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Ativan Dependency: Taper Lorazepam Safely

Last Updated on February 22, 2024 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

You are not alone if you are struggling with Ativan dependence. Four out of 10 people experience intense withdrawals when attempting to stop. These problems can become so intensified that many feel they cannot express the depths and complexities of their suffering.

We understand.

Did Ativan Trap You
into Your Own Living Hell?

ativan dependency
Alternative to Meds has led the world on benzodiazepine withdrawal now for 17+ years and have published evidence documenting our clients’ success. There is a way out of the trap but it does require precise, nuanced and gentle steps. Many of our own staff have lived through similar experiences and have successfully overcome these difficulties. We are a team of professionals and are dedicated to help you recover.
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Tapering — What You Need to Know About Ativan Dependency

To better understand safe tapering from Ativan, information on the mechanics involved in Ativan dependence is provided below. Especially for long-term Ativan users, but also in the short term for those sensitive to the drug, it is highly recommended to consider a proven inpatient benzodiazepine recovery program. We recommend learning about the mechanics of benzodiazepine dependence to assist you in deciding the level of care that would be most appropriate.

what is dependenceThe words “dependence” and “addiction” have generated much discussion in the learned halls of medicine, but their definitions remain fluid. What one can say with confidence is that dependence is a characteristic of addiction which means a person experiences withdrawal reactions when trying to stop taking a drug.16,17

Some define drug dependence as needing the substance just to feel normal. Again, that is because withdrawal symptoms emerge when the drug is not in the system. The neurochemistry of the body has begun to “depend on” having Ativan circulating in the body to prevent uncomfortable withdrawal phenomena.

Addiction can also mean dependence that is marked by other characteristics which can be extreme, such as reckless pleasure-seeking, overwhelming cravings, and continuing excessive consumption, despite known risks. In prescribed medication settings, these are not typically the focus. Sometimes denial is associated with addiction, which can be overcome with therapy. This may be needed prior to cessation as denial can block recovery altogether. But the physical and mental manifestations of drug withdrawal are the same, nonetheless, in both addiction and drug dependence.

In order to safely taper Ativan, one needs to manage the withdrawals that accompany an extremely gradual reduction of dosage. At the same time, the neurochemistry of the body must be given the greatest assistance possible to come back into drug-free proper balance. The protocols for addiction treatment and medication dependency may overlap but can be tuned to address the individual’s exact needs for a full recovery.

In the early days of benzodiazepine drugs coming to market, these drugs were considered ultra-safe, and with few to none of the issues we now know that can arise after Ativan dependence has developed.9

Clinical signs of Ativan dependence are the physical and mental withdrawal symptoms that occur when a dose is missed, or delayed, when the dosage is reduced, or when the drug is stopped suddenly. All of these scenarios can produce intense reactions.18

The below symptoms are more extreme with abrupt cessation, but can occur in even the smallest reduction. But do not lose hope. Following these, more information is provided about the ways to soften or prevent harsh withdrawals during the process of gradually tapering Ativan.

Top 11 Ativan Taper Symptoms:
  • Suicidal thoughts
  • Seizures*
  • Psychosis, visual and sensory hallucinations
  • Rapid heartbeat
  • Increased sensitivity to light/sound/environment
  • Tingling in extremities
  • Sleep problems
  • Extreme mood changes, i.e., bouts of rage, paranoia, grief, etc.
  • Gastro issues such as nausea, indigestion, stomach pain, abdominal bloating
  • Memory loss
  • Diarrhea, constipation

*The FDA warns that abruptly stopping lorazepam can induce seizures, especially when antidepressants are used concurrently.1

Some persons may experience unmanageable symptoms when stopping suddenly, even after just a short time of taking the medication.5 For these reasons, it is always recommended to come off of lorazepam very slowly & safely under the supervision of a licensed professional. The same is true even if attempting Ativan tapering on an outpatient basis. This ensures that medical complications can be closely monitored and treated promptly, and more severe medical emergencies can be prevented if the person has access to the necessary immediate response.

15 Years Experience by Professionals Who Understand Your Journey.
Up to 87 ½% Long-Term Success Rate.
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How To Ensure You Taper Off Ativan Safely

Due to the toxic reactions that frequently occur, work with a trusted physician familiar with benzo tapering, and have a set plan to follow. Lorazepam must be tapered at a very, very gradual rate. Quitting Ativan cold turkey places a person at extreme risk as the shock to the body is hard to tolerate, and may leave lingering after-effects for a very, very long time.

A treatment center that is familiar with benzodiazepine tapering is the best care option. For severe cases such as co-occurring disorders, an inpatient setting will greatly help make things more comfortable. If you or a loved one is suffering and needs immediate advice, please call Alternative to Meds now.

