Ativan® vs Xanax®: Both are relatively common and popular anti-anxiety medications that can be used to help deal with the acute symptoms of anxiety. Doctors may prescribe them for various reasons, but they always work to create a calmer and more relaxed mood in users.
Unfortunately, one of the realities of these medications is that they can be abused for those same effects, and that there are additional risks to using them, even with a prescription.
Here’s what you need to know about these two medications, how they measure up, and what each does and is best for. We’ll also talk about the risk of addiction, Ativan® vs Xanax®, and the side effects and individual risks of each drug.
Ativan® vs Xanax®: Are They the Same Thing?
No, Ativan® and Xanax® aren’t the same drug; though they are fairly similar. Both drugs  belong to a class of drugs called benzodiazepines, which are generally used to treat anxiety, panic disorders, and some kinds of seizures.
While both drugs work largely the same way, there are some key differences between Ativan® and Xanax® that are important for both prescribers and patients to understand before prescribing and using them. Understanding the key differences of Ativan® vs Xanax® can make it easier to stay safe and avoid addiction to these drugs.
First, let’s start with a basic overview of both drugs, what they are used for, and the strengths and weaknesses of Ativan® vs Xanax®.
Ativan® is the brand name for the drug lorazepam, and it’s a relatively long-lasting drug. Typically, Ativan® will begin working within 2 hours of taking it with its effectiveness lasting 8 hours on average. Short-acting versions of the drug are available that can be taken up to 3 times  a day for faster, but more short-term effectiveness. Some people may have a longer effective time than average.
But, how does Ativan® work exactly? Ativan® makes the neurotransmitter GABA, or Gamma-Aminobutyric Acid, more effective. This increase in effectiveness produces a slower nerve response, in turn calming anxiety and sometimes soothing seizure activity as well.
Xanax® is the brand name for alprazolam, another benzodiazepine with a slightly different chemical structure.
Unlike Ativan®, Xanax® is known to have slightly different effects depending on who is taking it. Some Asian population groups, for instance, have a gene that makes Xanax® reach much higher concentrations when taken. The same gene also makes Xanax® last longer for these individuals. In some cases, Ativan® may be prescribed instead of Xanax® for people of Asian descent for exactly this reason.
Additionally, Xanax® is slightly faster acting than Ativan®, usually kicking in within 1-2 hours of taking the dose, instead of a full 2 hours, and it’s also shorter-lived, with an effective time of between 4-6 hours depending on the milligram dosage and other factors.
At the same time though, Xanax® works similarly to Ativan® by increasing the GABA in your brain and slowing nerve reactions.
Ativan® vs Xanax®: Which Is More Effective?
When it comes to treating anxiety, Ativan® and Xanax® are both incredibly similar; there isn’t a big difference in effectiveness or in how effectively the drugs work to control anxiety or panic attacks overall.
That said, doctors may prescribe one drug over the other depending on your health history, what condition they are treating (there are many different kinds of anxiety and seizure disorders), and your overall health and ethnic background.
The good news is that no matter which drug you have been prescribed, it should be equally effective when used properly and with doctor supervision.
Key Differences Between Ativan® and Xanax®
Despite the many similarities of Ativan® vs Xanax®, there are a few key differences that can determine which one is prescribed in the end.
For instance, Ativan® isn’t thought to have racial or metabolic sensitivity like Xanax®. Basically, Ativan® will work more consistently for different people than Xanax®, though both are generally highly effective.
That also means that Xanax® has a slightly higher risk of side effects or adverse reaction, but mostly only for the susceptible population group, rather than everyone taking it.
The other big difference is that most people will respond to a lower dose of Xanax® compared with Ativan®. Generally, 0.5mg of Xanax® is considered equivalent to 1mg of Ativan®, though that difference isn’t too important from a prescribing perspective.
There are also some differences in side effects, when people are likely to feel certain side effects from each drug, and how long the side effects are likely to last overall.
The good news is that both drugs generally have mild side effects for most users, but they are still important enough to cover in their own section.
Side Effects Of Ativan® And Xanax®
Both of these drugs have relatively similar side effects, which is important partially because it shows how similar both of these drugs are not only in what they do, but how they do it in your body.
Some people will have a stronger reaction to one of these drugs than the other, which means that for a lot of people the action of switching between Ativan® and Xanax® needs to be carefully considered.
It’s also important to know that older adults, especially anyone age 65 or older, may have a more severe reaction  to both Ativan® and Xanax® than usual. They may need an alternative medication, or they may need a lower dose to reach the same effectiveness compared with younger adults, or even themselves before reaching 65.
