Do you often feel restless and unable to pay attention to your daily activities? Do you consider yourself less capable of achieving your life goals? You are suffering from an anxiety disorder. But there is nothing to worry about as you can get rid of your anxious state with the help of psychiatric medications which specifically involve benzodiazepines, Ativan or Xanax. This article provides a detailed guide to the major differences and similarities between Xanax and Ativan and how they differ in treating anxiety. Moreover, you will also get an idea of how these medications work as well as the side effects caused by their inappropriate usage.
Xanax Vs Ativan: Treatment of Anxiety
‘’Xanax and Ativan are specialized medications that belong to the class of benzodiazepines and are useful for the treatment of anxiety and all other related chronic anxiety disorders. The Anxiety and Depression Association of America (ADAA) has also recommended Ativan or Xanax as the second line of treatment for general anxiety disorders. These medications are used only in those cases when the first line of treatment does not provide the desired results’’.
Xanax and Ativan belong to psychotropic drugs that are used for managing the symptoms of anxiety disorder as well as other mental issues such as panic disorder, mania as well as insomnia. Xanax is chemically known as alprazolam and Ativan is named as lorazepam. They are also named as anxiolytic medications and are widely prescribed by professional experts. Anxiety disorders are common mental issues characterized by a prolonged phase of sadness and fear.
Individuals suffering from anxiety do not feel pleasure or happiness in anything and remain in stress. Moreover, they feel nervous in any social setting and consider themselves worthless. Multiple recent studies have reported that approximately 19.1% of US individuals suffer from anxiety disorder every year. The symptoms of anxiety negatively affect the life functioning of individuals. However, anxiety can be treated with useful and reliable treatment options. Experts recommend psychiatric medications which include Ativan and Xanax to alleviate the symptoms of anxiety.
Xanax Vs Ativan: Comparison for Professionals and Patients
If the professionals and patients are aware of each aspect of both Xanax and Ativan then they can make well-informed decisions with the main goal of delivering the best mental health outcomes. The absolute knowledge reading the dosage, effectiveness, and tailored treatment plans assists in getting rid of anxiety disorders and obtaining mental well-being.
1. Medical uses
Both Xanax and Ativan are considered medically effective for treating or managing the symptoms of anxiety disorders. However, both medications are preferred in different scenarios. As the mode of action of Xanax is rapid, therefore it is preferred for the treatment of panic attacks as compared to Ativan which has a slower onset. Therefore, ativan is specifically recommended by the experts for the treatment of generalized anxiety disorder.
Furthermore, Ativan is also used for treating the status epilepticus, a severe form of seizure. Likewise, there are other multiple uses of Ativan as it is also used as a premedication for anesthesia. Therefore, based on the speed of action, both medications are effective in varied scenarios.
2. Pharmacological characteristics
Both Xanax and Ativan directly affect gamma-aminobutyric acid (GABA), a specific neurotransmitter that inhibits brain activity and in turn results in a soothing and calming effect. Moreover, the half-life of Ativan is shorter as compared to Xanax and also exhibits more potency. Therefore, before directly recommending both Xanax and Ativan, experts first consider the potency and duration in the body so the affected individual overcomes the anxiety symptoms and experiences the desired benefits in each type of clinical scenario.
3. Dosage
The dosage of both Xanax and Ativan is not the same for each individual as each individual responds differently to the mental issue and the recommended treatment plan. Experts first deeply evaluate the mental condition before deciding the appropriate dosage of both Ativan and Xanax. Moreover, they also determine each individual’s needs so they remain protected from the side effects or any negative consequences. The other factors that experts determine before the recommendation of dosage are the tolerance level of medication and the condition that is going to be treated.
- The recommended safe dosage of Xanax ranges from 0.25 to 0.5 mg three times per day.
- The dosage of Ativan is 1 to 3 mg per day.
Keep in mind: The dosage and time frame of both Xanax and Ativan are different for each individual. The variation is based on the medical condition being treated.
However, if you notice any undesired change in your medication regimen. then immediately report it to your healthcare professional. Then based on the requirement, they can make some changes in your medication intake schedule or recommend you alternate so you can overcome your anxiety in a highly safe and sound way.
4. Onset of action
Although both Xanax and Ativan are highly effective for the treatment of anxiety, the difference lies in their onset of action. Xanax is quicker in showing action as it takes only 15 to 30 minutes to work effectively. While Ativan on the other hand is comparatively slow in showing the effect as the duration is longer which is 20 to 30 minutes. However, the effects of Ativan usually last longer as compared to Xanax. Therefore, Ativan is considered useful for getting long-lasting relief from anxiety.
