Ativan withdrawal occurs when an individual develops dependence to the drug and experiences physical and psychological symptoms when they stop using it. Ativan is a highly potent benzodiazepine drug that has strong sedative/hypnotic effects. It is used medically for the short-term treatment of anxiety, insomnia, acute seizures and sedation of hospitalized or aggressive patients. Benzodiazepines are generally used as sedatives, hypnotic (sleep-inducing), anti-anxiety, anticonvulsant and as muscle relaxants and amnesic action. Benzodiazepines are categorized as either short-, intermediate- or long-acting. Ativan is mostly used for short-term management of severe anxiety, and the FDA advises against use of benzodiazepines such as Ativan for longer than 2-4 weeks.
Abrupt, or overly rapid cessation of the drug can cause withdrawal symptoms, and Ativan withdrawal has been known to occur even after taking medically prescribed doses of Ativan for as little as one week. This is because Ativan can cause physical dependence and addiction. Short-acting benzodiazepines like Ativan is more likely to cause severe withdrawal symptoms as compared to longer-acting benzodiazepines. Severity of Ativan withdrawal symptoms is dependent on dosage and duration of use. The higher the dose and the longer the drug is taken, the greater the risk of Ativan withdrawal.
Ativan withdrawal symptoms can range from mild anxiety and insomnia to more severe symptoms such as seizures and psychosis. Common Ativan withdrawal symptoms include headaches, anxiety, tension, depression, insomnia, restlessness, confusion, irritability, sweating, dysphoria, dizziness, derealization, depersonalization, numbness/tingling of extremities, hypersensitivity to light, sound, and smell, perceptual distortions, nausea, vomiting, diarrhea, appetite loss, hallucinations, delirium, seizures, tremor, stomach cramps, myalgia, agitation, palpitations, tachycardia, panic attacks, short-term memory loss, and hyperthermia. It takes approximately 18-36 hours for Ativan to remove itself from the body.
Ativan belongs to the Food and Drug Administration pregnancy category D, which means that it is likely to cause harm to the developing baby, if taken during the first trimester of pregnancy. Regular Ativan use during late pregnancy (the third trimester), puts the unborn child at risk of Ativan withdrawal syndrome. Neonatal Ativan withdrawal may include muscle weakness, reluctance to suck, apneic spells, blue or purple coloration of the skin due to low oxygen, and impaired metabolic responses to cold stress. Neonatal Ativan withdrawal has been reported to persist from hours to months after birth. Ativan may also inhibit liver function, leading to neonatal jaundice. Ativan does pass into breast milk, so caution must be exercised when breast feeding.
Ativan is commonly abused as a recreational drug, where it is taken to achieve a high, or use is continued long term against medical advice. Individuals using the drug in this way are at risk of Ativan withdrawal, not to mention serious health consequences if mixed with other drugs or alcohol. Ativan has also been diverted and used by criminals who take the drug to deliberately seek disinhibition before committing crimes, which increases their potential for violence. The amnesia and sedative-hypnotic effects of Ativan make it a drug of choice for predators on unwitting victims as date rape drugs, or for the purpose of robbery.
A nationwide study of emergency room visits found that sedative-hypnotics such as Ativan are the pharmaceuticals most frequently used outside of their prescribed medical purpose. An estimated 35% of drug-related emergency room visits involved sedative-hypnotics, with benzodiazepines being the most commonly used. Benzodiazepines such as Ativan are the most commonly used pharmaceutical drug pharmaceutical-related suicide attempts, with 26% of attempted suicides involving benzodiazepines. Ativan was the third-most-common benzodiazepine used outside of prescription in the emergency room visit study.
Aside from Ativan withdrawal, the drug causes many adverse side effects, which are increased if combined with other drugs or alcohol. The most common side effect that is reported is sedation. Other adverse effects can include hypotension, confusion, ataxia, amnesia and hangover effects. Ativan also appears to have serious adverse effects on memory and is known to cause cognitive impairment which may or may not be reversible. Adverse effects are more common in the elderly, which are experienced at lower doses than in younger individuals. Benzodiazepines such as Ativan can also cause or worsen depression. Adverse effects from Ativan are dose-dependent, meaning the higher the dose, the stronger the effects and side effects.
Ativan, whether used medically or recreationally, is a highly potent drug that is addictive and can cause individuals to become dependent. It is important that anyone deciding to stop using Ativan seek help to get through Ativan withdrawal at a long-term inpatient drug treatment facility where professional and medically trained staff can get them through this process.