Q. How to deal with panic attacks during Ativan withdrawal after using it for six weeks?

Answered by
Dr. Seikhoo Bishnoi
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 07, 2023

Hello doctor,

I need help with an Ativan taper from a psychiatrist. I am having Ativan taper withdrawal for six weeks and it is 0.5 mg at bedtime for insomnia. I have a history of panic from the same medicine 30 years ago and a bad experience with Xanax 10 years ago. Currently, I am on Ativan 0.5 mg, and Mylanta. It is my belief that a psychologist cannot help me. Can I consult with a psychiatrist?



Welcome to

Thank you for your query.

Please elaborate on your issue in detail. Ativan is Lorazepam and it is a short-acting benzodiazepine drug. The dose 0.5 mg is very less and if you want to stop the drug then this can be stopped. For episodic exacerbations, the drug can be used as needed. If you are having panic attacks and anxiety then either the doses have been reduced rapidly or this could be a relapse of anxiety.

I hope this has helped you.

Thank you.

Hello doctor,

Thank you for the reply.

I must have built a tolerance because it stopped gelling at sleep a few weeks ago. There were five times in the past six weeks that I took a second one the night. Also was taking Dramamine for nausea. Every time I tried to stop, when I get to the second night I woke up with my heart racing and hands trembling. I did not have anxiety prior. It was prescribed for insomnia from a shift change at work. However, I now have anxiety from the medicine. The doctor told me to take half at dinner and then Melatonin at bedtime. Woke up two hours in a panic. Should I restart the original dose and do a 25 % taper as recommended here?



Welcome back to

If you have multiple episodes of panic then I think for some time you can increase the dose again and then very gradually reduce the dose. I advise my patients to reduce the dose by 25 % every week and once the dose is very less like 0.25-0.5 mg then make the drug on alternate days or sos (if there is a need) followed by complete stoppage. In most individuals, withdrawal symptoms are prevented. But if your anxiety persists then I think there is a need to take an anti-anxiety drug for reducing the symptoms. If Melatonin is helping you then you can continue to take or if it is not helping then you can stop. For how long have you been taking Lorazepam? If the duration is less than four weeks then the chances of withdrawal are very rare.

I hope this has helped you.

Thank you.

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