How much longer will it take to return to normal?
I have been experiencing insomnia for three months after discontinuing Lorazepam, which I had been taking for over three months.
This insomnia is not caused by autonomic nervous system dysfunction; my symptoms of autonomic dysregulation are limited to stomach pain, nausea, and vomiting.
However, since stopping Lorazepam, my stomach pain has significantly decreased.
Prior to taking Lorazepam, I never had issues with insomnia.
The doctor who originally prescribed Lorazepam told me that taking it for a lifetime would not cause any problems.
When I asked my current doctor, he expressed confusion about my symptoms and questioned why the previous doctor recommended long-term use of Lorazepam.
He mentioned that there are many alternative medications available.
I am uncertain how long the insomnia after discontinuation will last.
I tapered off the medication over three weeks before stopping completely, and I'm not sure if that was too fast.
Currently, I am taking one-third of the dosage of Dong Jian and Le Xin Ping, 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.
The doctor I am currently seeing believes that my condition will gradually improve, so he prescribed lighter medications, but I am unsure 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 Hao, 30~39 year old female. Ask Date: 2021/12/01
Dr. Dai Wanxiang reply Psychiatry
Hello, Xiaohao: Long-term use of anxiolytics or sleep medications may lead to increased tolerance and dependence.
If your insomnia improves for more than 1-2 weeks, you may consider gradually tapering the dosage.
It is generally recommended to reduce the dosage by 1/4 to 1/5 over a period of 1-2 weeks.
In the initial phase of tapering, if you experience mild withdrawal symptoms (such as anxiety or insomnia) for 1-3 days, these may alleviate as you adapt.
Additionally, aside from using sleep medications, you can improve your insomnia through non-pharmacological methods, including sleep hygiene practices, sleep restriction therapy (to enhance sleep efficiency), and pre-sleep muscle relaxation training to create a conducive state for mental and physical relaxation.
The details of sleep restriction therapy and muscle relaxation training are extensive and may require practical guidance, which you can find through online resources like Google or YouTube.
You may also discuss with your psychiatrist about treating insomnia through both pharmacological and non-pharmacological approaches.
Wishing you well.
Reply Date: 2021/12/01
More Info
Recovering from insomnia after discontinuing Lorazepam can be a challenging process, and the duration of recovery varies significantly from person to person. Generally, withdrawal symptoms from benzodiazepines like Lorazepam can last anywhere from a few days to several weeks. However, in your case, since you have been experiencing insomnia for three months after stopping the medication, it is essential to consider several factors that may be influencing your recovery.
Firstly, Lorazepam is a benzodiazepine that is often prescribed for anxiety and sleep disorders. When used for an extended period, the body can develop a tolerance to the medication, meaning that over time, higher doses may be required to achieve the same effect. Upon discontinuation, withdrawal symptoms, including insomnia, anxiety, and other physical symptoms, can manifest as the body readjusts to functioning without the drug. The acute withdrawal phase typically lasts about 10 to 14 days, but lingering effects, such as insomnia, can persist for weeks or even months, especially if the medication was used for an extended period.
In your situation, it is crucial to assess whether the insomnia is purely a withdrawal symptom or if it is related to underlying anxiety or other psychological factors that may have been masked by the medication. It is not uncommon for individuals to experience a rebound effect, where the original symptoms that led to the prescription of Lorazepam resurface after stopping the medication. This could explain why you are experiencing insomnia now, even though you did not have issues with sleep prior to taking the medication.
You mentioned that you have been prescribed alternative medications and are currently taking a lower dose of other medications. It is essential to communicate openly with your healthcare provider about your symptoms and concerns. They may recommend a gradual tapering of any remaining medications or suggest alternative treatments, such as cognitive-behavioral therapy (CBT) for insomnia, which has been shown to be effective in treating sleep disorders without the use of medications.
In terms of how long it may take to recover, some individuals may start to see improvements in their sleep patterns within a few weeks, while others may take several months to return to their baseline sleep quality. Factors such as stress levels, overall mental health, and lifestyle changes (such as sleep hygiene practices) can significantly influence recovery time. It is also worth noting that some individuals report persistent sleep disturbances for months or even years after discontinuing benzodiazepines, although this is less common.
To support your recovery, consider implementing good sleep hygiene practices, such as maintaining a consistent sleep schedule, creating a relaxing bedtime routine, and ensuring your sleep environment is conducive to rest. Avoiding stimulants, such as caffeine and nicotine, especially in the hours leading up to bedtime, can also be beneficial.
In conclusion, while the timeline for recovery from Lorazepam withdrawal insomnia can vary, it is essential to work closely with your healthcare provider to monitor your symptoms and adjust your treatment plan as needed. With patience and appropriate support, many individuals can eventually regain their ability to sleep well without the need for benzodiazepines. If your symptoms persist or worsen, do not hesitate to seek further evaluation from a specialist in sleep medicine or psychiatry.
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