Ativan questions and help, please


I need some help. I was given ativan by my psychiatrist I have bad health anxiety and general anxiety. I have been take a very small dose. I take a 1/4 of a .5 mg and I’ve started taking it every few days then he said to take it everyday, I’ve been taking it evey day for 5 days now and I think I’m having some effects from it, within an hour of taking it I get a headache and sore and tight muscles in the back of my neck and a feeling of deep breathing, I don’t know if these are the pills or my anxiety. I 'm scared to death of all these meds, I’ve read so many bad things about this med. I am wondering do I know need to taper off this and how? I started on the med on Oct 15th of this month and took it every 2 or 3 days then the doc said to take daily, but only taking it for 5 days straight as of today, I don’t know how to taper. its such a low dose I don’t know if I should just stop or take or cut the 1/4 pill into 1/2 of the quarter for a day or 2 then stop. I used to take xanax when needed and I didn’t have all these side effects but the doc doesn’t want me taking the xanax. I tried mirtazapine and had swelling issues with it, then trazaone and had dizziness with it, so he said ativan. Can someone please help. I’m really worried about what this med can do to you if taken long term. He hasn’t told me how long I’m suppose to take it. can someone please help. Thank you

Moderator Action

Since this concerns a real world medical issue, let’s move it to IMHO (from GQ).

Klonopin survivor here.

I don’t know anything about Ativan (Lorazepam) specifically… But it’s in the class of benzodiazipines, of which there are at least a dozen common drugs, maybe more. They all have different detailed characteristics.

One common feature of benzos — all of them, maybe more so for some than other — is their addictiveness. They may be well and good for short-term anxiety, insomnia, or whatever else they are supposed to treat. For long-term usage, not so good. Over time, all these drugs tend to cause habituations and dependency. Whatever dose you are using will, over time, become less effective, and you will need to increase the dosage ad infinitum to maintain the same effect.

When that eventually starts happening, you might decide that it’s just not working anymore, and with all due regrets, you’ll feel you need to quit. When that happens, prepare your soul for gruesome torture.

They say that quitting a benzo is tougher than kicking a heroin habit. A typical residential heroin rehab program runs four weeks. They will do the same for kicking benzos, but it’s not enough. Figure on it taking at least six weeks. At least. Benzo withdrawal is nasty and can take six weeks, or six months, or (in my case) 18 months :eek: and even after that I didn’t feel quite right for another two years. And I was only taking 0.5 mg of Klonopin twice a day, a small fraction of the prescribed dosage!

All drugs come with a “package insert”, a detailed and technical description of the drug that you’ll need a medical dictionary and a strong magnifying glass to read. Most pharmacists won’t give you that unless you ask, so ask. There will usually be a section suggesting a schedule for tapering off. If you need to do that, my advice is: Taper off much slower and more gradually than even what they suggest. For really small doses, try dissolving a half (or quarter) tablet in water, stir well, and drink only a portion of that. You can get really small and fairly well-measured doses that way.

Don’t trust your doctors to know this shit. I consulted with six of them over the time I was trying to kick the habit. Not one of them knew anything about benzos beyond some basic generic stuff. One on them (well after the fact), upon hearing what a small dose I had been using, told me that I should have just quit cold-turkey. Well, that’s what I did, with gruesome long-lasting withdrawal results as described above. Nobody understands how long-lasting the withdrawal can last for some people.

Here’s somebody who does understand: Professor Heather Ashton (long retired), at a teaching hospital, ran a benzo detox rehab for a dozen years. She wrote this paper:
Benzodiazepines: How They Work and How To Withdraw (TL;DR: Basically what I said: Very gradually and even then be prepared to be miserable.)

The above paper is found on this web site:, a British-based support site for benzo users. I suggest studying that. Also, google for whatever you can find on benzos and Ativan in particular. You’ll find plenty.