Lorazepam / Ativan Dependency

Benzodiazepine prescriptions have soared to epidemic levels according to recent research and reporting.13

Benzodiazepines cause nearly immediate calming and pleasurable effects. However, tolerance may develop very quickly. Tolerance means a drug becomes less effective the longer it is used. A person may begin to take the drug more frequently, or at a higher dosages to get the same effects as before. When a person becomes dependent, they may develop a fear of not having the medication, or on a bad day or flare-up of symptoms, they may tend to take more than their prescribed dosage.3

Ativan is a sedative prescribed for anxiety and insomnia. Like all benzodiazepines, it suppresses the central nervous system. it is used during alcohol cessation to prevent seizures. Ativan binds to the GABA receptors, which are the chief and most numerous inhibitory receptors found throughout the body. These receptors are disabled in benzodiazepine use.19,20 This is, at least in part, why benzo withdrawal causes quite a significant burden of adverse effects across the entire CNS and body structures. Ativan (generic lorazepam) is classed as a Schedule IV substance, meaning it has less addictive potential than heroin or fentanyl. Some would question this classification, as the risk of benzodiazepine addiction and dependence are clinically well-known.14

Severe symptoms associated with long-term benzodiazepine use are well-established, both mentally and physically. Research has shown that without proper benzodiazepine discontinuation support and treatment, these symptoms can persist for a very long time.10,11

Ativan-dependence: stopping without assistance can be catastrophic.

A person going through severe benzo cessation may experience psychotic reactions as well as physically debilitating symptoms and may start to believe they will never recover. Too often, an unfamiliar physician may diagnose “relapse” in error, which can lead to further catastrophic outcomes. It doesn’t have to be this difficult. Get competent help to assist with your Ativan taper.2,7,8

Treatment Options for Stopping Lorazepam Use

The symptoms associated with stopping benzodiazepines, especially after long-term use, may best be helped with inpatient care and medical oversight.

Deciding on the best course of action can be confusing. Here are some options you can expect to find when looking for lorazepam cessation help or a treatment program. Analyze them carefully for your best options:

Ativan Rapid Detox

Alternative to Meds Center does not recommend rapid detox as it does not allow enough time for the body, brain, and CNS to adjust to the absence of the medication. Rapid detox is very fast, usually between 3 and 7 days. Typically the patient is discharged with additional medications to take upon returning home. Alternative to Meds designed their programs to begin gently and gradually normalize the neurochemistry even before tapering begins. This prevents shocking the body, especially after long-term use of a benzodiazepine, and can significantly speed up recovery. It is not realistic to expect this major healing event to occur and sustain itself stably, in just a few days or weeks.

Ativan Withdrawal At Home — Nutrients and Remedies

There are over-the-counter remedies that can help dampen the milder symptoms associated with coming off benzodiazepines. These remedies can be purchased at health food stores and pharmacies and taken at home without medical supervision. For headaches there is aspirin. For insomnia there is melatonin, warm milk, and Epsom salt baths. For indigestion, there is peppermint tea or apple cider vinegar diluted in water.

While these remedies may provide some benefits, please note that coming off benzodiazepines without medical oversight can be both dangerous and unpredictable. If symptoms become more severe, call a doctor or clinic that you know is familiar with benzodiazepine withdrawal for help.1,2,4

Slow Ativan (lorazepam) Taper

For most people, trying to get off Ativan safely with a knowledgeable doctor is the safest way to get off Ativan. Some benzo tapers last for over a year. Doing it slowly, with adequate support, can reduce the chance of major symptoms. This gradual transition may ease the impacts on daily work duties or responsibilities. If major symptoms persist or become unmanageable during a medication taper at home, seeking the care of an expert can help move the healing along more smoothly. With a more focused inpatient approach and daily monitoring, this process can take considerably less time without lingering and disabling health impairments.1,2,5,12

Get off Ativan Safely at a Holistic Treatment Center

Inpatient holistic centers such as Alternative to Meds Center in Sedona, AZ use proven, gentle methods to help individuals overcome the mental health challenges associated with coming off benzodiazepines.

Recovery stories from our clients express the relief they found from becoming benzo-free, some after decades of taking the addictive medication!

How to Get Off Lorazepam Safely for Good!

Getting off lorazepam safely, under the care of a doctor, a benzo detox program, or a wellness center, also means your treatment professional should offer some sound recommendations for maintaining a healthy lifestyle upon returning to your daily routine. Make sure to ask for resources and have a counselor or doctor already arranged for follow-up visits.

A person may still experience physical, mental, or emotional symptoms once becoming med-free, so finding a healthy daily routine is important. As a basic roadmap, a person recovering from benzodiazepine use, anxiety, or any mental health condition should follow a regimen that makes their health the top priority. Be sure to incorporate healthy exercise activities and a well-planned diet to support neurochemistry repair and healing the gut. The Ashton materials have helped many to find a practical path to recovery and these can be discussed with the prescriber where inpatient care is not accessible. 5

An individual leaving a recovery program prematurely, with no real plan in place, or having scheduled just one follow-up appointment per month will have a far lower rate of success than a person who is provided a daily regimen of holistic therapies, counseling, and nutrient therapy. Focusing your energy on your health is the best way to make sure your days keep getting brighter and will provide resources that can ease any symptoms that do pop up.

Holistic Ativan Tapering and Treatment at Alternative to Meds Center

holistic ativan tapering sedona drug rehabAlternative to Meds Center is an inpatient holistic mental health and recovery center located in Sedona, Arizona.

