Anxiety disorders are among the most common mental health conditions worldwide, causing persistent worry, fear, and nervousness. To help manage these symptoms, doctors often prescribe benzodiazepines—medications that calm the nervous system.
Xanax (alprazolam) and Ativan (lorazepam) are two of the most widely prescribed benzodiazepines drugs for treating anxiety.
Both medications share similarities in their uses and effects, but they have some important differences. Understanding them can help you make the best choice for your health.
What is Ativan?
Ativan is the brand name for lorazepam, a medication that belongs to a class of drugs known as benzodiazepines. It is commonly prescribed to treat anxiety disorders, panic attacks, and insomnia. It works by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which helps to calm the brain and nerves.
Ativan for Anxiety: How Does It Work?
Ativan is known for its fast-acting properties, making it an effective option for managing acute anxiety symptoms. It can help individuals feel calmer and more relaxed within a short period of time after taking the medication. However, Ativan is not recommended for long-term use due to the risk of developing tolerance, dependence, and withdrawal symptoms.
What is Xanax?
Xanax is the brand name for alprazolam, another benzodiazepine medication commonly prescribed for anxiety disorders and panic attacks. Like Ativan, Xanax works by increasing the activity of GABA in the brain, leading to a calming and sedative effect. It is also known for its fast-acting properties, with effects typically felt within 1-2 hours after taking the medication.e
Xanax for Anxiety: How Does It Work?
Xanax is often prescribed for the short-term relief of anxiety symptoms, as well as for the treatment of panic disorders. It is considered to be highly effective in reducing feelings of anxiety and promoting relaxation. However, similar to Ativan, Xanax can be habit-forming and may lead to dependence if used for an extended period of time.
Top Similarities Between Ativan and Xanax
Ativan and Xanax share several key similarities:
- Both effectively treat multiple types of anxiety.
- They are controlled substances with a risk of dependence and misuse.
- They are intended for short-term use.
- Their side effects are generally similar.
- Overdosing is possible, especially when combined with opioids or alcohol.
Key Differences Between Ativan and Xanax
Despite their similarities, Ativan and Xanax have notable differences:
- Xanax typically works faster than Ativan.
- Ativan lasts slightly longer in the body.
- They have different dosages and formulations.
- Ativan is often preferred for older adults.
- Xanax is FDA-approved for panic disorder, while Ativan is not.
- Ativan can treat status epilepticus (prolonged or recurrent seizures).
| Feature | Ativan (Lorazepam) | Xanax (Alprazolam) |
| Drug Class | Benzodiazepine | Benzodiazepine |
| Uses | Anxiety, seizures (status epilepticus), pre-anesthesia sedation | Anxiety, panic disorder |
| Onset of Action | Slower than Xanax | Faster than Ativan |
| Duration of Effects | Longer-lasting | Shorter duration |
| Formulations | Tablets, injection | Tablets, extended-release tablets |
| FDA-Approved for Panic Disorder | No | Yes |
| Preferred in Older Adults | Yes | No (higher risk of side effect) |
| Potential for Dependence | High | High |
| Risk of Overdose | Increased with opioids/alcohol | Increased with opioids/alcohol |
Side Effects of Ativan & Xanax
Ativan (lorazepam) and Xanax (alprazolam) belong to the benzodiazepine class of medications, primarily used to treat anxiety disorders, panic attacks, and insomnia. Due to their similar mechanisms of action—enhancing the effects of gamma-aminobutyric acid (GABA) in the brain—both drugs share many side effects. These effects are generally dose-dependent, meaning higher doses increase the likelihood and severity of adverse reactions.
Common Side Effects
The most frequently reported side effects of Ativan and Xanax include:
- Drowsiness
- Dizziness
- Fatigue and Weakness
- Unsteadiness or Impaired Coordination
These side effects are typically mild to moderate but can be concerning in some cases, particularly in elderly patients or those with pre-existing conditions.
Serious Side Effects
While less common, some individuals may experience more serious side effects that require medical attention. These include:
- Memory Impairment & Confusion – Difficulty remembering events or cognitive dysfunction.
- Respiratory Depression – Slowed or difficulty breathing, particularly in those with respiratory conditions.
- Hypotension (Low Blood Pressure) – Can cause fainting, dizziness, or extreme weakness.
- Paradoxical Reactions – Increased agitation, aggression, restlessness, or hallucinations.
