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Lorazepam (Ativan) Withdrawal Symptoms

lorazepam ativan withdrawal symptomsLorazepam withdrawal symptoms are extremely problematic for many persons. According to published medical research by Ashton, Brett, Lader, and others7,8,9 benzodiazepines such as lorazepam should, in the vast majority of cases, be prescribed for short-term use only to avoid these problems.

Lorazepam dependence and addiction and troublesome side effects are a concern not only in the US, but around the world — wherever these drugs are prescribed.

Medical regulators around the world have reduced the recommended window for 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 withdrawals such as rebound insomnia can occur even after a single week’s use of lorazepam.5 Below is a summary of lorazepam withdrawal symptoms.5,11,12

Withdrawal symptoms from lorazepam:

  • Rebound insomnia
  • Convulsions (occurs more often in persons with a previous history of convulsions or who are taking antidepressant medication concurrently with benzodiazepines)
  • Rebound anxiety — often worse than before starting medication therapy
  • Rebound depression or other rebound symptoms, often worsened
  • Confusion, cognitive impairment, memory loss
  • Derealization/depersonalization — the feeling of being detached from one’s surroundings, or from ones own identity
  • Sweating
  • Tingling or numbness in the extremities
  • Sensitivity to light (photophobia), touch (hyperreflexia), noise (hyperacusis)
  • Headache
  • Dysphoria, tension, restlessness, irritability, agitation
  • Tachycardia, heart palpitations
  • Panic attacks
  • Increased breathing rate
  • Delusions or 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

*In general, the abruptness of withdrawal, the greater the dosage, and the longer the period of medication use, the more severe the withdrawal symptoms will likely be. 5,11

Unless medically as directed by a hospital, never abruptly stop benzodiazepines that have been in regular use, but do a gentle taper off of the drug under medical supervision.14 Abruptly stopping benzodiazepines may result in seizure or death, especially if they have acclimated to using it over a longer duration.

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, etc
  • Restlessness, agitation, dysphoria
  • Lack of focus, cognitive impairments
  • Tremors, shakiness
  • Cravings
  • Dystonias or other movement disorders


Physicians dedicate years to their medical training, yet the horrible truth is that med school does not instruct how to help someone through lorazepam 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. Benzodiazepines are highly addictive and the physiological reactions during lorazepam (Ativan) withdrawal can be so hard to bear that a person may feel it’s a hopeless situation.

Do Your Symptoms Require Lorazepam?

getting off 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, where 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 program that reflects that fact well.
This video is of a woman who withdrew from benzodiazepines and antidepressants while at ATMC. She had lost her ability to work, take care of herself, and was barely able to walk. Her story of recovery is incredible. She now practices as a licensed counselor and has a very robust life!
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You probably already know the dark side of this drug. Benzodiazepines are 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. Lorazepam, like all benzo drugs, is recommended for short-term use only, to avoid dependence which can happen quickly. Despite the recommendations, many doctors continue to prescribe lorazepam far longer than the recommended time frame without advising of the potential consequences of 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 withdrawal manifestations. Should this be occurring, the tendency may be for the practitioner to include daytime dosing. It is for this reason that lorazepam (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

Lorazepam 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

Lorazepam 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

Lorazepam is often prescribed as a tranquilizer or sedative. The tranquilizing effects of lorazepam (Ativan) taken orally in pill form come on quickly, within approximately 30 minutes and peaking at about the two-hour mark.

The drug 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

Lorazepam side effects:  

  • Sedation, drowsiness
  • Unsteadiness, loss of balance
  • Dizziness, lightheadedness, vertigo
  • Mild euphoria, artificial sense of well-being
  • Mood swings, i.e., irritable mood, crying spells, aggression
  • Headache
  • Increased salivation
  • Dry mouth
  • Diplopia (double vision), blurred vision
  • Muscle weakness, fatigue
  • Dystonia (abnormal muscle spasms, can be painful)
  • Gastrointestinal issues, i.e., constipation, diarrhea, loss of appetite
  • Amnesia
  • Skin rash*
  • Vomiting, nausea
  • Dysarthria (slurring of speech, paralyzed muscles used in speech)
  • Ataxia (lack of muscle control), i.e., clumsiness, appears drunken, irregular gait
  • Asthenia (abnormal weakness)
  • Disinhibition
  • Sexual dysfunction
  • Menstrual irregularities
  • Incontinence
  • Stopped breathing, respiratory depression
  • Seizures
  • Suicidal thoughts, suicidal behavior
  • Addiction, dependence
  • Tachycardia (racing heartbeat)
  • Syncope (fainting)
  • Hypotension (lowered blood pressure]
  • Confusion, impaired cognitive function
  • Paradoxical effects, i.e., aggression, rage, crying spells, paranoia
  • Altered perceptions
  • Hallucination, delusion
  • Jaundice
  • Blood disorders, i.e., bone marrow disorders
  • 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 Lorazepam (Ativan)

