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What Are the Dangers of Quitting Ativan Cold Turkey?

Stopping Ativan cold turkey can result in life-threatening withdrawal symptoms, such as seizures, which is why medical detox is recommended for those with dependence on or addiction to Ativan.

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Because withdrawal from Ativan cold turkey can result in dangerous withdrawal symptoms, it’s not recommended to try stopping Ativan on your own. Medical detox is the safest way to quit Ativan, manage Ativan withdrawal symptoms, keep you safe and comfortable, and prevent complications.

What Happens When You Quit Ativan Cold Turkey?

Once you are dependent on Ativan (lorazepam), quitting suddenly can be extremely distressing and even life-threatening. [1] It is never recommended to quit Ativan or other benzodiazepines cold turkey. Instead, it is necessary for an individual to wean off Ativan instead of quitting suddenly and without warning. Quitting cold turkey shocks the brain and the body, especially in cases where tolerance has been built up. 

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Severe Ativan withdrawal symptoms can occur when quitting suddenly. These symptoms may include nausea, vomiting, hallucinations, psychosis, and seizures.[2],[3]

During the acute withdrawal phase (at around seven days after the last use), withdrawal symptoms are often at their worst. They may include sweating, shaking, lack of focus, depression, weight loss, heart palpitations, respiratory issues, and other symptoms. If you or someone you know experiences any of these sorts of symptoms while quitting Ativan, it’s important to seek medical attention immediately.

Ativan Withdrawal Symptoms

Common symptoms of Ativan withdrawal may include:[4],[5]

  • Sweating
  • Fever
  • Rapid breathing
  • Rapid pulse
  • Tremors and shakes
  • Insomnia
  • Nausea and vomiting
  • Hallucinations, delirium and psychosis
  • Rapid, purposeless movements like pacing or fidgeting
  • Anxiety and panic attacks
  • Depression
  • Irritability
  • Memory and concentration problems
  • Neck and head pain or stiffness
  • Tingling and numbness
  • Seizures

Hallucinations, also known as withdrawal delirium, are not necessarily life-threatening but they can be extremely distressing and can also lead to accidents or injuries without professional oversight or support. Also, it’s estimated that about 20-30% of people experiencing sedative withdrawal (which includes Ativan) experience a seizure, emphasizing the need for medical detox and treatment.[4]

Factors Influencing Withdrawal Risk

Generally, the longer you’ve been using Ativan and the higher doses you’ve been taking, the more likely you’ll experience severe withdrawal symptoms. However, other factors may influence the risk, including:

  • Individual physiology
  • Withdrawal history (previous withdrawal episodes increase risk via kindling)
  • Comorbid medical conditions

Mixing Ativan with alcohol, opioids, or other depressants.

When is Ativan Withdrawal Most Dangerous?

Ativan withdrawal symptoms typically appear within 6-8 hours after the last use and peak in intensity on the second day. [4]

As such, withdrawal is most dangerous within 24-48 hours after quitting Ativan cold turkey. This is when the risk for seizures and hallucinations is highest and when withdrawal could be most life-threatening. [4] Again, medical detox and acute medical care are necessary to prevent and treat complications that may arise.

Ativan withdrawal symptoms tend to improve by day four or five and resolve within one week or so.[4]

Is it Safe to Quit Ativan Cold Turkey at Home?

No, if you are dependent on or addicted to Ativan, it is not safe to quit Ativan cold turkey at home. The Substance Abuse and Mental Health Services Administration (SAMHSA) strongly recommends that anyone withdrawing from benzodiazepines receive hospitalization or 24-hour medical care due to safety concerns related to seizures.[6]

Do not attempt to quit Ativan or other benzodiazepines at home without first consulting your doctor or entering a medical detox program.

How to Quit Ativan Safely 

The safest way to quit Ativan is to go through a medical detox program, which most often entails tapering off the drug. Recommended detox settings for Ativan withdrawal include:[6]

  • Acute care hospital
  • Psychiatric hospital
  • Freestanding medical detox program
  • Inpatient detox within an addiction treatment program

Tapering off Ativan is conducted by lowering the dose over a certain period of time (usually around eight weeks) until the dosage amount is lowered to zero. This slow approach to withdrawal reduces the likelihood of severe withdrawal symptoms and cravings, keeping patients safe throughout the process.

If any symptoms do occur, they can be managed by a medical professional, or the tapering dosage can be adjusted.

Medications to Manage Ativan Withdrawal

In a detox setting, the treatment team may switch your intermediate-acting Ativan to a long-acting benzodiazepine, such as clonazepam or chlorodiazepoxide. [5],[6] Other medications used to manage Ativan withdrawal may include: [6]

  • Anticonvulsants like valproate and carbamazepine
  • Sedating antidepressants like imipramine and trazodone

These medications aren’t typically used as first-line treatment but rather as adjunctive medications.

How Long Does It Take to Detox Completely From Ativan?

The length of Ativan withdrawal and detox varies, depending on whether you receive medical care or not and the nature of your treatment team’s detox plan. 

If you quit Ativan cold turkey, which is not advised, your withdrawal may resolve within about a week or two, granted you don’t experience any complications.[4]

If using the tapering method, under the guidance of a professional, full detox from Ativan may take anywhere from a few weeks to a couple of months, depending on what dose you started on, how your body reacts to lowered doses, and your specific doctor’s recommendations.[6]If you have been misusing Ativan or any drug, detox won’t cure the underlying issue. You’ll need to participate in Ativan addiction treatment via an inpatient or outpatient program to address the root causes of substance abuse. In therapy, you’ll develop coping mechanisms, so you don’t return to substance abuse, and you’ll begin to build habits that support a healthy life in recovery.

Updated January 19, 2024
Resources
  1. Lorazepam. (November 2022). StatPearls Publishing.
  2. Benzodiazepine Withdrawal Seizures and Management. (February 2011). Journal of the Oklahoma State Medical Association.
  3. Benzodiazepine Withdrawal: Potentially Fatal, Commonly Missed. (December 2001). Emergency Medicine News.
  4. Benzodiazepines: Uses, Dangers, and Clinical Considerations. (November 2021). Neurology International.
  5. Association Between Coping Strategies and Drug Use in a Large Cohort of Students From a Northern Italian University. (September 2021). Acta Biomedica.
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