5. Side effects
No doubt, both Xanax and Ativan are suitable for anxiety treatment but they can also cause side effects which are common among them such as a sense of fatigue or tiredness, dizziness, drowsiness, confused thoughts, and blurred vision. Moreover, Xanax is also reported to cause mood alterations or swings as a side effect due to its potent nature. If the side effects are not treated on time then it can also negatively affect cognitive abilities.
6. Drug interactions
Both Xanax and Ativan can interact with substances that can depress or suppress the actions of the central nervous system such as alcohol and opioids. Moreover, they can also interact with other benzodiazepines. However, their drug interactions can cause life-threatening respiratory depression. Therefore, it is also advised by the experts to avoid the intake of these medications if you are taking any other antidepressants, antibiotics as well as the antifungal medications. Otherwise, it can result in the elevated concentration of benzodiazepines in the body which in turn can cause some major issues.
7. Withdraw potential
If you are taking Xanax or Ativan for a longer period then there is an increased probability of physical dependence. However sudden withdrawal or cessation can result in multiple withdrawal symptoms which include increased stress levels, seizures, sleep issues as well and the most common irritable behavior. Moreover, if we compare the speed of withdrawal symptoms then Xanax can result in the rapid onset of withdrawal symptoms as compared to Ativan due to its shorter half-life. In addition, both Xanax and Ativan enter the brain tissues and result in reinforcement with the drug intake and more severe form of withdrawal symptoms.
8. Intake Considerations for Pregnancy and Breastfeeding
Pregnant females and those who are at the stage of breastfeeding should take the expert recommendation before the intake of Ativan, Xanax, or any other psychotropic medication. Different studies have indicated that these medications can cross the placenta, which is a connection between the mother and fetus. After crossing the placental barrier, these medications can affect the development of the fetus and result in some cognitive abnormalities. This mostly occurs if females take these medications in the first trimester of pregnancy.
Furthermore, if there is an intake of these medications in late pregnancy then they can result in the floppy infant syndrome and neonatal withdrawal syndrome. Likewise, during breastfeeding, both Xanax and Ativan are released into the breastmilk which negatively affects the nursing infant. Therefore, females are always advised to take the expert recommendation to protect themselves and their babies.
How Does Ativan and Xanax Work in the Brain and Body?
Xanax (alprazolam) and Ativan (lorazepam) function similarly in the brain and body.
1. Mechanism of action
Enhancement of GABA: Both Ativan and Xanax specifically bind to the GABA receptors which results in the increased enhancement of GABA neurotransmitters.
Neuronal inhibition: The elevated rate of chloride influx reduces excitation of neurons which ultimately results in decreased brain activity. This then produces soothing effects.
2. Effects on brain & body
Both medications exert the following effects on the brain and body:
- Relaxation of muscles
- Anxiolytic effects
- Sedation and hypnosis
- Anticonvulsant properties
FDA Warnings
If you are continuously taking the benzodiazepine but suddenly stop taking that then it can lead to physical dependence and withdrawal symptoms. If you are taking Ativan or Xanax with any other substance such as an opioid then you can experience respiratory depression, difficulty in sleep, coma, or death in more severe cases. The misuse of Ativan or Xanax can result in overdose and some major negative issues. So take each benzodiazepine after getting the expert recommendation. Before choosing any drug, talk to your healthcare provider to protect yourself from any major issues in the future.
Which is more addictive? Xanax or Ativan?
Expert recommendation is vital to prevent the addiction, side effects, or any other potential negative effects of both medications. Both Xanax and Ativan should only be used for a short period as they can cause potential physical dependence and addiction. Among all benzodiazepines, Ativan, and Xanax have shorter half-lives compared to others. Therefore, they are difficult to stop and can result in more addiction as compared to diazepam and some other medications which have comparatively longer half-lives. Furthermore, their reinforcement in drug intake can cause an increased risk of abuse.
