If you are dependent on or addicted to Ativan and suddenly quit taking it, you will experience Ativan withdrawal symptoms like anxiety, tremors, and nausea or vomiting. Lorazepam withdrawal can be potentially life-threatening due to the risk of seizures and withdrawal delirium.
Acute vs. Protracted Ativan Withdrawal Symptoms
| Acute | Protracted |
| Anxiety and panic | Anxiety |
| Heart palpitations | Depression |
| Nausea and vomiting | Concentration issues |
| Sweating | Apathy |
| Rapid pulse | Irritability |
| Tremors and shakiness | Ativan cravings |
| Rapid, purposeless movements | Sleep disturbances |
| Hallucinations | |
| Seizures |
What Is Ativan Withdrawal?
Ativan (lorazepam) is a type of benzodiazepine, a powerful medication used to treat anxiety, sleep disorders, and seizures. Doctors use the medication to treat acute but short-term problems.
The U.S. Food and Drug Administration (FDA) doesn’t recommend using the drug for longer than about 4 weeks because you can develop a physiological dependence. Dependence means that a person’s brain and body have become accustomed to the presence of Ativan and need it to function optimally.
You shouldn’t take lorazepam for longer than 4 weeks because of the risk of physiological dependence.
If someone who is dependent on lorazepam suddenly stops taking it, they’ll experience unpleasant and potentially life-threatening symptoms known as Ativan withdrawal syndrome. These symptoms may include tremors, sweating, heart palpitations, and more. [1],[2],[5]
People who use their medication as directed can become dependent on Ativan, which is a normal adaptation and doesn’t indicate an addiction. In this case, the withdrawal symptoms will likely be milder than if someone were abusing Aativan. Ativan misuse and abuse can speed up the development of dependence and lead to addiction, a compulsive pattern of use despite negative consequences.
Acute Withdrawal Symptoms for Lorazepam
Acute withdrawal begins in the days following abrupt cessation of Ativan use. Those symptoms can include the following:[1],[2],[3]
- Anxiety and panic attacks
- Irritability and agitation
- Cravings
- Heart palpitations
- Rapid pulse
- Headaches
- Dizziness
- Nausea
- Vomiting
- Weight loss
- Blurred vision
- Irregular sleep patterns
- Poor concentration
- Confusion
- Rapid, purposeless movements like pacing
- Tremors
- Sweating
- Paranoia
- Hallucinations and delirium
- Grand mal seizures
Some people develop seizures when they stop taking Ativan suddenly. This problem is most common in people with pre-existing seizure disorders and those taking antidepressants and other seizure-causing drugs, although it can happen if you have a severe addiction.[2]
Protracted Withdrawal Symptoms
When the acute stage passes, your brain cells need more time to heal. You can develop a long-lasting withdrawal syndrome as your brain cells adjust to sobriety. Symptoms include the following:[4]
- Anxiety
- Insomnia
- Poor concentration, problem-solving, and memory
- Feelings of unreality or depersonalization
- Depression
- Irritability
- Apathy
- Ativan cravings
Your Ativan withdrawal experience can vary based on the following factors:
- Your age and health
- How much Ativan you took
- How long you took Ativan
- Whether or not you took other drugs
What are the Most Dangerous Ativan Withdrawal Symptoms?
The most dangerous symptoms associated with Ativan withdrawal are seizures, which can be life-threatening without emergency care or preventative treatment.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), between 20% and 30% of people withdrawing from sedatives like Ativan may experience a grand mal seizure.[2] And grand mal seizures have been reported in people taking therapeutic doses of benzodiazepines for fewer than 15 days.[7]
Hallucinations and withdrawal delirium can also be hazardous because people may be at an increased risk of accidents. People who are hallucinating may also make impulsive or dangerous decisions because of delirium.
These risks are why seeking professional detox is so important. A team of nurses and doctors can keep you safe while you go through withdrawal.
What is the Safest Way to Manage Lorazepam Withdrawal Symptoms?
The safest way to manage withdrawal from lorazepam is a medical detox setting, which can occur in environments, such as:
- Acute care unit
- Psychiatric hospital
- A freestanding detox program that offers medical care
- Inpatient treatment center that offers medical detox
During medical detox, you receive 24/7 care, supervision, and monitoring to manage Ativan withdrawal symptoms, address complications or medical emergencies like seizures, and ensure your comfort.
Replacement Benzodiazepines for Withdrawal
During medical detox, the treatment team will likely administer a long-acting benzodiazepine that can relieve your symptoms and reduce the risk of seizures. These may include:[6]
- Chlordiazepoxide (Librium)
- Diazepam (Valium)
- Oxazepam
These long-acting benzos need to be administered less frequently than intermediate-acting ones and are cross-tolerant with Ativan since it is a benzo as well.
Professional Medical Care
Aside from administering benzodiazepines, the medical team will also provide:
- Supportive care like IV fluids
- Additional medications, if needed, such as anticonvulsants
- Monitoring of your vital signs
- Counseling
- Case management and wraparound services
Once you complete acute withdrawal and are medically stable, the best course of action is to transition into a comprehensive addiction treatment program where you can receive therapy and individualized treatment planning to help you recover.
Frequently Asked Questions About Ativan Withdrawal Symptoms
No. You should not quit Ativan cold turkey, as the risk of seizures is too great.
Ativan withdrawal symptoms can range from mildly uncomfortable to severe and life-threatening. Some mild symptoms may include anxiety and nausea while more serious symptoms include seizures, tremors, and hallucinations.
Yes, it’s possible to die from Ativan withdrawal, due to the risk of grand mal seizures. The people most at risk have a severe Ativan addiction, a history of seizures, and a history of withdrawal delirium. However, withdrawal seizures have been reported in people taking benzodiazepines for two weeks at therapeutic doses.[7]
- Ativan (Lorazepam) Tablets. U.S. Food and Drug Administration. (September 2016)
- Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. (2013).
- Management of Benzodiazepine Misuse and Dependence. (October 2015). Australian Prescriber.
- Post-Acute Withdrawal Syndrome (PAWS). SEMEL Institute for Neuroscience and Human Behavior. (n.d.).
- Challenges of the Pharmacological Management of Benzodiazepine Withdrawal, Dependence, and Discontinuation. (May 2019). Therapeutic Advances in Psychopharmacology.
- Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. Journal of Clinical & Diagnostic Research. (September 2015.)
- Benzodiazepine withdrawal seizures and management. The Journal of the Oklahoma State Medical Association, 104(2), 62–65. Hu X. (2011).