Ativan is an intermediate-acting benzodiazepine, or benzo, that carries the risk of misuse and abuse, and dependence can develop after a short time, even when used as prescribed. While there are dangers with quitting Ativan cold turkey, help through medically assisted detox is a safe and effective way to quit Ativan.

How Long Does Ativan Last?

Benzos have three categories: short-, intermediate- and long-acting. These categories refer to how soon you feel the drug after taking a dose and how long it lasts. For example, Ativan is an intermediate-acting benzo, like Xanax or Restoril. Generally, the effects of Ativan last for 11 to 20 hours. 

Factors that can influence this time frame include your age, weight and kidney and liver function. In addition, how long Ativan lasts can also be impacted by factors like whether you have eaten, consumed alcohol and taken other medications around the same time as Ativan.


Can You Stop Taking Ativan Cold Turkey?

Ativan works to slow signaling between the brain and the body. Over time, your brain becomes dependent on the drug and adjusts by decreasing the number of receptors, which is the process of developing tolerance. When you stop taking Ativan cold turkey or even lower your dose too quickly, your brain does not have enough time to adjust to the change. This can lead to withdrawal symptoms ranging from mild to severe or even life-threatening. 

Without Ativan to slow signaling down between the brain and the body, this can lead to overstimulation and cause withdrawal symptoms like coma or death. For this reason, it is always vital to discuss wanting to stop this medication with your healthcare provider. They can help you to determine a plan for stopping safely.  

Ativan Tapering Schedule

The safest way to stop taking a benzo like Ativan is to taper or slowly decrease your dose. This process usually takes many weeks, and the time it takes to stop safely will depend on your starting dose of Ativan. An example of a taper schedule might look like this:

  • Week 1: Dose might be reduced slightly, if at all. 
  • Week 2: Reduce your total daily dose by 25%.
  • Week 3: Similar to week one, your dose may be reduced slightly or not at all.
  • Week 4: Reduce your total daily dose by another 25% (which will now be 50% of your starting dose).
  • Weeks 5–8: Make no change to allow your body time to adjust to this lower dose.
  • Week 9 and after: Every two weeks, reduce your total daily dose by 25% until you can safely stop taking Ativan.


Ativan Withdrawal

Withdrawal is the process the body goes through when it suddenly doesn’t have a chemical or substance it is used to having. For example, if Ativan dependence develops, individuals will go through withdrawal when they stop taking the drug. The same is true in cases of Ativan abuse. People may desire professional help when it comes time to detox from Ativan use, as the withdrawal symptoms can be challenging to manage.

Drug tolerance refers to the need for increased doses to achieve the same effect over time, which can lead to dependency and addiction. Ativan users rapidly develop tolerance, which is why the drug should never be prescribed (or used) for more than a few months. Ativan works by acting on gamma-aminobutyric acid (GABA) receptors in the brain — a class of inhibitory neurotransmitter receptors. When Ativan activates these receptors, it inhibits brain action. This result is why Ativan is so successful as an anti-seizure medication and why Ativan can reduce anxiety and panic attacks.

GABA inhibition also affects the regulation of dopamine (which controls the “reward circuit”), although the precise mechanism is still an area of study. Activation of the reward circuit is why people struggling with addiction feel euphoric when they take their drug of choice.

Ativan withdrawal happens when a user quickly reduces or stops taking the drug. The immediate effects of reduced or eliminated Ativan include increased activity in neurons with GABA receptors. Because GABA dampens neuronal excitability, the net effect of less Ativan, and therefore less GABA, is more neuronal excitability. This can lead to anxiety, restlessness and insomnia. In extreme cases, seizures and death can also occur.

Ativan Withdrawal Symptoms

Once detox is over, Ativan withdrawal generally has two stages: acute and protracted. Acute symptoms typically last for two to four weeks. Protracted symptoms can persist for months, even years. Symptom duration reflects the length and amount of use.

