Ativan vs. Xanax: What’s the Difference?

Understanding Ativan vs Xanax

What Are Ativan And Xanax?

Xanax (alprazolam) and Ativan (lorazepam) are benzodiazepines used to treat the symptoms of anxiety and panic disorders.

Both medications boost the calming effects of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. GABA is a brain chemical that decreases neural activity, which creates a calming effect. Their effects as central nervous system depressants help stabilize and manage the symptoms of anxiety. 

Additionally, Xanax and Ativan are effective medications for managing panic disorder because of their calming effect.

Xanax Vs Ativan: What Is The Difference?

While both effectively treat anxiety, they differ in duration of effect, time to onset, and formulation. 

Onset of Action

• Xanax can take approximately one to two hours to reach peak effect. However, some may experience its effects in 30 minutes.
• Ativan has a slower onset of action. In general, it can take approximately two hours. However, Ativan’s injectable formulation can take one to three minutes if injected intravenously or if injected into a muscle between 15 and 30 minutes.

Duration of Action

• The half-life of Ativan is 12 to 18 hours, which means it takes that long for the active substance in it to reduce by half in your body.
• Xanax’s half-life is 11.2 hours.

Differences in half-life mean Ativan’s effects last longer.

Formulation Differences

• Ativan is available in injectable and oral forms. The injectable form is useful in situations like seizures.
• Xanax has different oral options, such as disintegrating and extended-release tablets. These options allow multiple dosing choices.

There are other differences between the two, such as:

• Prescribing Ativan versus Xanax is preferred for older adults
• Xanax is explicitly approved for panic disorder; Ativan isn’t
• Ativan is effective in treating status epilepticus, seizure disorders that occur for a long time or close together
• Xanax is specifically approved for treatment of panic disorder, while Ativan is not
• Ativan can be prescribed to treat nausea and vomiting caused by chemotherapy

Is Ativan A Benzo?

Yes, Ativan is classified as a benzodiazepine.

Is Xanax a Benzo?

Yes, Xanax is found in the class of drugs called benzodiazepines.

Uses for Ativan and Xanax

What Is The Medication Ativan For?

Ativan is prescribed to treat anxiety disorders, panic disorder, status epilepticus, and the overlapping symptoms of depression and anxiety.

Individuals are prescribed Ativan for short-term treatment of several mental health conditions because of its calming effect on the central nervous system. 

What Does Xanax Treat?

The primary use of Xanax is to treat the symptoms of anxiety disorders and panic disorder.

There are many types of disorders, such as:

• Panic Disorder: Recurrent episodes of panic attacks, uncontrollable episodes of extreme fear
• Social Anxiety Disorder: Fear of potential embarrassment in social situations
• Specific Phobias: Known for the fear of specific situations or objects, which often leads to avoidance behavior
• Agoraphobia: Avoidance of public places because of the fear of not being able to escape
• Generalized Anxiety Disorder (GAD): Characterized by persistent and excessive fear and worry about everyday issues. For example, worrying about health

Are Ativan and Xanax Used For Panic Disorders Or Generalized Anxiety Disorder?

Yes, both are used for generalized anxiety disorder and panic disorders.

Anxiety disorders like GAD have symptoms that include excessive, continuous worry and fear. Individuals with panic disorders or GAD can benefit from both medications because both alleviate the symptoms by enhancing the neurotransmitter GABA.

Ativan and Xanax are prescribed for short-term alleviation of the symptoms of GAD and panic disorders; however, they are prescribed based on an individual’s mental health needs and specific factors such as health and the specific symptoms they’re experiencing.

For those who are experiencing an acute psychiatric crisis, once they’re admitted to inpatient rehab, Ocean View Psychiatric Health Facility’s doctor will review their medication, health history, and specific symptoms. Once this is done, the appropriate medication and dosage will be prescribed.

Does Xanax Help Nausea?

Yes, Xanax can be prescribed to relieve nausea caused by anxiety or stress.

The calming effect of Xanax on the central nervous system can reduce the feelings of nausea that are associated with anxiety. However, Xanax can also cause nausea. To help determine if your nausea is caused by stress and anxiety or the medication, your medical doctor or psychiatrist can provide medication management.