Comparison of Side Effects: Ativan vs. Xanax
The table below outlines the potential side effects of both medications:
| Side Effect | Ativan | Xanax |
| Nausea | Yes | Yes |
| Constipation | Yes | Yes |
| Increased Salivation | No | Yes |
| Appetite Changes | Yes | Yes |
| Weight Gain | No | Yes |
| Drowsiness & Fatigue | Yes | Yes |
| Weakness & Tiredness | Yes | Yes |
| Unsteadiness (Coordination Issues) | Yes | Yes |
| Dry Mouth | No | Yes |
| Menstrual Irregularities | No | Yes |
| Disinhibition (Impulsivity) | No | Yes |
| Depression or Mood Changes | Possible | Yes |
| Withdrawal Symptoms (with prolonged use) | Yes | Yes |
Ativan Dosage vs. Xanax Dosage
Ativan and Xanax are both prescription medications used to treat anxiety and related conditions. They are typically taken at home and are usually prescribed for short-term use (about 2 to 4 weeks). However, in some cases, they may be taken daily for a longer period under medical supervision. Doctors usually start with the lowest possible dose and adjust it based on how the patient responds.
Ativan Dosage
Ativan is available in both brand-name and generic versions. The most commonly prescribed form is the immediate-release (IR) tablet, which comes in 0.5 mg, 1 mg, and 2 mg strengths.
- For anxiety disorders, the usual dosage ranges from 2 mg to 6 mg per day, divided into 2 to 3 doses throughout the day. Some individuals may take up to 10 mg per day, depending on their condition and response to treatment.
- Ativan is also available in an extended-release (XR) form under the brand name Loreev XR, which is taken once daily in the morning.
- Additionally, Ativan comes as a 2 mg per mL oral liquid and an injectable form, which is administered by a healthcare professional.
Xanax Dosage
Like Ativan, Xanax is available as both a brand-name and generic medication. It comes in multiple forms, including immediate-release (IR) tablets, extended-release (XR) tablets, oral liquids, and orally dissolving tablets.
- The IR tablets are the most commonly prescribed and come in 0.25 mg, 0.5 mg, 1 mg, and 2 mg strengths.
- For generalized anxiety disorder (GAD), the typical starting dose is 0.25 mg to 0.5 mg, taken three times a day as needed.
- For panic disorder (PD), the usual starting dose is 0.5 mg three times a day.
- The XR tablets are designed for longer-lasting effects and come in 0.5 mg, 1 mg, 2 mg, and 3 mg strengths.
- These are more commonly used for panic disorder, with a typical dose of 0.5 mg to 1 mg once daily in the morning.
Both Ativan and Xanax should be taken exactly as prescribed to avoid dependence and withdrawal symptoms. Always consult a doctor before adjusting your dosage.
Ativan vs. Xanax: Which One Is Better?
Ativan and Xanax each have unique benefits. Xanax works faster, while Ativan lasts longer in the body. Both can cause withdrawal symptoms after 4 to 6 weeks of continuous use. Xanax is approved for adults 18 and older, whereas Ativan can be prescribed to children as young as 12.
Choosing the right medication depends on factors like health conditions, medical history, and lifestyle. A doctor will determine the best option, and online psychiatry services can help when in-person visits aren’t possible.
The answer depends on your specific needs. Here’s a simple guide:
- If you have frequent panic attacks: Xanax is better because it works fast.
- If you need long-lasting relief for anxiety: Ativan is better because it stays in the system longer.
- If you have trouble sleeping due to anxiety: Ativan may be more helpful since it has a calming, sedative effect.
- If you have a history of addiction: Neither drug is ideal, but Ativan may have a slightly lower risk of dependence.
Always talk to your doctor about which medication is best for you.
How to Get a Prescription for Ativan or Xanax
Only licensed professionals—such as psychiatrists or nurse practitioners—can prescribe Ativan or Xanax after evaluating your anxiety. They assess mood, physical health, and medical history to determine the best treatment. Understanding the xanax online prescription process can help guide your treatment decisions.
Bottom Line: Ativan vs. Xanax
Ativan (lorazepam) and Xanax (alprazolam) are both benzodiazepines commonly prescribed for anxiety disorders, panic attacks, and related conditions. While they function similarly by enhancing the calming effects of gamma-aminobutyric acid (GABA) in the brain, there are key differences in their onset, duration, and overall effects.
- Xanax acts more quickly and provides rapid relief, making it useful for acute anxiety or panic attacks. However, its effects wear off faster, which may lead to more frequent dosing.
- Ativan has a longer duration of action, providing more sustained relief with a lower risk of rebound anxiety between doses.
The choice between Ativan and Xanax depends on individual medical history, the specific condition being treated, and personal response to the medication. If you’re unsure which is best for you, consult your healthcare provider for guidance tailored to your needs.
