How Long Will It Take to Recover from Lorazepam Withdrawal Insomnia?

Q: How Long Will It Take to Recover from Lorazepam Withdrawal Insomnia?

Hello： After discontinuing Lorazepam, insomnia symptoms may appear. <br>If this is solely due to withdrawal from the medication, most cases will improve within a few weeks. <br>It is important to assess the original reason for using Lorazepam, as it may also indicate a worsening

How much longer will it take to return to normal?

I have been experiencing insomnia for three months after discontinuing Lorazepam, which I was taking for over three months.
This insomnia is not caused by autonomic nervous system issues; my symptoms of autonomic dysfunction were limited to stomach pain, nausea, and vomiting.
However, since stopping Lorazepam, my stomach pain has significantly decreased.
Before taking Lorazepam, I never had insomnia.
The doctor who initially prescribed Lorazepam told me that taking it for a lifetime would not cause any harm.
When I asked my current doctor, he expressed confusion about my symptoms and questioned why my previous doctor recommended long-term use of Lorazepam.
He mentioned that there are many alternative medications available.
I am unsure how long the insomnia after discontinuation will last.
(I tapered off the medication over three weeks and wonder if that was too quick.) Currently, I am taking one-third of the doses of Dong Quai and Loxoprofen, but I can only sleep for 2 to 3 hours before waking up.
Although I can lie down and fall back asleep, I feel increasingly fatigued, and I lack energy during the day.
My current doctor believes that my condition will gradually improve, so he prescribed lighter medications, but I am uncertain how long it will take to return to my previous state.
I have read online that discontinuation can lead to poor sleep in the latter half of the night, and it may persist for months or even years.
Seeing this information makes me wonder how much longer I can endure this or if I should return to taking Lorazepam.
I hope the doctor can provide me with some answers, and I would be very grateful.

Xiao Cheng, 30~39 year old female. Ask Date: 2021/11/29

Dr. Cai Qijin reply Psychiatry

Hello: After discontinuing Lorazepam, insomnia symptoms may appear.
If this is solely due to withdrawal from the medication, most cases will improve within a few weeks.
It is important to assess the original reason for using Lorazepam, as it may also indicate a worsening of pre-existing psychiatric symptoms or rebound symptoms.
It is recommended to consult a psychiatrist to evaluate whether it is necessary to resume the use of benzodiazepines (BZD).
Even if you do resume use, there is no need for excessive concern, as these medications have a high safety profile, and the side effects of other medications (such as those you are currently taking) may not necessarily be less.
Non-pharmacological treatments for insomnia, such as sleep hygiene, stimulus control therapy, and cognitive-behavioral therapy, should also be considered.

Reply Date: 2021/11/29

More Info

Recovering from insomnia after discontinuing Lorazepam (Ativan) can be a challenging process, and the duration of recovery varies significantly among individuals. Generally, the timeline for withdrawal symptoms, including insomnia, can range from a few weeks to several months, depending on various factors such as the duration of use, dosage, individual physiology, and underlying mental health conditions.

When Lorazepam is used for an extended period, as in your case of over three months, the body can develop a tolerance to the medication. This means that over time, the same dose may become less effective, leading to increased dosages or prolonged use. Upon cessation, withdrawal symptoms can manifest, including anxiety, restlessness, and insomnia. Research indicates that withdrawal symptoms can peak around 10 to 14 days after stopping the medication, but lingering effects, particularly insomnia, can persist for weeks or even months.

In your situation, you have already been off Lorazepam for three months, and the insomnia continues to be a significant issue. It’s important to recognize that the insomnia you are experiencing may not solely be due to withdrawal but could also be exacerbated by underlying anxiety or stress that may have been managed by the medication. The fact that you did not experience insomnia prior to taking Lorazepam suggests that your body may still be adjusting to the absence of the medication, and your anxiety symptoms may have returned or intensified.

Your current treatment regimen, which includes lower doses of other medications, may not be sufficient to address your insomnia effectively. It’s crucial to have an open dialogue with your healthcare provider about your symptoms and treatment options. They may suggest alternative medications that are less habit-forming or non-benzodiazepine options that can help manage your sleep issues without the risks associated with long-term benzodiazepine use.

In addition to pharmacological treatments, non-pharmacological approaches can be beneficial. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a highly effective treatment that focuses on changing sleep habits and misconceptions about sleep. Techniques such as sleep hygiene education, stimulus control therapy, and relaxation techniques can significantly improve sleep quality and duration.

As for the timeline for recovery, while some individuals may start to see improvements in their sleep patterns within a few weeks, others may take several months to fully recover. It’s essential to be patient with yourself during this process. If you find that your symptoms are not improving or are worsening, it may be worth discussing the possibility of reintroducing a benzodiazepine under careful supervision or exploring other medication options that your current physician may recommend.

In conclusion, the recovery from Lorazepam withdrawal insomnia can take time, and it is influenced by multiple factors. Regular follow-ups with your healthcare provider, adherence to a structured treatment plan, and incorporating behavioral strategies can enhance your chances of regaining restful sleep. Remember, you are not alone in this journey, and seeking support from healthcare professionals can make a significant difference in your recovery process.

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