatient services are delivered in our pristine and comfortable facility, with over 50 licensed staff to assist our clients.
Please contact us at Alternative to Meds Center for more information about how our Ativan withdrawal program could help you or your loved one to achieve your long-term goals for success and renewed natural mental health.
This content has been reviewed and approved by a licensed physician.
Dr. Michael Loes, M.D.
Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.