Ativan: How Long Does It Last?

Ativan: How Long Does It Last?

The clinical effects of Ativan typically last 6–8 hours after a single oral dose. It stays in your system longer, though. Ativan can be detected on a urine test for up to 5 days after the last time it was taken. Although Ativan works well for anxiety due to its calming effect, it can also be dangerous. As a schedule IV controlled substance, it carries the risk of abuse, addiction, and physical dependence. With this comes the related risks of Ativan withdrawal and overdose.

What Is Ativan?

Ativan is the brand name of a drug known as lorazepam. Lorazepam is a member of a class of drugs called benzodiazepines. Ativan is FDA-approved to treat anxiety disorders. [1] It is sometimes used to treat insomnia and short-term situational anxiety.

Ativan, like other benzodiazepines, carries the risk of abuse and addiction if not taken as prescribed. For this reason, the U.S. Drug Enforcement Administration has classified it as a Schedule IV controlled substance. [2] Taking Ativan without a prescription or sharing your prescription is illegal and can result in criminal charges. However, felony charges such as drug trafficking usually involve intent to distribute or larger quantities.

What Does Ativan Do?

Ativan works by slowing down the central nervous system, which has a calming effect for those with anxiety disorders, who may have increased activity in the central nervous system.[3] Although the peak time for blood concentration is about 2 hours after the initial dose, you may begin to feel the effects of Ativan sooner. [4]

Side Effects of Ativan

As with other prescription medications, you can expect to experience some side effects when you first start taking Ativan. These can range from mild to severe.

Common Ativan Side Effects

Common Ativan side effects include: [5]

• Sedation
• Drowsiness
• Dizziness
• Weakness
• Unsteadiness

If these side effects are severe or persist for more than a few days, consider contacting your healthcare provider.

Serious Ativan Side Effects

Some Ativan side effects are more serious than others. You should contact your doctor immediately if you experience any of the following side effects of Ativan: [6]

• Changes in vision
• Confusion
• Aggression
• Hallucinations
• Becoming unusually talkative
• Sudden restlessness
• Sudden excitement
• Extreme drowsiness
• Insomnia
• Depression
• Seizures
• Yellowing of the eyes
• Yellowing of the skin
• Mood swings
• Suicidal thoughts
• Thoughts of self-harm

Signs of Ativan Addiction

Because of the risk of addiction and physical dependence, it’s important to take Ativan only as prescribed. Never take more than the recommended dose, even if you feel like the drug isn’t having the intended effect.

Even if you take Ativan exactly as prescribed, there’s a chance that you could develop an addiction, also known as substance use disorder. If you think you’re becoming addicted to the medication, tell your doctor right away. The following signs may indicate an addiction to Ativan: [7]

• Strong cravings
• Difficulty controlling how much Ativan you take
• Needing more of the medication to have the intended effect (i.e., building tolerance)
• Experiencing withdrawal symptoms when not taking Ativan

Ativan Withdrawal Symptoms

If you stop taking Ativan abruptly without tapering the dose, you may experience withdrawal symptoms as your body gets used to functioning without the medication. Some Ativan withdrawal symptoms include: [8]

• Unusual involuntary movements
• Anxiety
• Depersonalization
• Derealization
• Nausea
• Vomiting
• Panic attacks
• Memory problems
• Muscle pain and stiffness
• Headache
• High blood pressure
• Restlessness
• Tremor
• Psychosis
• Seizures
• Suicidal thoughts
• Delirium tremens

Because some of these withdrawal effects can be life-threatening, it’s important to contact a healthcare professional or rehabilitation center before stopping Ativan use. Medical detoxification may be necessary.

Protracted Withdrawal Syndrome

Benzodiazepines like Ativan have been linked to a condition known as protracted withdrawal syndrome. Protracted benzodiazepine withdrawal symptoms have been reported to persist for several months in rare cases, though most patients improve significantly within weeks. Symptoms of protracted withdrawal syndrome associated with Ativan use or misuse include: [9]

• Insomnia
• Tremor
• Muscle twitches
• Anxiety
• Cognitive impairment

Ativan Overdose Symptoms

Like other benzodiazepines, Ativan is a central nervous system depressant. It slows your breathing, and, at higher doses, it can lead to coma or death. Most cases of fatal Ativan overdoses occur when Ativan is mixed with another CNS depressant, like alcohol or opioids. If you or a loved one takes Ativan, it’s important to know the signs of an overdose: [10]

• Drowsiness
• Confusion
• Weakened reflexes
• Hypnotic state
• Loss of coordination
• Slowed breathing
• Coma

If a loved one is experiencing any of the severe signs of Ativan overdose listed below, call 911 or go to the nearest emergency room. You can also call the poison help line.

How Long Does Ativan Stay in Your System?

Ativan begins working almost immediately after you take it, and you may continue feeling the effects for up to eight hours. Peak concentrations occur approximately two hours after administration. The half-life of Ativan, however, is between 10 to 20 hours, depending on the individual. [11] Generally, it takes about 5-6 times the half-life of a drug for it to leave the system entirely. Thus, Ativan can stay in your system for 60-72 hours on average.

Ativan Detection Times

Even after 72 hours, Ativan metabolites can still linger in the body. This is how it’s detected on drug tests. In urine, for example, Ativan can be detected up to five days after your last dose. [12] Xanax (alprazolam) may be detected in urine for up to 4 days, but detection times can vary and are not necessarily identical to Ativan. In a saliva test, Ativan can be detected for up to 8 hours. [13] The drug may remain in hair samples for much longer.

Natural Ativan Alternatives

If you have a history of substance abuse or addiction (whether personally or within your family), you may want to avoid taking Ativan. There are natural alternatives to consider, which could have a similar effect on conditions such as anxiety and insomnia. Some of these alternatives include:

• Herbal supplements like ginkgo biloba, valerian root, or ashwagandha
• Dietary supplements like magnesium and vitamin B6
• A regular exercise routine
• Good sleep hygiene
• A nutritious diet that includes whole grains, lean proteins, and leafy greens
• Deep breathing exercises (e.g, box breathing, alternate nostril breathing, pursed lip breathing, etc.)
• Yoga or tai chi
• Journaling
• Grounding techniques
• Mental health therapy, such as cognitive behavioral therapy (CBT)
• Meditation
• Mindfulness practices
• Relaxation techniques such as progressive muscle relaxation
• Guided imagery and visualization tools

Natural alternatives may help manage anxiety symptoms, but they are not proven to be as effective as benzodiazepines like Ativan in controlled clinical settings. Be sure to tell your doctor before starting any new supplements or exercise routines.

Ativan Addiction Treatment

If you or a loved one is showing signs of an addiction to Ativan or other benzos, consider a drug treatment program. Benzodiazepine withdrawal can be dangerous and potentially life-threatening, particularly if seizures or delirium tremens occur, though this is more common in high-dose or long-term users. Therefore, it’s not safe to detox at home. With treatment, you can overcome an Ativan addiction.