How to Taper Off Ativan: Guidelines, Example & Schedule

Why You Should Not Stop Ativan Cold Turkey 

Quitting Ativan cold turkey is not recommended due to the potential for dangerous withdrawal symptoms like seizures. Stopping these drugs abruptly can lead to intense withdrawal symptoms and make long-term sobriety harder to attain. 

Benzodiazepines work by enhancing or facilitating gamma-aminobutyric acid (GABA) inside the central nervous system. When your Ativan is active, electrical impulses inside your brain slow, leading to relaxation and reduced anxiety.[1]

If you quit abruptly, you can experience a rebound effect. Your brain lights up with electrical activity long suppressed, and the symptoms can be serious. 

An estimated 10% to 25% of people who use benzodiazepines for long periods have protracted withdrawal symptoms when they quit. Most people develop mild to moderate symptoms that fade within a few weeks.[2]

Ativan Withdrawal Symptoms 

Ativan withdrawal symptoms range from mild to serious. The issues you’ll feel may vary, depending on how long it’s been since your last dose.[2]

Most people experience these symptoms within the first 5 to 28 days after quitting:[2]

• Anxiety 
• Panic attacks 
• Shaking
• Insomnia 
• Muscle spasms
• Anorexia 
• Sweating 
• Hallucinations or the feeling you’re not real (depersonalization)
• Delirium 
• Seizures 

Some people experience long-lasting symptoms like depression or insomnia for up to 12 months. 

Why Do Withdrawal Symptoms Occur?

Withdrawal symptoms occur because the body has developed a dependence on a drug to account for its continued presence. The body adapts to achieve homeostasis. When the drug is not present, withdrawal symptoms happen as the body attempts to achieve a state of balance once again.

Psychological dependence on the drug can also induce withdrawal. The cessation of a drug can result in anxiety and a feeling that you cannot function normally without the substance. This can be tough to manage without sufficient support.

How to Taper Off Ativan Properly 

Tapering off Ativan is essential for reducing withdrawal symptoms. By tapering off the drug, you are teaching your body and mind to gradually become accustomed to its absence in your system. 

Two main types of tapers exist:

1. Direct Ativan Taper

In a direct Ativan taper, you keep using Ativan under the direction of a doctor. However, you use a smaller amount on a schedule set by your doctor.

A typical direct Ativan tapering schedule generally involves reducing your dosage by 25% within the first two weeks and then reducing the dosage by up to 25% every one to two weeks until you can safely discontinue use altogether.[4]

2. Substitute Ativan Taper

In a substitute Ativan taper, doctors switch their patients to another benzodiazepine, such as diazepam.

Diazepam remains active for long periods, and it enters the body slowly. Experts say it can make for a smooth taper, as people are less likely to experience withdrawal symptoms and cravings between doses.[5]

After you’ve switched from Ativan to another benzodiazepine, you’ll taper that dose on a schedule set by your doctor.

Sample Ativan Tapering Schedule

The following table is an example of an Ativan tapering schedule for someone who has been consuming 40 mg of Ativan daily. Note that your tapering schedule may vary depending on these factors:

• The strength of your dose
• The frequency with which you have used Ativan
• Medical history
• History of mental health issues
• History of substance abuse

How Long Does It Take to Fully Wean Off Ativan?

Some people can wean off Ativan within about two weeks. Others need much longer.

If you experience withdrawal symptoms, your taper is moving too quickly. But if you don’t, you could speed up the process. 