As for me: I ended up living with relatives for 8 months and then in a board-and-care home for another 8 months, I was so debilitated by the withdrawal problems. That was over 10 years ago. Since then, I’ve gotten over it. I’ve managed to keep my chronic anxiety and depression mostly down to sub-thermonuclear levels somehow (don’t ask me how!). Benzos seems to be falling out of favor — my HMO won’t use it, and I think Medicare doesn’t cover it. If I ever get a serious bout of anxiety or depression I’ll just buy a bottle or several of my favorite vino to deal with it (and yes, that’s happened and not hypothetical).

You’re taking 1/4 of a half milligram tablet? I can’t imagine that is doing anything at all. I’ve never heard of a dose that small. I have been prescribed 2 mg tablets in the past, but my current Rx is only 1 mg. BUT…my doctors have always stressed this is for occasional use only. The onset of a panic attack or if I know I am going into a situation that will cause one or at least cause severe anxiety. I have always been cautioned against daily use for Ativan.

A bit more: One of the nasty withdrawal effects is some really intense insomnia, among other nasty effects.

Pretty much every one of those doctors I consulted offered me a different pill that was supposed to mitigate the side effects, and help me sleep in particular. The most common result was that those pills worked fairly well for one to three days, then stopped working. At one time or another, I tried hydoxyzine (a close relative of Benadryl); clonidine (an alpha-blocker, usually used for blood pressure control); trazadone; and yes, Mirtazipine (a.k.a. Remeron).

The mirtazipine really knocked me out and seemed to keep on working (just what I wanted of course) but began to have weird side effects after a couple weeks. I quit that, and then the insomnia reappeared with a vengeance! And the weird side effects didn’t go away either.

I am a doctor, I do prescribe ativan (mainly for end of life patients in a hospice setting) and I’ve managed folks through benzodiazepine withdrawal many times.

Having said that, I’m not your doc, I’ve not taken your history nor examined you. So I am speaking in general terms only.

I would not be worried about stopping ativan abruptly in someone who was only taking 0.125 mg once a day for less than two weeks. I would doubt that any habituation or physical dependence has occurred at all in that time frame.

However, whether you should be on this type of medication, and how much and for how long is not something I’m able to help much with, other than to say I think this med is a risky one for anyone with any history of substance abuse or past addiction issues.

You need to be asking your prescriber these questions that you’re asking us here.

Yes, mine is for .5 mg only when I am panicky or know I will become so. I am to take one and if I don’t fall asleep in a short amount of time, one more. But it is for occasional use only, not for daily use.

I have such severe anxiety that I haven’t worked in two years. (I started a job today!)

My doctor will give me 4 .5mg pills a month - only to manage episodes. Worried about the benzo addiction.

Buspar might be a better choice. I don’t take it, but a friend does.


I just started taking Buspar a bit back to augment Zoloft, it seems to fix all of the side effects of Zoloft and boost its efficacy, with none of the addiction potential or lethargy that benzodiazepines provide. I specifically asked for something different that the likes of ativan, since I did not like how it made me feel. As for OP, Not a doctor here, but I agree with not worrying so much about addiction from such a small amount. I used to notice that taking new drugs would trigger anxiety attacks/panic with myself with similar symptoms that you describe. Since you were taking such a small dose, it likely didn’t have any effect other than psychosomatic, and negative. Try Buspar (Buspirone), starts to work after a few weeks, but is a great alternative and if you don’t have coverage for prescriptions, its pretty cheap.

All the best to you!!

Patty818, just 1/4 of a .5mg pill? I thought .5mg was the smallest dosage one could take. Or you cutting it in quarters? With that small of dosage, don’t think I’d be too overly concerned.

It’s the only prescription pill we give my 86 year dad who has severe dementia. We use it to help him with occasional anxiety and for sleep. We cut the .5mg pill in half in the morning, and give him a full tablet of .5mg at night. We’ve tried to wean him off of it completely before, as we did completely about a dozen other drugs, and he’s far better off without them. But for a little over a year now, it’s probably our best route to at least keep him on the antivan, and a handful of vitamins our Dr. recommended.

Seems like the only side effect we have noticed is that he digs in with his fingers on his pants or shirt sleeves, we keep him in long sleeve shirts because of this. Whether it’s related to the antivan or his severe dementia, we don’t know.