Ativan and Xanax may both be benzodiazepine drugs, but there are key differences between each medication and what they may be used to treat.
Ativan vs Xanax
Benzodiazepines, also known as benzos, are a class of sedative drugs used to treat anxiety, panic disorders, muscle spasms and seizures. Currently, Ativan (lorazepam) and Xanax (alprazolam) are two of the most commonly prescribed benzodiazepines. There are many similarities between the two medications, including what they are used to treat and how they affect the body. However, there are also some key differences.
The similarities and differences between Ativan and Xanax include:
|Drug Schedule||Schedule IV||Schedule IV|
|Uses||Anxiety, procedural anxiety, epilepsy||Anxiety disorders|
|Dosage||0.5 mg to 2 mg every four to six hours as needed (max 10 mg/day)||0.25 mg to 4 mg every four to six hours (max 10 mg/day)|
|Short-term or Long-term Use||Short-term||Short-term|
|Side Effects||Sedation, dizziness, weakness, unsteadiness||Drowsiness, lightheadedness|
|Warnings||High potential for abuse, can affect the liver and kidneys, tolerance may develop quickly, should not be used in older patients||High potential for abuse, can affect the liver and kidneys, tolerance may develop quickly, should not be used in older patients|
|Drug Interactions||Alcohol and other CNS depressants||Alcohol and other CNS depressants|
Similarities Between Ativan and Xanax
Ativan and Xanax both affect a chemical messenger of the brain called gamma-aminobutyric acid (GABA). GABA helps regulate communication between nerve cells in the brain. Benzos enhance GABA’s effects and reduce the activity of nerves in the brain to produce a relaxing effect on the mind and body.
Since Ativan and Xanax have similar effects on the body, they are often prescribed for similar reasons. For example, they may be used as a short-term treatment for anxiety.
Both medications have a number of side effects, including:
- Dry mouth
- Blurred vision
- Changes in appetite
- Low blood pressure
- Muscle weakness
- Problems with memory
- Loss of balance or coordination
If you are taking Ativan or Xanax, you should not drive or operate heavy machinery because many of these side effects can impair alertness.
Benzos like Ativan and Xanax can be addictive if used in excess or over an extended period of time. Ending use abruptly can cause dangerous withdrawal symptoms, including:
- Heart problems
Due to the potential for abuse and addiction, these drugs are only prescribed for short-term use and given in the lowest doses necessary.
Ativan vs Xanax: Differences
The most significant difference between Xanax and Ativan is the way each medication is processed by the body. Ativan has a slightly longer active time than Xanax, as Ativan’s effects peak within two to six hours after consumption. Once Xanax is consumed, its effects peak within one to two hours.
The half-life of each substance, or the amount of time required for a drug’s concentration to be reduced by half in the body, also varies significantly. The average half-life of Ativan is 10–20 hours, while the average half-life of Xanax typically falls between 12 and 15 hours.
What They Treat
Both Ativan and Xanax are used to treat anxiety, but these medicines can also be used for other reasons. For example, Ativan is also approved for use as a pre-surgery sedative.
Both drugs have several off-label uses for other conditions or problems, including:
- Mania from bipolar disorder
- Vomiting from chemotherapy
- Alcohol withdrawal symptoms
Ativan vs Xanax: Side Effects
Although Ativan and Xanax have many of the same side effects, some side effects of Xanax differ from those of Ativan. These include:
Ativan vs Xanax: Which is Better?
Each medication is extremely similar in medical situations. The primary difference is how long they work in the body, so each has different situations where they may work best. For example, Xanax is used more often for panic attacks because it has a very quick onset and wears off quickly. Ativan is often used in situations that require several hours of sedation, such as when someone is agitated or about to begin a medical procedure.
If you or someone you love is struggling with benzodiazepines like Ativan or Xanax, Xanax Online Center can help. We offer a full continuum of care that can address benzo addiction as well as co-occurring mental health disorders like anxiety. Contact us today to learn more about treatment programs that can work well for your situation.
Which one works quicker?
Xanax is usually more quickly absorbed than Ativan with peak concentrations occurring within 1-2 hours following administration, compared to 2 hours for Ativan.1,2 Effects of Xanax last on average 4 to 6 hours although there are wide variations between individuals (see below). Effects of Ativan last approximately 8 hours, although may persist for longer in some people.1,2
How much Xanax equals 1mg of Ativan?