Xanax Vs Ativan: Major Differences
| Xanax | Ativan |
|---|---|
| Xanax works in a rapid manner (1-2 hours) | Ativan works slower (2 hours) |
| Xanax usually lasts for a shorter period (4-6 hours) | Ativan results in long-lasting effects (8 hours) |
| The recommended dosage of Xanax is less than 4 mg per day | The recommended dosage of Ativan is 2-6 mg per day |
| Xanax is recommended for adults aged 18 and older | It is specifically recommended for older adults |
| Xanax is approved for the treatment of panic disorder and anxiety disorder | Ativan is not recommended for panic disorder |
| Xanax is majorly affected by age, race, and certain health conditions | Ativan is less influenced by individual factors |
| The withdrawal potential of Xanax is higher | The withdrawal potential of Ativan is slower |
| Xanax is not available in the form of an injection | Ativan is available in the form of an injection |
| Xanax comes in different forms such as liquid, disintegrating tablet, immediate-release tablet, and extended-release 24-hour tablet | Ativan also comes in varied forms such as tablets, liquids, and injections |
| The misuse potential of Xanax is higher | The misuse potential of Ativan is comparatively lower |
Xanax & Ativan: Major Similarities
| Ativan | Xanax |
|---|---|
| Ativan is effective in treating all types of anxiety | Ativan is also equally effective for treating each form of anxiety |
| Ativan should be used for a short period | The recommended duration of Xanax is also shorter |
| Side effects are the same | Side effects are the same |
| Overdose can occur when taken with any other substance, especially alcohol or opioids. | There is an equal possibility of an overdose |
| There is a risk of addiction or abuse | There is also a risk of addiction or abuse |
Mental health conditions treated by the Ativan & Xanax
| Mental Condition | Xanax | Ativan |
|---|---|---|
| Anxiety | FDA-approved | FDA-approved |
| Panic Disorder | FDA-approved | Off-label |
| Seizures | No | Ativan injections are FDA-approved, off-label for tablets |
| Anxiety-associated sleep issues | Off-label | Off-label |
| Tranquilization for agitation | No | Off-label |
| Anesthesia premedication | No | FDA-approved for Ativan injection, Off-label for tablets |
| Insomnia | Off-label | Off-label |
| Delirium | No | Off-label |
| Premenstrual syndrome | Off-label | No |
Is the intake of Xanax and Ativan risky for older adults?
Yes, The non-recommended intake of Xanax or Ativan is riskier in older adults as compared to young adults as the symptoms can get worse in late adulthood stages. Therefore, individuals aged 65 or older should always consult the experts before taking benzodiazepines. Otherwise, they can experience the following side effects:
- Falls
- Difficulty in thought processing
- Difficulty in decision-making
- Confusion
- Crashing a motor vehicle
However, it does not mean that the intake of Xanax or Ativan is not useful for anxiety treatment in older adults. Most of the experts also recommend the intake of the ativan in older adults. The main reason behind this is that liver functioning gets slower with age and therefore there is a lesser chance that Ativan can build up in the body as compared to Xanax.
How long do both Xanax and Ativan stay in the system?
Among both Xanax and Ativan, ativan usually stays longer in the body as compared to Xanax. The action of Ativan usually lasts longer in the body, around 8 hours. However, Xanax only stays in your body for a period of 4 to 6 hours.
Which medications are recommended as the first-line treatment for anxiety?
APA and ADAA have recommended the SSRIs and SNRIs as first-line medications for treating anxiety.
1. Comparing Benzodiazepines with Other Anxiolytics
There is always a comparison of Benzodiazepines with other medications which include antidepressants and anxiolytics to determine which medication works best in which condition. Experts always determine multiple factors recommending any medication which include the dosage, duration of onset, potential drug interactions as well as pharmacological properties. Each medication works differently as compared to others such as:
2. SSRIs/SNRIs
The major difference between Benzodiazepines and SNRIs and SSRIs is that Ativan and Xanax are not considered the first-line treatment for anxiety and related disorders. However, both SNRIs and SSRIs are recommended by the experts as the first-line treatment and they target the serotonin and norepinephrine pathways. This is due to some major factors which include the wide efficiency in treatment and well as the reduced physical dependence. Therefore, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are ideal for long-term use in certain conditions as compared to Benzodiazepines which include Xanax and Ativan.
3. Z-drugs
Z-drugs are also named as the non-benzodiazepine hypnotics. They include eszopiclone, zolpidem, and zaleplon. Z-drugs are mostly used for the treatment of insomnia or sleep issues. They extant a resemblance to Xanax and Ativan as they both target the GABA-A receptors. However, the major difference is that the Z-drugs are selective in terms of some specific subunits of the receptor. Moreover, this also involves reduced side effects. But as the Z-drugs are majorly used for the treatment of insomnia they are less considered for the treatment of anxiety.