The program incorporates many educational segments into the tapering program, which give much information about how to maintain good health during recovery and after returning home.

Protocols used in treatment include lab testing and analysis, orthomolecular nutrition-based therapies, neurotoxin removal, neurotransmitter rehabilitation, talk therapy, IV therapy, exercise, Chinese Traditional medicine, Equine-assisted therapy, diet correction, microbiome repair, and a wide range of adjunct treatments designed for true recovery.

A person can turn their entire life around by becoming med-free. But it must be done precisely, and with adequate support. Thousands of cases of even the most severe condition have been assessed, treated, and safely assisted with the oversight of the medical team at Alternative to Meds. Ours is a client-centered program, within a friendly supportive context of professional and peer support. The best treatment protocols in the world are delivered at Alternative to Meds Center in the context of a well-managed, individually tailored Ativan dependency recovery program. Insurance-wise, the center is covered by the most widely used private insurers. Please contact us to find out more about how our Ativan tapering program in a comfortable and welcoming facility may be the answer you have been looking for.

Sources:


1. FDA Label Ativan (lorazepam oral tablets) [approval Sept 30, 1977] [cited 2023 April 14]

2. 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 2022 June 8]

3. Griffin, C. E., 3rd, Kaye, A. M., Bueno, F. R., & Kaye, A. D. (2013). Benzodiazepine pharmacology and central nervous system-mediated effectsThe Ochsner journal13(2), 214–223. [cited 2023 April 14]

4. Guina, J., & Merrill, B. (2018). Benzodiazepines I: Upping the Care on Downers: The Evidence of Risks, Benefits and Alternatives. Journal of clinical medicine7(2), 17. https://doi.org/10.3390/jcm7020017 [cited 2023 April 14]

5. Ashton H, “The diagnosis and management of benzodiazepine dependence.” Current Opinion in Psychiatry [Internet] 2005 May [cited 2022 June 8]

6. FDA Pediatric Postmarketing Pharmacovigilance Report for injectable lorazepam in children [July 8 2019] [cited 2022 June 8]

7. Khong E, Sim MG, Hulse G. Benzodiazepine dependence. Aust Fam Physician. 2004 Nov;33(11):923-6. PMID: 15584332. [cited 2022 June 8]

8. Ghiasi N, Bhansali RK, Marwaha R. Lorazepam. [Updated 2022 Feb 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. >Available from: https://www.ncbi.nlm.nih.gov/books/NBK532890/ [cited 2022 June 8]

9. Stewart SA. The effects of benzodiazepines on cognition. J Clin Psychiatry. 2005;66 Suppl 2:9-13. PMID: 15762814. [cited 2022 June 8]

10. Barker MJ, Greenwood KM, Jackson M, Crowe SF. Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis. Arch Clin Neuropsychol. 2004 Apr;19(3):437-54. doi: 10.1016/S0887-6177(03)00096-9. PMID: 15033227. [cited 2022 June 8]

11. Barker MJ, Greenwood KM, Jackson M, Crowe SF. An evaluation of persisting cognitive effects after withdrawal from long-term benzodiazepine use. J Int Neuropsychol Soc. 2005 May;11(3):281-9. doi: 10.1017/S1355617705050332. PMID: 15892904. [cited 2022 June 8]

12. Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015 Oct;38(5):152-5. doi: 10.18773/austprescr.2015.055. Epub 2015 Oct 1. PMID: 26648651; PMCID: PMC4657308. [cited 2022 Aug 7]

13. Schmitz A. (2016). Benzodiazepine use, misuse, and abuse: A review. The mental health clinician6(3), 120–126. https://doi.org/10.9740/mhc.2016.05.120 [cited 2023 April 14]

14. Dept of Justice/DEA Fact Sheet Benzodiazepines [published April 2020] [cited 2023 April 14]

15. DEA Controlled Substance Schedules [published 2023] [cited 2023 April 14]

16. Fluyau D, Charlton TE. Drug Addiction. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549783/ [cited 2023 Aug 10]

17. Khong E, Sim MG, Hulse G. Benzodiazepine dependence. Aust Fam Physician. 2004 Nov;33(11):923-6. PMID: 15584332. [cited 2023 Aug 10]

18. Edinoff, A. N., Nix, C. A., Hollier, J., Sagrera, C. E., Delacroix, B. M., Abubakar, T., Cornett, E. M., Kaye, A. M., & Kaye, A. D. (2021). Benzodiazepines: Uses, Dangers, and Clinical Considerations. Neurology international13(4), 594–607. https://doi.org/10.3390/neurolint13040059 [cited 2023 Aug 10]

19. Ghit A, Assal D, Al-Shami AS, Hussein DEE. GABAA receptors: structure, function, pharmacology, and related disorders. J Genet Eng Biotechnol. 2021 Aug 21;19(1):123. doi: 10.1186/s43141-021-00224-0. PMID: 34417930; PMCID: PMC8380214. [cited 2024 Feb 22]

20. Jewett BE, Sharma S. Physiology, GABA. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513311/ [cited 2024 Feb 22]


Originally Published Nov 2, 2018 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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