Tapering Off Ativan (Lorazepam)

Last Updated: October 27, 2022

Ativan (lorazepam) is a benzodiazepine drug prescribed to treat anxiety disorders. If you are trying to quit Ativan, you may have heard of an Ativan taper. Tapering is a method of coming off a drug slowly, which decreases your risk of side effects from stopping the drug. An Ativan taper can be the safest way to stop Ativan use.

Can You Stop Ativan Cold Turkey?

It is a dangerous idea to stop Ativan cold turkey. When you take a benzodiazepine like Ativan over a long period, your body can become physically dependent on it. Physical dependence means your brain begins to expect the presence of Ativan and adapts accordingly, changing its chemistry. If you abruptly stop Ativan while physically dependent, you may experience benzodiazepine withdrawal symptoms. A taper is a much safer alternative to quitting cold turkey.

Ativan Withdrawal

Ativan withdrawal occurs because of changes in your brain’s balance of chemicals called neurotransmitters — specifically, benzodiazepines like Ativan work by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA). In the brain, GABA works opposite another neurotransmitter called glutamate. GABA calms and slows down your brain’s activity while glutamate excites it. 

When you take a medication like Ativan that increases GABA activity, your brain becomes increasingly sensitive to glutamate. For this reason, when you suddenly stop taking Ativan, your brain can become flooded with glutamate. This can lead to uncomfortable and dangerous withdrawal symptoms as your brain becomes overexcited.

Ativan Withdrawal Symptoms

Withdrawal symptoms from Ativan are similar to those of other benzodiazepines. These symptoms can last for several weeks and may include symptoms like:

• Anxiety
• Insomnia
• Restlessness
• Agitation
• Irritability
• Concentration problems 
• Poor memory 
• Muscle tension or muscle aches

However, more serious withdrawal symptoms are possible. For example, seizures can occur due to the chemical imbalance between GABA and glutamate if you quit Ativan cold turkey.

Reasons to Taper Off Ativan

Tapering off Ativan is much safer than quitting cold turkey. Slowly reducing the Ativan dose over time significantly reduces the chances of withdrawal symptoms because your brain chemistry has a chance to adapt to the slow Ativan dose changes. This helps you come off Ativan in a much gentler way than suddenly stopping the drug.

How to Taper off Ativan

Many different strategies exist for tapering off Ativan. However, you should always discuss an Ativan taper with your doctor; do not attempt a taper on your own. Based on your other medications and your medical history, your doctor will be able to advise you on the safest taper to use and will make sure you are closely monitored to avoid withdrawal effects. 

If you are struggling with an benzo ddiction like Ativan addiction, you may find sticking to a tapering schedule difficult. In these cases, a medical detox and rehab program may be more appropriate.  

Dry Tapering

Dry tapering is a method where a person weighs out Ativan with a scale. Using a pill cutter, the person then shaves off pieces of the Ativan tablet to reduce the dose, which is then weighed.

A downside of dry tapering is that it assumes the Ativan itself is uniformly distributed within the tablet. However, this may not be the case, leading to the weighted Ativan amount being misleading. In addition, not all Ativan tablets should be cut. For example, long-acting Ativan XR tablets should not be cut or crushed. The dry taper strategy is not mentioned in widely accepted benzodiazepine tapering guidelines.

Micro-Tapering

Micro-tapering is a strategy often used in conjunction with dry tapering. In a micro-taper, a person will attempt to taper their Ativan by extremely small amounts — sometimes even by micrograms — on a regular basis.

As a type of dry taper, micro-tapering shares downsides with dry tapering and cannot be used on long-acting Ativan tablets. Micro-tapering is not mentioned in benzodiazepine tapering guidelines.

Tapering Strips

Tapering strips are a strategy that takes the guesswork and calculations out of dry tapering and micro-tapering. In tapering strips, Ativan is prepackaged in decreasing doses and is specially produced to help people wean from the drug. Tapering strips are not widely available but can be ordered online from some specialty pharmacies with a valid prescription from your doctor.

Ativan Taper Schedule

An Ativan taper schedule is highly individualized and will depend on the person and their dose of Ativan. In addition, tapers can speed up or slow down depending on whether a person starts to show withdrawal symptoms. For this reason, tapers should always be medically supervised by a doctor. 

Generally, when tapering a short or medium-acting benzodiazepine like Ativan, the drug is first converted to the long-acting benzodiazepine Valium (diazepam). Valium is much less likely to cause withdrawal symptoms due to its slow wearing-off time. Therefore, a sample Ativan taper would often first involve a conversion to Valium and then may proceed as follows:

• Week 1 – decrease dose by 25% 
• Week 3 – decrease dose by 25% and continue for one to two months
• Week 10 – decrease dose by 25% 
• Week 13 – decrease dose by 25% 
• Week 14 – stop the medication completely

However, similar to Ativan, Valium also has the potential to be addictive. In some cases, people who switch to Valium after Ativan use may become physically dependent on Valium or become addicted to the substance. In these cases, benzodiazepine addiction treatment may be recommended. 

How Long Does It Take To Wean Off Ativan?

It can take months to wean off Ativan, depending on your dose before starting the taper. Ativan taper schedules vary widely from person to person, depending on how much of the drug you take. If you take a high Ativan dose multiple times a day, it will likely take you longer to wean completely off the drug than if you take a moderate Ativan dose once a day at bedtime. 

Medically Supervised Detox for Ativan in Ohio

Stopping Ativan can be difficult, especially if you:

• Misuse Ativan by taking more or more often than prescribed, or taking Ativan that is not prescribed to you
• Have other co-occurring physical or mental health conditions, like anxiety
• Use multiple substances, including other medications, illicit drugs or alcohol

For this reason, it can be safer to wean off Ativan in a medically supervised detox facility under round-the-clock care from doctors and nurses. The Recovery Village Columbus offers an Ativan detox program that will help you gently wean off the medication in a comfortable setting and will facilitate follow-up with our rehab programs. Rehab treatment can set you up for a successful recovery where you leave Ativan for good. Don’t wait: contact us today to discuss your treatment options.