Can Tapering Off Ativan Cause Withdrawal Symptoms?

Video Transcript

Can tapering off a .5 milligram dose of Ativan daily cause withdrawal symptoms? My doctor didn’t think so because he said the dose was so small. But I am having a lot of symptoms, such as restless sleep, shakiness, brain and head sensations, and so on.

Yes, tapering off a .5 milligram dose of Ativan daily can cause withdrawal symptoms.

Ativan is a benzodiazepine medication that can quickly create physical dependence even when used as directed. That’s because benzo medications affect GABA (Gamma-Aminobutyric Acid), the primary inhibitory neurotransmitter responsible for calming the body.

When a benzo is taken, it interferes with how the body naturally produces and processes GABA. Consequently, the body loses its natural ability to completely calm itself when a benzo is taken regularly.

Then, when a benzo medication is reduced and eventually withdrawn, the body isn’t as resilient to stimulation until it has had time to restore GABA to its normal level, which can take a few to several weeks after the benzo has been stopped. Therefore, tapering off even a low dose of Ativan can cause withdrawal symptoms.

Common symptoms of Ativan withdrawal include increased feelings of anxiety, irritability, insomnia, sweating, trembling/tremors, restless legs, muscle cramps, nausea, seizures, brain and head sensations, and so on.

Discontinuing a benzodiazepine medication requires a slow taper so the body has sufficient time to adjust. However, too long of a taper can prolong withdrawal symptoms. It’s important to follow the correct tapering and discontinuation process.

We recommend talking with a pharmacist about the correct tapering protocol. However, even with a correct tapering protocol, most people experience benzo withdrawal and cessation symptoms.

On average, you can expect withdrawal symptoms while tapering off the benzo and at least four weeks of withdrawal symptoms after stopping the benzo.

In the meantime, it can be a rough ride. The symptoms you mentioned are common for benzo withdrawal.

It’s important to remember you should never stop a benzodiazepine medication abruptly. Stopping cold turkey can cause a major upset. Always follow a proper tapering and discontinuation protocol.

Moreover, .5 milligrams of Ativan daily might not seem a lot to your doctor. However, that dosage is sufficient to cause problems with discontinuation because of how it affects the body’s ability to produce and process natural GABA.

The frequency and length of time taking a benzo can also play a role in the severity of withdrawal symptoms. For example, taking .5 milligrams of Ativan off and on for only a couple of weeks might not produce many withdrawal symptoms during the discontinuation process.

However, most people have some difficulty withdrawing when Ativan has been taken daily for more than three weeks. This difficulty can range from slight to significant. So, if you’ve taken your benzo regularly for more than three weeks, be prepared for anything.

This is not to say you will have difficulty withdrawing, but that there is a strong likelihood. Since each body has a unique chemical makeup, each withdrawal process can be different.

Nevertheless, once your body has had time to clear the benzo (usually around four weeks), you should see some stabilization.

Working with an experienced anxiety disorder therapist during this time can be helpful, as ongoing reassurance can make a significant difference during the discontinuation process.

Fortunately, benzodiazepine medications don’t generally leave lasting negative effects once they have been stopped and the body has had sufficient time to recover and stabilize. Once your body has cleared it, you should be fine.

However, it’s important to recognize that anxiety symptoms can return if you haven't addressed your underlying factors. If you see a rebound of anxiety symptoms after your body has cleared the benzo, that usually means you have some unaddressed underlying factors.

Dealing with anxiety’s underlying factors eliminates the potential for a rebound into troublesome anxiety and symptoms. Working with an experienced anxiety disorder therapist is the most effective way (and often the only way) to gain lasting freedom from anxiety disorder and its symptoms.