Ativan (lorazepam) is a common medication used to treat anxiety, seizures, and panic attacks. It is a type of benzodiazepine drug, similar to Xanax (alprazolam), Valium (diazepam), and Rivotril (clonazepam). These drugs work by changing the levels of an inhibitory neurotransmitter called gamma-aminobutyric acid (GABA). GABA limits activity in your nerves, causing you to feel more calm and relaxed. In turn, the influence of Ativan on GABA levels allows it to relieve anxiety, panic attacks, and seizures.
But there’s a catch. Benzodiazepines are classified by the Drug Enforcement Administration (DEA) as Schedule IV controlled substances because of their potential for abuse. If not used properly, Ativan can cause you to become dependent on it. Once you have become dependent, quitting the drug is harder as you will experience Ativan withdrawal symptoms. These can get uncomfortable enough to compel you to take Ativan again just to get relief.
If you are wondering what dose of Ativan is enough to trigger withdrawal symptoms, read further to find out.
What are the usual doses of Ativan?
Ativan is a prescription-only drug, so determining the right dose for you is your doctor’s job. The optimum dosage, frequency, and treatment duration vary per person, depending on their cases. To accommodate different dosages, Ativan tablets come in 0.5 mg, 1 mg, and 2 mg variants.
Dosages can range from 1 to 10 mg per day. In most cases, 2 to 6 mg per day of Ativan is prescribed, taken in doses divided throughout the day. The largest doses are often taken in the evening before bedtime.
Most of the time, when you take Ativan following your prescription, your risk of withdrawal is low. After your treatment period is done, your doctor may recommend that you gradually taper your dose instead of stopping intake abruptly. This is another precaution to prevent withdrawal.
Increasing your dose should only be done by your doctor when necessary. It is dangerous if you increase it on your own because you feel that Ativan is not taking effect as much as before. This increases your chances of dependence and withdrawal. When you consult your doctor, she may decide to put you on a different medication or stop it entirely, depending on how your body responds.
At what dosage of Ativan will I risk withdrawal?
Again, there is no one-size-fits all answer to this question. The dose at which you may develop dependence varies per individual. For some people who follow their prescription, they may still have a risk of developing Ativan withdrawal.
If you have concerns about developing withdrawal symptoms, talk to your doctor before he prescribes Ativan to you. Inform him of any underlying physical conditions, mental health issues, and past histories of medication or substance abuse, if there is any. All of this information will help your doctor make the best decision whether to prescribe Ativan or not.
If your doctor does prescribe you with the drug, follow the prescription carefully. Do your best not to miss any doses, and follow the tapering schedule once it’s time to stop the medication. If you experience any adverse effects while on medication, tell your doctor immediately. Do not stop taking Ativan immediately, as you will have a higher risk of withdrawal that way.
What are the withdrawal symptoms?
Ativan withdrawal usually occurs in two phases. The first phase – acute withdrawal – can happen within 1 to 4 days of your last dose of Ativan. The second phase is a more prolonged withdrawal stage that can last 10 to 14 days following the end of the acute phase. In some cases, a post-acute withdrawal syndrome (PAWS) can follow after the second phase. PAWS is the most drawn out, persisting for months or even years after the last dose of Ativan.
In the acute phase, you will have these symptoms:
- Increased blood pressure
- Increased heart rate
- Heart palpitations
- Mood swings
- Panic attacks
- Difficulty sleeping
- Difficulty concentrating
- Abdominal cramps
- Seizures (in rare cases)
The second phase includes these symptoms:
- Drug cravings
- General feelings of discomfort
During PAWS, the prominent symptoms are generalized discomfort, persistent depression, anxiety, and mood swings.
At any point during withdrawal, your symptoms may become too uncomfortable to bear. If you do not have a good support system in place, the compulsion to take Ativan again may overpower you. For this reason, efforts to quit Ativan on your own often end up unsuccessful.
What is the best way to deal with Ativan withdrawal?
If Ativan is a necessary medication for your condition, make sure to follow your prescription religiously. Take the prescribed dosages at the prescribed times, and make sure you always have enough Ativan on hand. If you’re about to run out, refill your supply immediately to avoid missed doses and abruptly stopping your intake before the treatment period is over.
Tell your doctor right away if you feel that Ativan’s effects are weakening. Don’t attempt to take more of it without your doctor’s approval. Increasing your dose on your own is considered misuse, and you are more vulnerable to withdrawal that way.
If your treatment is about to end, ask for a tapering schedule if your doctor did not give you one yet. Decreasing your dose gradually further reduces the chances of developing withdrawal symptoms. Tapering schedules vary from person to person. Your doctor will determine the best schedule for your case.
If you already are experiencing withdrawal and want to quit Ativan use, it’s a good idea to seek professional guidance. Ask your primary healthcare provider or a mental health professional to know which treatments are right for you.
Often, you will have to go through a medically-assisted detox procedure to flush out the drug from your system. During detox, you may be given medications to help you manage any withdrawal symptoms that may come out.
Then, you may have to go through behavioral therapies for a full recovery. After your treatment program is over, you can expect to live a drug-free life once more.