4. Buspirone
Buspirone is also a medication that belongs to the different class of anxiolytics. This medication also exhibits multiple differences from Ativan or Xanax. Moreover, it is often used for treating generalized anxiety disorder.
The main factor that distinguishes buspirone from Ativan or Xanax is that it does not target the GABA receptors and only acts on the serotonin receptors. Moreover, this medication does not result in sedative effects. Likewise, there is no link of buspirone with anticonvulsant properties which are found in the case of benzodiazepines. Other distinctive things include the slower onset of action and duration of achieving the complete and desired therapeutic effects.
5. Barbiturates
Barbiturates were mostly used in previous times for anxiety and insomnia treatment but nowadays, they are replaced by benzodiazepines. The main reason behind replacement is that they have a higher safety profile. Moreover, there are also some reasons for avoiding the intake of barbiturates: withdrawal symptoms, high risk of overdose as well as physical dependence. As Ativan and Xanax are majorly recommended to treat anxiety, therefore barbiturates are currently used for the treatment of severe forms of insomnia and epilepsy.
6. Gepirone
The main target of gepirone is the 5-HT1A receptor agonist. Moreover, it is also used for managing generalized anxiety disorder due to multiple reasons which include reduced risk of physical dependence, abuse, sedation as well as withdrawal symptoms. Although it can be used for treating anxiety, it is still under investigation and experts are still trying to find more facts.
Other Complementary therapies to treat Anxiety
Although Xanax and Ativan are used for anxiety treatment, there are still some other non-pharmacological approaches which include psychotherapy. Psychotherapy or talk therapy is a widely used therapy that is used for treating anxiety by targeting negative, undesired, or anxious thoughts. The most common psychotherapy that is widely recommended and used by experts include:
1. Cognitive behavioral therapy
Cognitive behavioral therapy is also used by experts and is considered effective for the treatment of anxiety disorders. The main responsibility of cognitive behavioral experts is first to identify the undesired, negative, or intrusive thoughts that trigger anxiety or related disorders. They teach the individuals how they can overcome their anxious thoughts. They learn multiple ways to transform their negative thoughts into positive and realistic thoughts. Moreover, they also guide individuals on how they can manage those unwanted or undesired situations that trigger their anxiety or fear.
2. Exposure therapy
Exposure therapy is also another type of psychotherapy that is widely recognized for the treatment of anxiety disorders. This involves the exposure of individuals to those places, objects, and situations that trigger their stress and fear. Experts first ask the individuals to note down their stress and fear and then face them gradually without showing any response. Initially, they face difficulty in restricting themselves but with time, they learn to adapt themselves to each situation and control their fear.
3. Healthy & Positive changes in lifestyle
If you think that your anxiety symptoms are mild or less severe then you can also take control of your mind with the help of some positive changes in your lifestyle. Focus on your diet and add some healthy products in your diet such as protein, carbohydrates, and essential fats. Moreover, you can also add some healthy nutrients to your diet. Likewise, you should also focus on your sleep patterns. If you do not get sufficient sleep then you will feel lazy and tired all the time. Moreover, you will also feel reduced energy levels to overcome your life challenges and remain in a distressing situation throughout the day. Therefore, try to make a complete schedule, wake up early, and sleep on time.
Furthermore, make a routine to perform a daily exercise or any physical activity so you remain mentally fresh and active. Moreover, you can also keep a journal where you note all your positive thoughts and focus on them to live a normal and healthier life.
Concluding thoughts
Ativan and Xanax are benzodiazepines that are recommended for the treatment of anxiety disorders. Both medications are equally effective but exhibit some similarities and major differences in terms of dosage onset of action etc. Experts recommend Ativan or Xanax based on the mental condition of the individual. The inappropriate dosage or excessive intake of Xanax and Ativan can result in multiple negative consequences. Moreover, they are not recommended by the experts as the first-line treatment.
Consult the Professionals for Safe and Lasting Recovery!
If you or your loved one is struggling with any issues that are linked to intake of Ativan, Xanax or any other medication then reach out to the Renewed Mental Health Group to consult the professional to get a secure and appropriate recommendation.
So if you are currently taking any psychiatric medication or planning to take then stay relaxed as we are here to help. Don’t wait anymore and book an appointment with our experts to get personalized recommendations so you can seamlessly start your journey of mental strength, resilience, and empowerment.
