Ativan withdrawal symptoms (generic lorazepam) are extremely problematic for many persons. According to published medical research by Ashton, Brett, Lader, and others 7,8,9 benzodiazepines such as Ativan should, in the vast majority of cases, be prescribed for short-term use only to avoid these problems.
Ativan addiction, dependence, and troublesome side effects are a concern in the US and around the world — wherever Ativan is prescribed.
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
Convulsions
Confusion, cognitive impairment, memory loss
Derealization/depersonalization — the feeling of being detached from one’s surroundings, or from one’s own identity
Sweating
Tingling or numbness in the extremities
Sensitivity to light (photophobia), touch (hyperreflexia), noise (hyperacusis)
Headache
Tension, irritability
Restlessness, agitation
Tachycardia, heart palpitations
Panic attacks
Increased breathing rate
Delusions, hallucinations, perception changes
Tremors, especially in the hands, shaking, involuntary movements
Nausea, vomiting, dry-retching
Muscle cramping, abdominal cramps
Diarrhea
Loss of appetite, weight loss
Hyperthermia (overheating, fever)
Dizziness, vertigo
Unless medically as 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 on 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
Restlessness, agitation
Lack of focus, cognitive impairments
Tremors, shakiness
Cravings
Movement disorders such as dystonia– repetitive twisting or contortion of feet, hands, 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 risk of Ativan addiction is extremely high, 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. We have accumulated over 15 years 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 This can be remedied without pain or discomfort by cleaning out accumulated toxins, drug residues, etc. 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 about your situation.
Did your doctor cover these items BEFORE prescribing lorazepam?
Lorazepam, sold under the brand name Ativan, is a potent, short-term-use tranquilizer that induces sedation and muscle relaxation. Ativan, like all benzo drugs, is recommended for short-term use only, to avoid dependence or Ativan addiction, 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.
Before prescribing, physicians can employ guidelines that they have been directed to follow, which includes 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 side 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, 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?
Benzodiazepine drugs such as Ativan are 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.
One of the considering factors regarding lorazepam is that it is short-acting. 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, that improve sleep and provide relief from stress, depression, and anxiety, but without the addictive characteristics or harsh side effects. Some examples of these can include:
Nutritional GABA 28
Amino acids such as taurine, glycine, L-lysine, L-theanine, 5-HTP, etc. 29,30
Magnesium 31
Diet modification to include fermented foods, probiotics, 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. Despite the DEA schedule, Ativan addiction is a risk, especially in populations that have a history of turning to drugs or alcohol, and if the medication is used long-term.35
Ativan Alternative Names and Slang
Lorazepam 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 medicating symptoms of addiction or withdrawal. Here are some of the drug’s nicknames:
Tranks
Benzos
Nerve Pills
Downers
Ativan (lorazepam) Side Effects
Ativan is often prescribed as a tranquilizer or sedative. The tranquilizing effects of Ativan taken orally in pill form come on quickly, within approximately 30 minutes and peaking at about the two-hour mark.
Lorazepam also comes in an injectable form, producing effects within 15 to 20 minutes, which effects last from 6 to 8 hours. Common side effects are shown below 5 including more severe, less common side effects.17,27
In a comparative clinical trial, Ativan was found to have the greatest motor impairment, memory impairment, and other drug effects, when compared to other anxiolytic types of drugs used in the trial.27
Intra-arterial gangrene (death of tissues from lack of circulation)
*Should a person taking benzodiazepines begin to show signs of confusion, over-sedation, amnesia, or other adverse effects, changes in heart rate, etc., these could indicate medical attention is needed. FDA recommendations are to send for immediate medical assistance. Benzodiazepines drugs such as lorazepam act as a CNS depressant, and should never be mixed with alcohol, or other depressants such as opiates or barbiturates. When two or more depressants are taken together, the effects become more potent, and can become life-threatening, leading to coma, stopped breathing, stopped heartbeat, and death.5
The number of ER visits for adverse events involving benzodiazepines tripled from 1998 to 2008, which demonstrates clearly the dangers that can be linked with benzodiazepines.26
Discontinuing/Quitting Ativan (lorazepam)
Withdrawal from Ativan is safest when done slowly; giving the body a chance to stabilize and adjust to incrementally reducing the drug 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:
A person takes 1mg Ativan daily, split into 4x.25mg dosings throughout the day. Dropping one of the doses to .125 would be a reasonable approach to discuss with your doctor.