Ativan® vs Xanax® Side Effects
Here are some of the most common side effects of Ativan® and Xanax®:
- Depression (rare)
- Difficulty Speaking (usually short-term)
- Poor coordination
- Changes in libido
- Changes in appetite, both up and down
- Skin rashes (rare)
Both Xanax® and Ativan® have essentially the same side effects, but Ativan® may have slightly fewer or milder side effects compared with Xanax®. Therefore, if side effects are a major concern, Ativan® may want to be considered a bit more than Xanax®.
You also shouldn’t ever combine these drugs with alcohol, or you may get more severe versions of the side effects, or potentially dangerous interactions between the benzodiazepine medication and the alcohol.
Ativan® vs Xanax®: Are Both Drugs Addictive?
Sadly, one of the most serious risks for anyone taking either of these medications is that they can be addictive. That’s one reason that they aren’t meant to be taken regularly or long term without close doctor supervision.
There are a few conditions or times when taking these medications regularly long-term might be the best option, like treating certain seizure disorders, or managing anxiety disorders that don’t respond to other medications or treatments.
However, these drugs have also made their way onto the black market and are sometimes sold as recreational drugs, which can leave users vulnerable to addiction not just to these drugs, but to other drugs as well.
Because Ativan® leaves your body slightly faster than Xanax®, despite having a longer effective time, it’s sometimes seen as a lower addiction risk. In practice though, the differences in terms of addiction between Ativan® vs Xanax® aren’t that significant. People vulnerable to addiction to one of these drugs are likely also vulnerable to addiction to the other.
In fact, some people dealing with an addiction to benzodiazepines may use these drugs interchangeably. Dose and duration differences between them can make using the drugs interchangeably more dangerous.
Signs Of Addiction
There are a lot of potential signs of addiction when it comes to Xanax® and Ativan®, and everyone will experience addiction a little differently. One of the most common signs of addiction is actually wondering if you’re addicted.
That said, if you’re taking these medications long term, remember that a certain amount of chemical dependence is expected, and you may have feelings similar to addiction because of your body’s dependence on the drug.
As long as you continue using the medication as prescribed, and do not take any extra, you should be fine.
If you’re really worried though, consider talking with your doctor about alternatives, or about seeing how you do without the medication to see if stopping, or switching to occasional use is a good option for you.
Just remember that you will need to taper or stop taking these medications slowly over time. It can be dangerous to stop taking any prescription drug suddenly because your body changes which chemicals and neurotransmitters it produces as a response to taking the drug.
Some other common signs of addiction include:
- Wanting to take more of the medication than prescribed
- Feeling like you’re only really yourself while taking the medication
- Feeling like you need to take more and more of the drug to get the same results
- Feeling like you need to hide your drug use
- Considering talking to more than one doctor about your condition to get more than one prescription
- Buying or considering buying medication on the black market
- Feeling sick between doses
- Feeling like you need to take more of the medication before it’s worn off
- Considering or using other drugs instead of your medication if you run out early between prescriptions
These are only some of the possible signs of addiction – there are many others. But if any or all of these feelings and thoughts sound familiar, you might want to seek out addiction treatment.
How To Get Help With Benzodiazepine Addiction
Fortunately, there are plenty of doctors who know exactly how to treat benzodiazepines addiction, and there are many strategies and treatment methods that work specifically for people struggling with this addiction.
However, because so many Ativan® and Xanax® users have physical or mental health complications that can make addiction treatment trickier to manage, it’s very important to have the support of medical professionals when you stop taking these medications.
Going to a treatment center is one of the best ways to overcome benzodiazepine addiction. If you’re ready to overcome your addiction or want to get more information for a loved one, call Ocean Recovery. We can help with even the most complicated cases of addiction.
- Drugs.com. (n.d.). Ativan vs Xanax® – What is the difference? Retrieved from https://www.drugs.com/medical-answers/ativan-vs-xanax-3029943/ on 2023, February 13
- GoodRx. (n.d.). Ativan vs. xanax® for anxiety: important differences and potential risks. Retrieved from https://www.goodrx.com/undefined/compare/ativan-vs-xanax on 2023, February 13
- GoodRx. (n.d.). Xanax® vs. ativan® (lorazepam): compare dosage, side effects, & usage. Retrieved from https://www.goodrx.com/conditions/generalized-anxiety-disorder/xanax-or-ativan-which-is-better-for-anxiety on 2023, February 13