Physical withdrawal symptoms include:

  • Heart palpitations
  • Tremors
  • Numbness
  • Tingling in extremities
  • Muscle aches
  • Cramps
  • Dizziness
  • Hypertension
  • Nausea
  • Vomiting
  • Loss of appetite
  • Seizures

Psychological withdrawal symptoms include:

  • Anxiety
  • Panic
  • Paranoia
  • Restlessness
  • Confusion
  • Anhedonia, or the inability to feel pleasure
  • Depression
  • Suicidal ideation 
  • Attempts to self-harm

Symptoms of Post Acute Withdrawal Syndrome

Many believe their addiction symptoms should be over once the drug is out of their system. Unfortunately, post-acute withdrawal syndrome (PAWS) affects recovery for many people. PAWS generally has similar physical and psychological effects as acute withdrawal, although the degree to which these symptoms are experienced tends to fluctuate over time. It is essential to understand that PAWS can involve cravings and the temptation to resume drug use for months or even years after quitting. However, these uncomfortable physical and psychological symptoms subside as time goes on.

Protracted Withdrawal Symptoms

PAWS and protracted withdrawal symptoms are synonyms. Protracted withdrawal is defined as “…the presence of substance-specific signs and symptoms common to acute withdrawal but persisting beyond the generally expected acute withdrawal timeframes” by the Substance Abuse and Mental Health Services Administration.

Ativan Withdrawal Timeline

Every individual’s Ativan withdrawal timeline will differ depending on factors such as metabolism, Ativan dosage, how long Ativan was taken and the Ativan taper schedule used.

However, the withdrawal will generally occur in two phases:

  • Acute withdrawal starts approximately three days after quitting and lasts about two weeks. This is the most dangerous phase of the withdrawal process, as the acute phase is when seizures are most likely to occur.
  • Prolonged withdrawal emerges later and can last for a long time (upwards of a year).

Factors Impacting Ativan Withdrawal

Several factors can influence the Ativan withdrawal process. The most significant factor is Ativan tolerance. Benzodiazepine tolerance, in general, will impact Ativan withdrawal because all benzodiazepines act similarly within the brain. Therefore, if you have been using Ativan for a long time, your withdrawal experience will differ from someone who only took Ativan a few times.

Additionally, abusing drugs such as alcohol can impact Ativan withdrawal because alcohol also acts on the GABA within your brain. If you are already prone to anxiety or have an anxiety disorder, Ativan withdrawal effects may be more profound than those without anxiety.


Can Ativan Withdrawal Kill You?

Benzodiazepine withdrawal (including Ativan) can be lethal. When an Ativan user stops using the drug “cold turkey,” significant changes in brain chemistry rapidly occur. For individuals who have used Ativan for a long time, suddenly depriving the brain of the drug can cause a hyperexcitable state, leading to elevated temperatures, hypertension, seizures and death.

A different type of risk associated with Ativan withdrawal can be suicidal tendencies. A recent meta-analysis of 17 studies found that benzodiazepines (including Ativan) are associated with an increased risk of attempting or completing suicide.

It is strongly recommended that anyone who develops an Ativan addiction undergo detox and withdrawal in a rehab facility equipped to deal with potential medical complications. In addition, medical consultation before quitting can provide a scheduled taper that can increase the likelihood of safe, successful withdrawal and rehab.

How To Cope With Ativan Withdrawal Symptoms

The side effects of Ativan withdrawal are not pleasant, but there are treatment methods you can utilize to help cope with withdrawal symptoms, such as:

  • Tapering your dose of Ativan: You can avoid the worst withdrawal symptoms by tapering your dose. Tapering is when you take progressively smaller amounts of Ativan over a long period (weeks to months).
  • Exercise: Exercise can be therapeutic and reduces stress and anxiety.
  • Practice mindfulness or meditation: Focusing on and accepting the present moment through mindfulness techniques or meditation can be beneficial. This method can help you cope with cravings and urges that occur during withdrawal.

These methods may help someone treat withdrawal at home, but professional detox is the safest way to go through the withdrawal process.

Medically Supervised Ativan Detox

Ativan withdrawal symptoms can be challenging to manage on your own. A medically supervised detox at a rehab treatment facility provides a safe environment to detox in, around-the-clock care from medical professionals and medication to manage symptoms when appropriate. For many, having this support in a drug-free environment ensures they don’t relapse back to using Ativan during withdrawal and can start their recovery on the right foot.   

If you or someone you care about is struggling with Ativan addiction, we can help. Our knowledgeable and caring professionals provide medical detox to incoming patients to make their withdrawal experience as safe and comfortable as possible. The Recovery Village at Baptist Health accepts most insurance plans and offers 24-hour admission coordination, including holidays and weekends. Contact us today and get started on your road to recovery.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.