How To Taper Off Ativan (Lorazepam) | Weaning Schedule & Recommendations

Ativan, the brand name for lorazepam, is a benzodiazepine used to treat anxiety and panic disorders. It is recommended for short-term treatment because of its high risk for physical dependence. Once dependent, you may experience potentially dangerous withdrawal symptoms. 

Your doctor may help you stop taking Ativan by tapering, or slowly decreasing your dose. Tapering can take weeks or months to complete but minimizes the risk of severe withdrawal symptoms. 

If you think you or a loved one may be addicted to lorazepam, a detox program may be more beneficial when stopping Ativan. 

Ativan Withdrawal

Ativan is a benzodiazepine (benzo) that can lead to physical dependence and addiction with long-term use. Stopping Ativan cold turkey can lead to severe withdrawal symptoms, like seizures. 

You may experience withdrawal within several hours after your last dose because of its short half-life. Half-life is the time it takes the amount of the drug in your system to reduce by half. Half-life is used to determine how long it will take a drug to be eliminated from your body.

The intensity and severity of withdrawal depends on several factors, including the strength of your dose and how frequently you use Ativan. 

Benzodiazepine withdrawal symptoms may include:

• anxiety
• irritability
• insomnia
• restlessness
• nausea and vomiting
• panic attacks
• cognitive impairment
• seizures

Tapering your medication can help minimize the risks associated with Ativan withdrawal. Some people may not experience any withdrawal symptoms when weaning off Ativan with the help of their doctor. 

Tapering Off Ativan

Tapering should always be done under the supervision of your prescribing doctor. Tapering your prescription may take weeks or months to complete. 

Your doctor may consider the following factors when you start your Ativan tapering schedule:

• strength of dose
• frequency of use
• medical and mental health history
• history of substance abuse 

Ativan Taper Recommendations

Tapering may become difficult and your doctor will adjust your schedule to help you comfortably transition. 

Rebound Anxiety

Antidepressants and alternative sleep medications may be prescribed to help you cope with rebound anxiety, which is the abrupt return of symptoms. They may also offer psychotherapy and other psychological support.

Detox

If you take a high dose of Ativan, your doctor may consider referring you to a detox center. A detox can provide medical supervision during the difficult weaning process, especially if you are at a higher risk for experiencing withdrawal symptoms. 

Replacement Medications

Another option for tapering off high doses is switching your medication to long-acting benzos, like diazepam (Valium) or clonazepam (Klonopin). These benzos stay in your system longer and can help minimize withdrawal. 

Ativan Weaning Schedule

Ativan tapering schedules generally begin by reducing the dose by 25% during the first two weeks. Your doctor may then decrease the dose by up to 25% daily or weekly until it is discontinued. 

Your doctor may choose to pause the taper after your dose has been reduced by half to allow your body the time it needs to adjust. The taper generally resumes within 1-2 months and may be completed within 3-4 months. 

*Please consult your doctor/physician or a licensed medical professional before beginning any tapering schedule.

The following is an EXAMPLE of a tapering schedule for Ativan taken 40mg/day:

• Week 1: 35mg/day
• Week 2: 30mg/day
• Week 3: 25mg/day
• Week 4: 20mg/day
• Weeks 5-8: 20mg/day 
• Weeks 9-10: 15mg/day
• Weeks 11-12: 10mg/day
• Weeks 13-14: 5mg/day
• Week 15: discontinued

During the process, your doctor will monitor you for withdrawal symptoms and the return of anxiety or insomnia. Although a slow taper is beneficial to avoid these issues, a taper longer than six months can cause negative effects. 

Ativan Addiction Treatment

If you or a loved one has a substance use disorder related to Ativan, it may be more difficult to taper the medication. Intense cravings can interfere with the tapering schedule, increasing the risk of abusing Ativan. 

Professional treatment programs may be more beneficial for someone with Ativan addiction. These programs can help treat addiction and dependence in a supervised and supportive environment. 

Ativan addiction treatment options may include:

• detox, in which medical professionals help wean you off Ativan and cope with withdrawal symptoms 
• outpatient treatment, which provides an individualized schedule of treatment sessions per week 
• inpatient/residential treatment, which is highly structured and offers counseling, group therapy, and healthy activities
• support groups, which includes 12-step groups that support long-term recovery with like-minded peers

If you would like more information about Ativan addiction treatment options, please contact Ark Behavioral Health to learn more.