Ativan and Xanax may both be benzodiazepine drugs, but there are key differences between each medication and what they may be used to treat.
Article at a Glance:
Ativan and Xanax are both benzodiazepine drugs, but there are several differences between them.
The side effects and addiction risks are similar between these two medications.
Due to their unique drug properties, Ativan and Xanax are each used to treat different types of conditions.
Xanax vs. Ativan
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:
| Ativan | Xanax | |
|---|---|---|
| Generic Name | Lorazepam | Alprazolam |
| Drug Class | Benzodiazepine | Benzodiazepine |
| 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 |
Neither drug is stronger than the other, but both are dosed differently due to how long they last in the body and how quickly they take effect.
Yes, Ativan is a benzodiazepine drug.
Ativan and Xanax are both benzodiazepines with similar side effects and uses.
Depending on the type of anxiety disorder, one drug may be more effective than the other. Xanax is a better option when fast-acting anxiety relief is needed, while Ativan (lorazepam) is best suited for people who need several hours of sedation. However, neither drug should be used for long-term treatment.
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:
- Drowsiness
- Dizziness
- Dry mouth
- Headache
- Blurred vision
- Nausea
- Changes in appetite
- Constipation
- Low blood pressure
- Muscle weakness
- Problems with memory
- Insomnia
- 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.
Important Warning
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:
- Nausea
- Vomiting
- Tremors
- Seizures
- 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.
Differences Between Xanax and Ativan
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:
- Irritability
- Mania from bipolar disorder
- Seizures
- Vomiting from chemotherapy
- Alcohol withdrawal symptoms
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:
- Confusion
- Fatigue
- Sweating
Is Ativan Better Than Xanax?
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, The Recovery Village 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.
Brett, Jonathan; et al. “Management of Benzodiazepine Misuse and Dependence.” Australian Prescriber, October 2015. Accessed November 3, 2021.
Food and Drug Administration. “Ativan Package Insert.” September 2016. Accessed November 3, 2021.
Food and Drug Administration. “Xanax Package Insert.” August 2011. Accessed November 3, 2021.
Craven, Caroline; et al. “Demystifying Benzodiazepine Urine Drug Screen Results.” Practical Pain Management, February 2014. Accessed November 3, 2021.
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