From the Guidelines
No, you should not abruptly stop taking Ativan (lorazepam) 0.5mg even after just a couple of weeks of use. Instead, you should work with your healthcare provider to create a tapering schedule to gradually reduce your dose. A typical taper might involve reducing your dose by 25% every 1–2 weeks, as suggested by a commonly used tapering schedule 1. Stopping benzodiazepines like Ativan abruptly can lead to withdrawal symptoms such as anxiety, irritability, insomnia, tremors, and in severe cases, seizures. This happens because your brain adapts to the presence of the medication, and sudden removal can cause rebound hyperactivity in your nervous system. Even at a relatively low dose like 0.5mg and a short duration of a couple weeks, physical dependence can still develop, making a gradual taper the safer approach to discontinuation. Some key points to consider when tapering benzodiazepines include:
- Gradually reducing the dose to minimize withdrawal symptoms
- Working with a healthcare provider to determine the best tapering schedule
- Being aware of the potential risks of abrupt withdrawal, including rebound anxiety, hallucinations, seizures, delirium tremens, and, in rare cases, death 1
- Considering the use of evidence-based psychotherapies, such as cognitive-behavioral therapy (CBT), to support the tapering process 1. It's also important to note that the most recent guidelines, such as the 2022 CDC clinical practice guideline for prescribing opioids for pain, emphasize the importance of gradual tapering of benzodiazepines to minimize the risk of withdrawal symptoms and other adverse effects 1.
From the FDA Drug Label
The continued use of benzodiazepines, including lorazepam may lead to clinically significant physical dependence. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose. Abrupt discontinuation or rapid dosage reduction of lorazepam after continued use may precipitate acute withdrawal reactions, which can be life-threatening To reduce the risk of withdrawal reactions, use a gradual taper to discontinue lorazepam or reduce the dosage
- Do not stop taking Ativan (lorazepam) 0.5mg abruptly after taking it for a couple of weeks.
- Gradual tapering is recommended to reduce the risk of withdrawal reactions, which can be life-threatening.
- The risk of dependence and withdrawal increases with longer treatment duration and higher daily dose 2, 2, 2.
From the Research
Stopping Ativan (Lorazepam) Abruptly
- It is generally not recommended to stop taking Ativan (lorazepam) abruptly, especially after taking it for a couple of weeks 3, 4, 5, 6.
- Ativan is a benzodiazepine, which can cause withdrawal symptoms when stopped abruptly, including anxiety, shaking, nausea, insomnia, and excessive sweating 7, 5.
- Studies suggest that gradually tapering off benzodiazepines, such as Ativan, can minimize withdrawal symptoms and reduce the risk of rebound effects 4, 5, 6.
- A tapering schedule of reducing the dosage by 0.25 mg per week has been recommended for clonazepam, another benzodiazepine, and may be applicable to Ativan as well 5.
- It is essential to consult a healthcare professional before stopping or tapering off Ativan, as they can provide guidance on the best course of action and help manage any potential withdrawal symptoms 3, 6.
Risks of Abrupt Discontinuation
- Abruptly stopping Ativan can lead to severe withdrawal symptoms, including seizures and psychosis, especially in individuals who have been taking the medication for an extended period 3, 7.
- Withdrawal symptoms can be mistaken for a recurrence of the underlying disorder, leading to unnecessary long-term medication 4.
- Gradual tapering can help minimize the risk of withdrawal symptoms and ensure a safer discontinuation process 4, 5, 6.
Consultation with a Healthcare Professional
- It is crucial to consult a healthcare professional before stopping or tapering off Ativan, as they can provide personalized guidance and support throughout the process 3, 6.
- A healthcare professional can help determine the best tapering schedule and provide monitoring and management of potential withdrawal symptoms 5.