Then, 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.
Then consider dropping the mid-day dose.
For the next taper adjustment, pick another dose to eliminate 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.
These 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 needs the guidance of an experienced and trusted medical professional to determine the correct strategy.
Ativan addiction 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 addiction and information about 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 side 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, 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 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
Risk of Ativan / Lorazepam Addiction
Benzodiazepines are one of the most frequently prescribed drugs, and their risk for addiction and dependence often results in seeking addiction help. Lorazepam is a high-risk drug for addiction and dependence and requires careful and precise Ativan withdrawal. We can see in statistics that there is a significant rise in people seeking help for lorazepam addiction who need to come off the drug and are struggling to do so both in the US, North America, and around the world.25
Lorazepam withdrawal management (as for all benzodiazepines) requires careful medical oversight, as the withdrawals can be intense, coupled with cravings for the drug. The risk is high for adverse withdrawal reactions which can be deadly, especially where constant oversight is not present to soften the process.5
Always seek medical attention and guidance for managing benzo withdrawals.
Treatment for Ativan Addiction and Dependence
Ativan addiction can be treated. Alternative to Meds Center designs an appropriately individualized Ativan withdrawal schedule, with ample preparation steps, and compassionate health-supportive therapies that ensure the safety and comfort of each client.
Our center is staffed by over 40 trained practitioners and caregivers who coordinate and assist the client to navigate through their lorazepam withdrawal steps comfortably and safely. Some of the treatments used at Alternative to Meds Center are listed below. You can find more details on our services overview pages as well.
Some of the steps include:
Lab testing to determine factors that may need addressing either before, during, or after Ativan withdrawal to reduce unwanted symptoms such as insomnia.
Heavy metal and neurotoxin removal are gentle and effective, often allowing for demonstrable and sustained relief from symptoms of nervousness, agitation, insomnia, low energy, and mood.
Holistic biochemical neurotransmitter replacement therapy, allowing normalization through proper diet, targeted supplementation, backed up by lab testing.
Comfortable, beautiful inpatient setting for a restful and nurturing experience.
Therapeutic massage, IV and NAD treatments, Reiki, craniosacral massage, nebulized glutathione treatments, and many more adjunctive therapies such as Equine therapy are made available.
Counseling in many genres is provided to address factors that may have prevented success earlier and could provide new strategies and confidence in reaching health and life goals.
Lorazepam Withdrawal and Removal of Excitotoxins
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 at Alternative to Meds Center
Ativan withdrawal doesn’t have to be painful, torturous, or unsustainable.
Inpatient services are delivered in our pristine and comfortable facility, with over 40 staff to assist our clients.
Please contact us at Alternative to Meds Center for more information about how our Ativan addiction and Ativan withdrawal program could help you or your loved one to achieve your long-term goals for success and renewed natural mental health.
32. Järbrink-Sehgal E, Andreasson A. The gut microbiota and mental health in adults. Curr Opin Neurobiol. 2020 Jun;62:102-114. doi: 10.1016/j.conb.2020.01.016. Epub 2020 Mar 9. PMID: 32163822. [cited 2022 June 10]
35. Meier PJ, Ziegler WH, Neftel K. Benzodiazepine–Praxis und Probleme ihrer Anwendung [Benzodiazepine–practice and problems of its use]. Schweiz Med Wochenschr. 1988 Mar 19;118(11):381-92. German. PMID: 3287602. [cited 2022 June 10]
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.
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Both drugs affect the GABA neurotransmitters, inducing a slowing or calming of the CNS.
There has been success regarding the extraction of excitotoxins, like heavy metals, chemicals, and pesticides that we have been commonly exposed to.