Benzodiazepine equivalency tables state that 0.5mg of alprazolam (Xanax) is approximately equivalent to 1mg lorazepam (Ativan).3 However, people of Asian descent metabolize Xanax differently to people of other races, and certain disease states such as alcoholism, liver and kidney disease, obesity and even old age can affect how Xanax behaves in the body; so benzodiazepine equivalency tables should be used as a guide only as they do not reflect individual variation.1,2,3 Both Ativan and Xanax should only be used short-term.1,2,3
How do Ativan and Xanax work?
Both Ativan and Xanax, like all benzodiazepines, enhance the actions of a neurotransmitter in the brain called GABA (gamma-aminobutyric acid).1,2 This neurotransmitter can reduce the activity of nerve cells, so enhancing it has a calming effect which can improve symptoms of anxiety, reduce muscle tension, stop seizures, and induce sleep. Benzodiazepines are also known for their amnesic effect – or ability to disrupt short-term memory – and this makes them useful before surgery. Because of structural differences, some benzodiazepines are more likely than others to make you sleepy, relieve anxiety, stop seizures, relax muscles, or make you forget.1,2,3 Ativan and Xanax are both FDA approved for anxiety-relief, and are less likely than some other benzodiazepines (such as diazepam or temazepam) to induce sleep. Sedative effects of lorazepam that did occur were of slower onset but lasted longer than alprazolam in one trial.4 Lorazepam may also be used in the treatment of seizures.1
Which drug is more effective for anxiety?
Trials that directly compared Ativan and Xanax for the treatment of anxiety have reported no significant differences in their effect, and few differences in their side effects, although mental confusion may be less with Xanax.5,6
Which drug is more addictive?
Both Ativan and Xanax should only be used short-term due to risk of addiction and dependence. Generally speaking, benzodiazepines with a shorter half life (such as Ativan and Xanax) are harder to stop than those with a longer half life (such as diazepam). Both Ativan and Xanax readily enter brain tissue which reinforces drug taking and is generally associated with more severe withdrawal symptoms. Therefore, Ativan and Xanax are both at high risk of abuse. Research directly comparing Ativan with Xanax is not available; however, many experts have particularly advised that Xanax be used with caution as it has been associated with particularly severe withdrawal symptoms.
WHAT DRUGS INTERACT WITH ATIVAN?
Ativan produces increased central nervous system (CNS) depressant effects when administered with other CNS depressants such as alcohol, barbiturates, antipsychotics, sedative/hypnotics, anxiolytics, antidepressants, narcotic analgesics, sedative antihistamines, anticonvulsants,and anesthetics
WHAT DRUGS INTERACT WITH XANAX?
Do not take Xanax if you are allergic to alprazolam, other benzodiazepines, or any of the ingredients in Xanax. See the end of this Medication Guide for a complete list of ingredients in Xanax. you are taking antifungal medicines including ketoconazole and itraconazole.
HOW SHOULD ATIVAN BE TAKEN?
Ativan (lorazepam) is administered orally. For optimal results, dose, frequency of administration, and duration of therapy should be individualized according to patient response. To facilitate this, 0.5 mg, 1 mg, and 2 mg tablets are available.
The usual range is 2 to 6 mg/day given in divided doses, the largest dose being taken before bedtime, but the daily dosage may vary from 1 to 10 mg/day.
For anxiety, most patients require an initial dose of 2 to 3 mg/day given two or three times a day.
For insomnia due to anxiety or transient situational stress, a single daily dose of 2 to 4 mg may be given, usually at bedtime.
For elderly or debilitated patients, an initial dosage of 1 to 2 mg/day in divided doses is recommended, to be adjusted as needed and tolerated.
The dosage of Ativan (lorazepam) should be increased gradually when needed to help avoid adverse effects. When higher dosage is indicated, the evening dose should be increased before the daytime doses.
HOW SHOULD XANAX BE TAKEN?
Take Xanax exactly as your healthcare provider tells you to take it. Your healthcare provider will tell you how much Xanax to take and when to take it. If you take too much Xanax, call your healthcare provider or go to the nearest hospital emergency room right away.
Xanax is a benzodiazepine medicine. Taking benzodiazepines with opioid medicines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma and death.
Xanax can make you sleepy or dizzy, and can slow your thinking and motor skills.
Do not drive, operate heavy machinery, or do other dangerous activities until you know how Xanax affects you.
Do not drink alcohol or take other drugs that may make you sleepy or dizzy while taking Xanax without first talking to your healthcare provider. When taken with alcohol or drugs that cause sleepiness or dizziness, Xanax may make your sleepiness or dizziness much worse.
Do not take more Xanax than prescribed.