What are the effects of Lorazepam Withdrawal?
Lorazepam withdrawal can occur after you develop a dependence on the drug. A dependence on the drug can occur even when you take the medication as prescribed by a professional health care provider. In fact, many people develop a physical dependence on lorazepam in as little as one week of taking the benzodiazepine.
Lorazepam is often referred to by its brand name Ativan, is one of the most widely prescribed benzos. In 2017, doctors wrote an estimated 26.5 million prescriptions for Ativan alone. The following year, studies found an estimated 5.4 million people over the age of 12 were misusing prescription benzos such as Ativan.
Due to its ability to treat a wide variety of ailments, along with overprescription, lorazepam is a very popular prescription drug. Many people take it regularly without realizing the dangers and how dependent they have become on the drug until they begin to experience uncomfortable withdrawal symptoms. An estimated 40% of people on benzos like lorazepam, who take it for more than six months, develop moderate to severe withdrawal symptoms.
More on Lorazepam
The Schedule IV controlled substance is a very popular benzos. It is a potent tranquilizer that induces sedation and muscle relaxation. It can help prevent seizures during alcohol detox, reduce discomfort during opioid withdrawal and is often used as a fast-acting sedative for surgery or for dental work.
Slang terms for lorazepam include tranks, benzos, nerve pills and downers. Benzos like lorazepam are central nervous system depressants. They are recommended for short-term use only. The typical duration of use is no longer than 2-4 weeks. Even when used as prescribed, dependence on the drug can develop quickly. And with the drug’s short half-life, withdrawal symptoms can also occur very quickly after drug use has ended.
Lorazepam Withdrawal
Dependence on a drug develops as a result of the body adapting to the drug due to constant use over a period of time. Once dependence develops, withdrawal symptoms can occur when a person abruptly stops using the drug. Withdrawal usually occurs when a person has become reliant on a drug to function normally.
When the drug is no longer in the system, the brain and nervous system go through a period of readjusting and rebalancing as it relearns how to function without the presence of the drug. Users may experience both physical and psychological discomfort while the body is adjusting.
Withdrawing from any type of benzos medication can be very unpleasant. Lorazepam’s half-life is about 12-18 hours. Withdrawal can occur in as little as 8-24 hours after the last dose. Lorazepam withdrawal can last anywhere from 1-4 weeks. With a supervised medical taper program, withdrawal can last anywhere from 3-5 weeks.
Lorazepam Withdrawal Symptoms
- Anxiety-related symptoms – rebound anxiety, panic attack, tremors, rebound insomnia, weight loss, muscle spasms, altered vision, sweating and mood swings
- Perceptual-related symptoms – hypersensitivity to light, sound and touch, abnormal body sensations, hallucinations, depersonalization and derealization
- Major event-related symptoms – generalized seizures, convulsions, precipitation of delirium and psychosis
- Cravings
- Irritability and mood swings
- Difficulty concentrating and cognitive impairment
- Confusion
- Nausea and vomiting
- Headache
- Changes in blood pressure and rapid heart rate
- Memory loss
- Dizziness or vertigo
- Rebound depression
- Paranoia
- Tingling or numbness in extremities
- Benzos induced neurological dysfunction
- Movement disorders
Rebound symptoms are common during lorazepam withdrawal. They are temporary and can enhance the return of symptoms like anxiety or insomnia. These are the conditions that lead a person to use lorazepam to begin with. Rebound symptoms usually occur 2-3 days after the acute withdrawal phase. During this period of withdrawal is also the period when many people tend to relapse due to rebound symptoms. An estimated 10-35% of those who detox from lorazepam will experience rebound effects.
Types of Withdrawal
- Acute Withdrawal – Acute withdrawal is most widely associated with withdrawal from lorazepam. During this phase, the majority of symptoms are physical and typically last anywhere from 7-14 days. Acute symptoms can last between one to four weeks.
- Post-acute withdrawal – Post-acute withdrawal can be tricky to predict. Some only experience this type of withdrawal for a month or two, while others can experience withdrawal symptoms for up to a year. Symptoms are generally psychologically related and can be difficult to overcome, often resulting in drug relapse. Post-acute withdrawal can also be referred to as protracted withdrawal. Studies have shown that 10-25% of people who take benzos like lorazepam for a long period of time, can experience protracted withdrawal. These symptoms are milder and can come and go for several months. Symptoms typically resolve within a year.
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Lorazepam Withdrawal Timeline
- Day 1-3. The person will feel acute withdrawal symptoms like headache and nausea that typically begin within the first 24 hours of drug cessation.
- Days 4-7. During this time, symptoms of withdrawal tend to peak and the severity of symptoms will vary from person to person. Symptoms can include tremors, cravings and mood swings.
- Days 8-14. Rebound symptoms can start a few days after acute withdrawal ends. Symptoms may include severe anxiety, rapid heart rate, increased blood pressure and insomnia.
- Day 15 and beyond. The most difficult part of withdrawal is over and acute symptoms should be gone. However, lingering symptoms can still persist and protracted withdrawal can begin for some with severe addictions.
Factors that influence Withdrawal
The severity and duration of lorazepam withdrawal are dependent on many factors. The last dose of lorazepam was taken? How long has a person been taking the benzos medication? Were other substances used alongside lorazepam? Was drug dosage already reduced? Was a professional medical detox using a gradual taper considered? These are all important factors to consider when assessing lorazepam withdrawal.
How to safely detox off Lorazepam
Benzos medications like lorazepam are known to have uncomfortable and even dangerous withdrawal symptoms that can continue to linger long after drug use has stopped. Lorazepam is also a short-acting benzos, which means the onset of withdrawal can occur much quicker than other long-acting benzos.
To avoid serious and severe withdrawal symptoms, it is recommended to detox under medical supervision. Medical detox allows a person to safely and gradually taper off benzos medications. Abruptly stopping use of benzos cold turkey can lead to a high risk of seizure and hallucinations.
Tapering can mean switching to a longer-acting benzos and reducing dosage slowly. A typical taper consists of reducing the dosage of drugs by 5-25% less every one to four weeks. Tapering off medications can help reduce the severity and dangers of side effects. Other medications can also be used during detox to help with withdrawal symptoms. Melatonin, antidepressants and anticonvulsants may be prescribed to treat specific symptoms.
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Treatment for Substance Use Disorder
The FDA drug label on lorazepam states that withdrawal symptoms such as rebound insomnia, can occur even after a single week of use of the medication. Lorazepam dependence can occur quickly and withdrawal symptoms can be very unpleasant and even dangerous. It can be a highly addictive drug and should not be prescribed to anyone with a history of alcohol or drug abuse.
Professional behavioral treatment programs such as Hotel California by the Sea provide substance use disorder treatment for benzos addiction. We offer treatment at all levels of care including detox, residential, PHP and IOP. We utilize evidence-based methods such as CBT, DBT and family therapy. Hotel California is dedicated to helping clients reach their goals of sobriety and overcome their addiction.
References:
https://www.addictioncenter.com/benzodiazepines/ativan/withdrawal-detox
https://www.alternativetomeds.com/blog/lorazepam
https://www.verywellmind.com/ativan-withdrawal-symptoms-4588394
https://rehabs.com/benzodiazepines/ativan/withdrawal
https://recovered.org/benzodiazepines/ativan-lorazepam/withdrawal-symptoms
https://www.rehabcenter.net/ativan/withdrawal/