Withdrawal from lorazepam 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 or tapering process, a clinic or setting that can provide close and careful medical monitoring is recommended.

Lorazepam tapering 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 might be:

  • A person takes 1mg 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, dropping each of the dosings to .125mg, one step at a time.
  • Over the course of four tapers, the person would be at .5mg total daily.
  • Then consider dropping the mid-day dose.
  • For the next taper, pick another dose to eliminate until medication-free.

In some cases, temporary bridge drugs like Trileptal or Gabapentin may be used to soften the tapering 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.

This process may additionally be challenging for your family. Consider residential treatment as it may significantly ease what you and your family may go through during this delicate time.

Lorazepam (Ativan) FAQs

The following topics relate to the most searched for and frequently asked questions about lorazepam (Ativan).

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 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.

The drug induces an artificial feeling of well-being, euphoria, drowsiness, and relaxation of muscle tension.

Is Lorazepam 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, even though it may have narcotic qualities.

What’s the Difference between Lorazepam (Ativan) and Xanax?

There are similarities and differences between lorazepam 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.

how benzodiazepines differBoth 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 or lorazepam 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 that do not have the same liability 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 Lorazepam?

Yes. Lorazepam 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 lorazepam or mixing it with alcohol or other CNS depressants can result in overdose, requiring medical intervention to prevent a fatality.

How Addictive Are Benzodiazepines?

Benzodiazepines are one of the most frequently prescribed drugs, often leading to seeking addiction help. Lorazepam is a high-risk drug for addiction and dependence. 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, and 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 Benzodiazepine Abuse and Addiction

Alternative to Meds Center designs an appropriately individualized lorazepam 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 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.
  • Gradual (precise) medication tapering to avoid PAWS.
  • 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

remove toxinsThere 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.

Two toxic substances, in particular, Aspartame and MSG have been examined closely regarding causing synaptic over-firing.

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.

Recovery at Alternative to Meds Center

Benzodiazepine withdrawal doesn’t have to be painful, torturous, or unsustainable.

Alternative to Meds Center has taken the lead in providing the best and most comprehensive holistic program for lorazepam withdrawal and recovery. Please contact us at Alternative to Meds Center for more information about how our lorazepam withdrawal program could help you or your loved one to achieve your long-term goals for success and renewed natural mental health.


1. “Benzodiazepines: Good Practice Guidelines for Clinicians” Dept of Health, Government of Ireland [Internet] 2002 Dec 10, updated 2019 Jul 10 [cited 2021 Aug 2]

2. Miller NS, Sheppard LM. The role of the physician in addiction prevention and treatment. Psychiatr Clin North Am. 1999 Jun;22(2):489-505. doi: 10.1016/s0193-953x(05)70089-7. PMID: 10385946. [cited 2021 Aug 2]

3. Keeley L “7. Acetylcholinesterase and Insecticide Inhibition” YouTube video, 2011 Oct 26 [cited 2021 Aug 2]

4. Guillory G MD “Aspartame and MSG Increase Risk of Serious Illness” TheCareGroupPC [Internet] 2018 May 15 [cited 2021 Aug 2]

5. FDA Label (Ativan). [Internet] N.D.[cited 2021 Aug 2]

6. Ashton H, “Benzodiazepines: How they Work and How to Withdraw” August 2002 [online] [cited 2021 Aug 2]

7. Ashton H. Guidelines for the rational use of benzodiazepines. When and what to use. Drugs. 1994 Jul;48(1):25-40. doi: 10.2165/00003495-199448010-00004. PMID: 7525193. [cited 2021 Aug 2]

8. Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015;38(5):152-155. doi:10.18773/austprescr.2015.055 [cited 2021 Aug 2]

