Xanax (Alprazolam) and Ativan (Lorazepam) Differences and Similarities

Benzodiazepine medications have been used for decades to treat a range of conditions, including anxiety disorders, panic disorders, epilepsy, and other similar conditions. Two widely prescribed medications in benzodiazepine family are Ativan and Xanax.

While Ativan and Xanax are both benzodiazepines and have similar side effects and risks for addiction, there are key differences between these drugs. Read on to learn about the both the differences and similarities between Xanax and Ativan.

How Xanax Works

Xanax is the brand name for alprazolam, which is a prescription benzodiazepine medication used to treat insomnia and anxiety. These disorders include generalized anxiety disorder, anxiety with depression, and panic disorder.

This medication works by depressing the central nervous system to help reduce symptoms associated with insomnia and certain types of anxiety disorders. Its calming effect allows individuals (who are taking this medication as prescribed and under the supervision of a professional) to experience relief from symptoms that otherwise negatively impact their daily lives. When Xanax is misused, it produces a euphoric effect that can quickly lead to continued misuse and subsequent tolerance, dependence, and addiction, as it is a habit-forming substance.

Xanax should not be taken for more than two weeks, as the body can quickly develop a tolerance to it. When this occurs, the prescription dose will not work as well. Furthermore, benzodiazepines like Xanax can also lead to addiction due to how they interact with gamma-aminobutyric acid (GABA) receptors.

Xanax was originally approved by the Food and Drug Administration in 1981, and since then, recommended doses and methods of ingestion have changed to reduce its addictive potential. Currently, in both brand name and generic forms, alprazolam is available as a liquid, oral disintegrating tablets, and extended-release tablets.

Alprazolam has a half-life of 6-12 hours, with a 0.5 mg dose. The medication is approved for prescription in adults ages 18 or older.

In some cases, alprazolam can be prescribed for:

  • Irritable bowel syndrome.
  • Premenstrual dysphoric disorder (PMDD).
  • Essential tremor.
  • Tinnitus, or ringing in the ears.

Side Effects of Xanax

There are several various effects that can develop in response to the use of Xanax. Some of these effects can include, but are not limited to, the following:

  • Sedation
  • Difficult or unclear ability to talk
  • Problems with coordination
  • Tiredness

More serious side effects associated with Xanax use can include seizures, mania, withdrawal symptoms, and misuse and dependence. Should an individual become dependent on Xanax, there is an increased risk for possible overdose, which can be fatal.

According to recent statistics, benzodiazepine overdoses accounted for over 31,000 emergency department visits between 2019 and 2020. Alprazolam alone accounted for approximately 1200 of those cases.

To enhance the effects of other substances, such as alcohol or opiates, sometimes people mix these drugs with benzodiazepines like Xanax. When some substances are mixed, they can impact each other’s effects. However, this can also rapidly lead to overdose and death. In 2020, 16% of overdose deaths involved a combination of benzodiazepines like Xanax and opioids.

How Ativan Works

Ativan is also a benzodiazepine medication. It is the brand name of the generic lorazepam, which is used to treat generalized anxiety disorder and anxiety stemming from depression. It is also sometimes prescribed to treat:

  • Insomnia
  • Epilepsy.
  • Irritable bowel syndrome.
  • Alcohol withdrawal syndrome.
  • Nausea and vomiting associated with treatment for cancer.

In some rare cases, Ativan is used for:

  • Mania.
  • Irritability.
  • Recurring seizures not due to epilepsy.
  • Pre-surgical sedation.

Like Xanax, Ativan is a CNS depressant, meaning that it helps to slow down the function of the central nervous system. When this occurs, symptoms closely associated with certain types of anxiety disorders, insomnia, and other conditions listed above can be mitigated or alleviated as a result of this action.

Like Xanax, it is not recommended that a person continue taking Ativan for more than 2-4 weeks. The medication is intended for short-term treatment unless a life-threatening condition such as a seizure disorder requires longer-term treatment. This is because Ativan, like Xanax, is very habit-forming and the body can easily develop tolerance to it, so the prescription dose amount will not work as well weeks later.

Ativan was originally approved by the FDA in 1977, and various versions of the drug, such as injectable formulas and different oral doses, have been approved since then. Ativan also has a half-life of 6-12 hours, but the size of the dose is 1-2 mg. Unlike Xanax, Ativan can be prescribed to people ages 12 and older.

Ativan Side Effects

Like other benzodiazepines, Ativan can produce a number of different side effects when it is being consumed, such as:

  • Dizziness
  • Sleepiness
  • Slowed motor skills
  • Sedation
  • Weakness
  • Unsteadiness

Additionally, if Ativan is misused, more serious side effects can occur, including:

  • Coma.
  • Delirium.
  • Paranoia.
  • Suicidal thoughts.
  • Seizures.
  • Difficulty breathing.
  • Death.

The DAWN Report notes that Ativan intoxication and overdose are frequently found to be reasons for emergency room visits, but less frequently than with Xanax.

Xanax Versus Ativan: Which is Stronger?

Xanax and Ativan are both effective benzodiazepine medications that can treat symptoms of some similar physical and mental health conditions. Each person who is prescribed Xanax or Ativan is going to have a different dose prescribed to them based on their specific needs. Therefore, it is not easy to determine Ativan versus Xanax strength, as varying doses of either will produce different effects, as can the frequency that it is consumed.

Get Help for Ativan or Xanax Addiction

It is very important for people struggling with benzodiazepine misuse, including misuse of Xanax or Ativan, to get help from a qualified healthcare provider or addiction treatment center. If you or someone you love is interested in drug addiction rehab in South Florida, Recovery First may be right for you. Our team of highly qualified and experienced addiction recovery specialists have decades of experience helping people get on the road to recovery from addiction to alcohol, drugs, and prescription medications.

Our admissions navigators are available night and day to help provide more information and answer your questions about starting rehab admissions, how to pay for addiction treatment in South Florida, or to tell you more about what to expect in inpatient rehab. Call us today at to find out more about your treatment options and get the help you need today.

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