During your treatment, whether you’re in Ocean View’s acute inpatient psychiatric care unit or one of our levels of outpatient care, you will receive medication stabilization and management to ensure your medication is providing you with the support you need to manage your symptoms.

Are There Off‑Label Uses For Ativan Or Xanax?

Both medications have off-label uses.

While the U.S. Food and Drug Administration (FDA) does not allow prescription medication to be used off-label, it is up to your doctor or psychiatrist to prescribe these medications for off-label use.

Ativan and Xanax can be used to treat mental health and physical conditions such as:

• Insomnia
• Alcohol withdrawal
• Muscle spasms
• Depression
• Bipolar disorder
• Dementia (behavior management)

Talk with your doctor about the benefits and side effects of using Ativan or Xanax for any of the conditions above before you decide to use them.

Side Effects of Ativan

What Are The Side Effects Of Ativan Compared To Xanax?

Both medications have similar side effects, some of which are:

• Confusion
• Dizziness
• Fatigue
• Headache
• Drowsiness
• Nausea, which can cause vomiting
• Poor Coordination

However, while both have similar side effects, the following are less common in Ativan than Xanax:

• Mood changes
• Slurred Speech
• Changes in appetite
• Irritability

Additionally, those who are prescribed Ativan have an increased chance of constipation.

Does Ativan Make You Sleepy?

Yes, Ativan’s effects on the central nervous system can cause sleepiness.

Both Xanax and Ativan are benzodiazepines that have a calming effect on the central nervous system because they boost the neurotransmitter GABA in the brain. Doctors specifically prescribe Ativan to treat anxiety-induced insomnia.

What Are Common Central Nervous System Effects Of Ativan?

The side effects most commonly experienced by individuals are:

• Sedation
• Dizziness
• Unsteadiness
• Weakness

Since Ativan is a CNS (central nervous system) depressant, these side effects are not unusual.

Can Ativan Cause Confusion, Dizziness, Or Slurred Speech?

Yes, Ativan side effects include slurred speech, dizziness, and confusion.

Benzodiazepines, like Ativan, are CNS depressants, which lead to feeling calm, some cognitive impairment, and relaxed muscles. For this reason, recommendations for Ativan use include avoiding heavy machinery, such as a vehicle.

Side Effects of Xanax

Does Xanax Cause Drowsiness And Sedation?

Yes, two of the side effects of Xanax include sedation and drowsiness.

The side effects associated with Xanax are associated with the calming effect it has on the neurotransmitter GABA. It boosts the effects of GABA, which leads to the reduction of the symptoms of anxiety and panic disorders.

Can Xanax Cause Hallucinations?

Yes, one of the rare side effects of Xanax is hallucinations.

There are risk factors associated with taking Xanax that include:

• Dosage: Higher doses can increase the risk of experiencing hallucinations
• Individual Sensitivity: Older adults in particular can be more sensitive to the side effects of Xanax
• Drug Interactions: The combination of other medications or substances can increase the risk of negative side effects such as hallucinations

While you are taking Xanax, it is crucial that you maintain medication management sessions with your prescribing medical professional. Throughout your stay at Ocean View Psychiatric Health Facility, we’ll monitor your progress to check on how you’re doing with medications. 

Are There Cognitive And Motor Side Effects Associated With Xanax?

Yes, experiencing these side effects while taking Xanax is not uncommon.

Whether it’s short-term or long-term use of Xanax, cognitive and motor side effects are associated with its use. However, there is a greater risk of worsening cognitive and motor side effects the longer you take Xanax. 

Some of the side effects include:

• Drowsiness
• Poor Coordination
• Slowed thought process
• Memory Impairment
• Brain Fog

Treatment Uses for Xanax vs Ativan

How Do Ativan And Xanax Differ In Terms Of Onset And Duration Of Action?

The differences between the two are:

• Xanax has a quicker onset of action. The peak of its effects occurs within 1 to 2 hours. 
• However, Xanax’s effects are shorter, lasting between 4 and 6 hours.
• Ativan reaches peak onset of action in approximately 1 to hours.
• Ativan’s effectiveness lasts around 8 hours.

