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

How much longer will it take to return to normal?

I previously took Lorazepam for over three months, and stopping the medication has caused insomnia.
It has now been three months since I stopped, and I have been experiencing insomnia for the entire duration.
This insomnia is not due to autonomic nervous system dysfunction; my symptoms related to autonomic dysregulation are limited to stomach pain, nausea, and a feeling of wanting to vomit.
However, since discontinuing Lorazepam, my stomach pain symptoms have significantly decreased.
Before taking Lorazepam, I never experienced insomnia.
The doctor who initially prescribed Lorazepam told me that taking it for a lifetime would not cause any issues.
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 concerned about how long the insomnia from stopping the medication will last.
I tapered off the medication over three weeks before stopping completely, and I wonder if that was too quick.
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 a lighter medication, but I am unsure how long it will take for me to return to my previous state.
I have read some information online stating that stopping medication can lead to poor sleep quality in the latter half of the night, which could potentially last for months or even years.
Seeing this makes me wonder how much longer I can endure this or if I need to go back 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: 2021/12/08

Dr. Tang Jiahong reply Psychiatry

Hello, after discontinuing lorazepam, the insomnia that occurs may have other possibilities, such as an exacerbation of anxiety symptoms during that period, which can trigger insomnia.
Later, if no anxiolytic medication is used, it naturally leads to the emergence of anxiety and insomnia symptoms.
Some data indicate that withdrawal symptoms (including anxiety and insomnia) after stopping lorazepam may last for 10-14 days, as noted in the following link: https://americanaddictioncenters.org/ativan-treatment/withdrawal-timeline.
Insomnia beyond this timeframe may also be influenced by individual constitution, stress, and psychological factors, making it difficult to determine causality.
It is recommended to work closely with your current physician for treatment and discuss any concerns with them.
Alternatively, you may seek assistance from a specialist in addiction psychiatry.
Thank you.

Reply Date: 2021/12/08

More Info

Recovering from insomnia after discontinuing Lorazepam can be a complex process, and the duration of recovery can vary significantly from person to person. Generally, the timeline for withdrawal symptoms, including insomnia, can range from a few weeks to several months. In your case, having been off Lorazepam for three months and still experiencing insomnia indicates that you may be dealing with a combination of withdrawal effects and possibly the return of underlying anxiety or sleep disorders that were previously managed by the medication.

When Lorazepam is discontinued, especially after prolonged use, the body may experience withdrawal symptoms, which can include anxiety, restlessness, and sleep disturbances. Research indicates that acute withdrawal symptoms typically peak within the first two weeks after stopping the medication and may last anywhere from 10 to 14 days. However, some individuals may experience protracted withdrawal symptoms, including insomnia, which can persist for months or even years, particularly if the medication was used for an extended period.

In your situation, it’s important to consider several factors that could be influencing your recovery:
1. Underlying Conditions: If you were using Lorazepam to manage anxiety or other mental health issues, it’s possible that these conditions have resurfaced after stopping the medication. This could contribute to your ongoing insomnia. It’s crucial to address any underlying anxiety or mood disorders with your healthcare provider.

2. Sleep Hygiene: Implementing good sleep hygiene practices can significantly improve your sleep quality. This includes maintaining a consistent sleep schedule, creating a comfortable sleep environment, avoiding stimulants like caffeine close to bedtime, and engaging in relaxation techniques before sleep.

3. Non-Pharmacological Treatments: Cognitive Behavioral Therapy for Insomnia (CBT-I) is a highly effective treatment for insomnia that does not rely on medication. This therapy focuses on changing thoughts and behaviors that contribute to sleep difficulties. It may be beneficial to explore this option with your healthcare provider.

4. Gradual Medication Adjustment: If your current medications (Dong Jian and Le Xin Ping) are not providing sufficient relief, it may be worth discussing with your doctor the possibility of adjusting your treatment plan. Sometimes, a different class of medications or a gradual reintroduction of a benzodiazepine under careful supervision may be necessary to stabilize your sleep while you work on other therapeutic strategies.

5. Support and Monitoring: Regular follow-ups with your healthcare provider are essential. They can help monitor your symptoms, adjust medications if necessary, and provide support as you navigate this challenging period.

In conclusion, while some individuals may see improvement in their sleep within a few weeks after stopping Lorazepam, others may experience prolonged insomnia that requires a multifaceted approach to treatment. It’s essential to maintain open communication with your healthcare provider about your symptoms and treatment options. Recovery is possible, and with the right support and strategies, you can work towards restoring your sleep and overall well-being.

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