Other Medications Used When Tapering Off Ativan

Some people develop physical symptoms during Ativan withdrawal, even though they’re following their doctor’s orders. These are common symptoms that could appear, along with medications used to treat them:[5]

• Headaches or muscle pain: acetaminophen or ibuprofen
• Diarrhea: loperamide
• Nausea or vomiting: metoclopramide, prochlorperazine, or ondansetron
• Muscle spasm: Methocarbamol, carisoprodol, or cyclobenzaprine

People taking high doses of Ativan may experience high seizure risks during a seizure. Sometimes, doctors use anticonvulsant medications (like gabapentin) to keep their patients safe. Antidepressants (like Cymbalta) can help people struggling with chronic pain. Your doctor can craft a medication plan that’s right for you.[6]

Different Strategies for Tapering Off Ativan 

Everyone who uses Ativan should use a taper to quit. But your doctor can customize your plan by choosing one of the following methods: 

Dry Tapering 

Ativan pills come in specific doses that can make a taper difficult. People who dry taper use a pill cutter to make their pills smaller, as needed, to fit the tapering schedule their doctor recommends. 

Micro-Tapering 

Micro-tapering is very similar to dry tapering. Once again, you’ll cut or split Ativan pills to meet a dose reduction schedule. But with micro-tapering strategies, you’ll make tiny adjustments every day rather than 5 mg adjustments once per week. 

Tapering Strips 

Some pharmaceutical companies sell premeasured Ativan strips for tapers. Each one has a slightly smaller dose, allowing you to stop use without measuring your dose with scales or pill cutters. 

Changing Benzodiazepines 

Some doctors recommend switching from fast-acting benzodiazepines like Ativan to long-acting versions like diazepam. The adjustment can ease the peaks and valleys of each dose, allowing for a smoother path to sobriety. 

Tips for Tapering Off Ativan

While a tapered approach to withdrawal is recommended for all benzodiazepines and will reduce the likelihood and severity of withdrawal symptoms, the tapering process isn’t always easy. The following recommendations may help:

• Manage rebound anxiety. Symptoms like anxiety can appear or worsen when you quit Ativan. If you’re overwhelmed, ask your doctor for help. Antidepressants and sleep aids can help you cope. Psychotherapy may also be beneficial.
• Use medical detox. A doctor should always manage benzodiazepine tapering schedules. Medical detox is imperative for individuals consuming higher doses of Ativan regularly and experiencing severe withdrawal symptoms. Medical supervision during tapering can ensure your safety and reduce the likelihood of relapse.
• Get support. Stopping sustained use or misuse of any drug can be challenging. Have a list of family members, friends, or support resources (like a therapist) you can turn to when things get tough.  

Medically Supervised Detox 

Medical supervision is needed when tapering off Ativan to determine the correct dose and frequency of your tapering schedule. These programs are called medically supervised detox.

Medical professionals will monitor your withdrawal symptoms and make any adjustments to the tapering schedule as needed. Your doctor can also recommend alternative medications and select a substitute tapering plan if your withdrawal symptoms are severe. 

In addition to medical supervision, medical detox provides psychological support, greatly increasing the likelihood that you will successfully make it through the detox process. People who attempt a cold-turkey detox are much more likely to relapse.

Benefits of Quitting Ativan

Moving through an Ativan taper isn’t always easy. However, the benefits of your hard work could be clear and easy to spot.

Ativan’s side effects include sedation, which can manifest as fuzzy thinking and a lack of coordination.[7] It could be hard for you to perform to your capacity at work, and driving could be difficult. These problems could stop when you quit using the drug.

People who take Ativan regularly may feel withdrawal side effects like anxiety, irritability, nausea, and dizziness when they try to quit.[8] In severe cases, you may also experience these issues when your dose is even slightly reduced. You may live in fear of losing your access to pills. When you quit, that fear can stop altogether.

As your Ativan addiction deepens, you may feel like your entire life is devoted to getting and using drugs. When you’ve been through treatment and quit, you can devote your time and energy to something more rewarding. In other words, you could get your life back.

How Boca Recovery Center Can Assist You 

You’ll need medical attention and support to complete a successful Ativan taper. Get what you need at Boca Recovery Center. 

Work with medical professionals who can design and administer a tapering schedule that’s right for your Ativan addiction, body, and preferences. Move through that taper in a safe, protected space surrounded by people who want you to get better. In this environment, you can feel nourished by delightful meals, clean rooms, and helpful peers. You can get started today. Contact us to find out more.