While Xanax reaches peak onset of action sooner than Ativan, its duration is shorter. Your doctor or psychiatrist will consider these differences when determining which would benefit you more in addressing your symptom management.

Which Is Stronger, Ativan Or Xanax?

Neither one is considered stronger than the other.

Ativan and Xanax have approximately the same strength concerning their effects on anxiety disorders. For some, the effects of Xanax can feel stronger because of the shorter time before the effects are felt.

How Do These Drugs Interact With Other Medications?

When taken with other medications, the risk of side effects and overdose increases.

The side effects, such as drowsiness, respiratory issues, confusion, and dizziness, of Ativan and Xanax are heightened when taken with other CNS depressants like alcohol, opioids, or specific antidepressants. Additionally, because both are benzodiazepines, it is recommended that they not be taken together.

Can You Take Xanax And Ativan Together?

You should not take Xanax and Ativan together.

Combining the two offers little to no therapeutic advantage. 

Combining Xanax and Ativan can significantly increase health risks such  as:

• Sedation
• Cognitive impairment
• Respiratory depression
• Coma
• Death

A key part of taking medication is talking with your doctor about their effects and how you’re responding. With consistent medication support and professional oversight, you can be assured that you are safely using medication.

Risks and Dangers of Xanax vs Ativan Use

What Are The Risks Of Tolerance And Physical Dependence?

Both medications have significant tolerance and physical risks of dependence. 

Because both calm the central nervous system, the risk of dependence increases. However, the potential is higher for addiction with Xanax because of its quick onset and shorter half-life. The combination of these factors means those who are taking Xanax will experience more abrupt withdrawal symptoms than those taking Ativan.

What Are Withdrawal Symptoms From Xanax vs Ativan?

The difference in symptoms between the two is:

Xanax

• Irritability
• Insomnia
• Anxiety
• Seizures

Ativan

• Hand tremors
• Confusion
• Nausea

Can People With A History Of Seizures Or Substance Use Safely Use These Medications?

Individuals who have a history of substance use or seizures should be careful when taking either medication.  

Both Ativan and Xanax can cause respiratory depression, which can result in life-threatening side effects. Your doctor will review your medical history before prescribing either one. It is also crucial that you tell your doctor your full health history.

Xanax vs Ativan for Managing Psychiatric Symptoms

Are These Benzodiazepines Effective For Acute Panic Attacks?

Medications classified as benzodiazepines are often used to treat panic attacks.

Benzodiazepines can provide quick relief for those who are experiencing the symptoms of an acute panic attack.

A few examples of symptoms are:

• Heart palpitations
• Feelings of doom
• Trembling
• Sweating

While benzodiazepines are effective for treating and managing the symptoms of an acute panic attack, they are often not used as a first line of defense. More often, those experiencing an acute panic attack are prescribed one of the several selective serotonin reuptake inhibitors (SSRIs).

Is Xanax Good For Anxiety Versus Chronic Anxiety Disorders?

The use of Xanax is appropriate for the short-term treatment of anxiety disorders, but not for long-term, chronic anxiety disorders.

Due to the increased risk of addiction and withdrawal associated with benzodiazepines, individuals are more likely to be prescribed SSRIs for chronic anxiety symptom management.

Can Ativan Be Used For Insomnia?

Yes, short-term use to alleviate insomnia is possible.

Ativan can help individuals fall asleep faster for a while, but the FDA has not approved it to treat insomnia. When used under medical supervision for short-term relief of insomnia, it can have positive effects.

How Should Ativan or Xanax Be Integrated With Psychotherapy And Antidepressants?

Ativan and Xanax can be used as a short-term method of relief for anxiety, and their symptom relief is enhanced when combined with psychotherapy methods like cognitive behavioral therapy.

The integration of these medications with psychotherapy can provide short-term relief of the symptoms associated with anxiety and panic disorders. Therapy can support immediate symptom relief while addressing underlying issues.

Ocean View provides acute crisis stabilization that combines the appropriate medication with structured, empathetic psychoeducational sessions. Our short-term crisis care addresses your current needs while encouraging you to seek ongoing care once symptoms are stabilized.