9. Lader M. Benzodiazepines revisited–will we ever learn? Addiction. 2011 Dec;106(12):2086-109. doi: 10.1111/j.1360-0443.2011.03563.x. Epub 2011 Oct 17. PMID: 21714826. [cited 20212 Aug 2]

10. Schweizer E, Rickels K. Benzodiazepine dependence and withdrawal: a review of the syndrome and its clinical management. Acta Psychiatr Scand Suppl. 1998;393:95-101. doi: 10.1111/j.1600-0447.1998.tb05973.x. PMID: 9777054. [cited 2021 Aug 2]

11. Gentile JP, Snyder M, Marie Gillig P. STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder. Innov Clin Neurosci. 2014 Jul;11(7-8):37-41. PMID: 25337444; PMCID: PMC4204471. [cited 2021 Aug 2]

12. Pétursson H. The benzodiazepine withdrawal syndrome. Addiction. 1994 Nov;89(11):1455-9. doi: 10.1111/j.1360-0443.1994.tb03743.x. PMID: 7841856. [cited 2021 Aug 2]

13. Ashton H. Protracted withdrawal syndromes from benzodiazepines. J Subst Abuse Treat. 1991;8(1-2):19-28. doi: 10.1016/0740-5472(91)90023-4. PMID: 1675688. [cited 2021 Aug 2]

14. Alexander B, Perry PJ. Detoxification from benzodiazepines: schedules and strategies. J Subst Abuse Treat. 1991;8(1-2):9-17. doi: 10.1016/0740-5472(91)90022-3. PMID: 1675694. [cited 2021 Aug 2]

15. Vicens C, Fiol F, Llobera J, Campoamor F, Mateu C, Alegret S, Socías I. Withdrawal from long-term benzodiazepine use: randomised trial in family practice. Br J Gen Pract. 2006 Dec;56(533):958-63. PMID: 17132385; PMCID: PMC1934057. [cited 2021 Aug 2]

16. Benzodiazepine Information Coalition, “Interdose Withdrawal.” ND [online] [cited 2021 Aug 2]

17. Ghiasi N, Bhansali RK, Marwaha R. Lorazepam. [Updated 2021 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532890/ [cited 2021 Aug 2]

18. Salam SA, Kilzieh N. Lorazepam treatment of psychogenic catatonia: an update. J Clin Psychiatry. 1988 Dec;49 Suppl:16-21. PMID: 3058684. [cited 2021 Aug 2]

19. Burrow JP, Spurling BC, Marwaha R. Catatonia. [Updated 2021 May 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430842/  [cited 2021 Aug 2]

20. Gautam L, Sharratt SD, Cole MD. Drug facilitated sexual assault: detection and stability of benzodiazepines in spiked drinks using gas chromatography-mass spectrometry. PLoS One. 2014;9(2):e89031. Published 2014 Feb 19. doi:10.1371/journal.pone.0089031 [cited 2021 Aug 2]

21. Scott-Ham M, Burton FC. Toxicological findings in cases of alleged drug-facilitated sexual assault in the United Kingdom over a 3-year period. J Clin Forensic Med. 2005 Aug;12(4):175-86. doi: 10.1016/j.jcfm.2005.03.009. PMID: 16054005. [cited 2021 Aug 2]

22. National Center for Biotechnology Information (2021). PubChem Compound Summary for CID 3958, Lorazepam. Retrieved August 2, 2021 from https://pubchem.ncbi.nlm.nih.gov/compound/Lorazepam.

23.  DEA authors, “Drug Scheduling.” [online] [cited 2021 Aug 2]

24. FDA Drug Label “Xanax” [online ] [cited 2021 Aug 2]

25. Schiralli V, McIntosh M. Benzodiazepines: are we overprescribing?Can Fam Physician. 1987;33:927-934. [cited 2021 Aug 2]

26. Kaufmann CN, Spira AP, Alexander GC, Rutkow L, Mojtabai R. Emergency department visits involving benzodiazepines and non-benzodiazepine receptor agonists. Am J Emerg Med. 2017;35(10):1414-1419. doi:10.1016/j.ajem.2017.04.023 [cited 2021 Aug 2]


Originally Published Sep 13, 2018 by Diane Ridaeus


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.

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