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Ativan vs. Xanax

Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD

Dealing with anxiety can be debilitating, impacting every aspect of daily life. When exploring treatment options, medications often come into consideration. Ativan and Xanax are two frequently prescribed medications for anxiety disorders, each with its own set of benefits and potential drawbacks. In this guide, we’ll delve into the intricacies of Ativan and Xanax, comparing their mechanisms of action, effectiveness, safety profiles, and considerations for personalized treatment plans.

Understanding Ativan and Xanax

  • Ativan (Lorazepam):
    • Ativan, a brand name for lorazepam, belongs to the benzodiazepine class of medications. Benzodiazepines are central nervous system (CNS) depressants commonly prescribed to alleviate symptoms of anxiety, panic disorders, insomnia, and seizures.
    • Lorazepam, the active ingredient in Ativan, works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that promotes feelings of relaxation and calmness.
    • Ativan is available in various forms, including oral tablets, liquid solutions, and injectable formulations, offering flexibility in dosage and administration.
  • Xanax (Alprazolam):
    • Xanax, a brand name for alprazolam, is another benzodiazepine medication widely prescribed for the management of anxiety and panic disorders.
    • Alprazolam acts similarly to lorazepam by enhancing the inhibitory effects of GABA in the brain, resulting in a calming effect and reduction of anxiety symptoms.
    • Xanax is available in immediate-release and extended-release formulations, providing options for both acute symptom relief and long-term management of anxiety disorders.

Which Works Better?

Determining the effectiveness of Ativan versus Xanax is complex and often depends on individual factors such as the severity of anxiety, coexisting medical conditions, and personal response to medication. While both drugs are considered equally potent in alleviating anxiety symptoms, some studies suggest slight differences in onset of action and duration of effect:

  • Onset of Action: Ativan typically has a faster onset of action compared to Xanax, with effects becoming noticeable within 15 to 30 minutes after administration. Xanax may take slightly longer to produce therapeutic effects, typically within 30 to 60 minutes.
  • Duration of Action: The duration of action varies between Ativan and Xanax formulations. Immediate-release Xanax typically has a shorter duration of action, lasting around 4 to 6 hours, while Ativan’s effects may last slightly longer, up to 6 to 8 hours. Extended-release Xanax formulations may provide more sustained symptom relief, with effects lasting up to 11 hours.

Understanding Side Effects and Risks

  • Common Side Effects:
    • Both Ativan and Xanax share common side effects associated with benzodiazepine use, including drowsiness, dizziness, confusion, blurred vision, and impaired coordination.
    • These side effects are usually mild to moderate in severity and tend to diminish over time as the body adjusts to the medication. However, some individuals may experience more pronounced side effects or adverse reactions.
  • Risk of Dependence and Withdrawal:
    • One of the most significant concerns with benzodiazepine medications like Ativan and Xanax is the potential for dependence and withdrawal symptoms.
    • Prolonged use or misuse of these medications can lead to physical and psychological dependence, making it challenging to discontinue treatment without experiencing withdrawal symptoms such as rebound anxiety, insomnia, tremors, sweating, and even seizures in severe cases.

Choosing the Right Medication

Selecting the appropriate medication for anxiety requires careful consideration of various factors, including:

  • Individual Response and Tolerance: Some individuals may respond better to Ativan, while others may find Xanax more effective in managing their anxiety symptoms. Personal tolerance levels, previous medication experiences, and genetic factors can influence individual responses to benzodiazepines.
  • Medical History and Co-occurring Conditions: Your medical history, including any coexisting physical or mental health conditions, plays a crucial role in medication selection. Certain medical conditions such as liver or kidney disease, respiratory disorders, substance abuse, or a history of benzodiazepine dependence may impact the choice between Ativan and Xanax.
  • Potential Drug Interactions: Both Ativan and Xanax have the potential to interact with other medications, including other benzodiazepines, opioids, antidepressants, antipsychotics, and certain antibiotics. It’s essential to inform your healthcare provider about all medications, supplements, and herbal remedies you’re currently taking to minimize the risk of drug interactions.
  • Dosage Flexibility and Formulations: Ativan and Xanax are available in various strengths and formulations to accommodate individual treatment needs. Healthcare providers may prescribe different dosages or formulations based on the severity of anxiety, desired onset and duration of action, and the presence of other medical conditions.

Tips for Safe Medication Use

If you and your healthcare provider decide that medication is the appropriate treatment option for your anxiety, it’s essential to be vigilant about monitoring for potential side effects and managing them effectively. Here are some tips for safe medication use:

  • Follow Prescribed Dosages: Take your medication exactly as prescribed by your healthcare provider. Avoid taking larger doses or more frequent doses than recommended, as this can increase the risk of side effects and dependence.
  • Be Aware of Potential Interactions: Inform your healthcare provider about all medications, supplements, and herbal remedies you’re currently taking, including over-the-counter medications. Certain medications and substances can interact with Ativan and Xanax, altering their effectiveness or increasing the risk of adverse effects.
  • Monitor for Side Effects: Pay attention to any changes in your physical or mental health while taking Ativan or Xanax. Common side effects to watch for include drowsiness, dizziness, confusion, blurred vision, and changes in mood or behavior. Contact your healthcare provider if you experience any concerning symptoms.
  • Avoid Alcohol and Recreational Drugs: Alcohol and recreational drugs can potentiate the sedative effects of benzodiazepines like Ativan and Xanax, increasing the risk of overdose and respiratory depression. Avoid alcohol and illicit substances while taking these medications.
  • Don’t Abruptly Stop Medication: If you decide to discontinue Ativan or Xanax, do not abruptly stop taking the medication without consulting your healthcare provider. Benzodiazepines should be tapered off gradually to minimize the risk of withdrawal symptoms and rebound anxiety.

Reach Out to Us Today!

At New Hope Healthcare Institute, our team of experienced professionals specializes in dual diagnosis treatment for both teens and adults, providing comprehensive assessments, individualized treatment plans, and ongoing support for individuals struggling with anxiety and co-occurring disorders. Contact us today at 866-806-1027 to schedule a confidential consultation and take the first step toward reclaiming your mental health and well-being.


Both Ativan and Xanax belong to the benzodiazepine class of medications, which have the potential for dependence and addiction, especially with prolonged use or misuse.

Ativan typically starts working within 15 to 30 minutes after ingestion, while Xanax may take slightly longer to produce effects, usually within 30 to 60 minutes.

Combining Ativan and Xanax or using them simultaneously is not recommended without medical supervision, as it can increase the risk of adverse effects and overdose.

Withdrawal symptoms from Ativan and Xanax may include anxiety, insomnia, tremors, sweating, and seizures, among others. It’s crucial to taper off these medications gradually under medical supervision to minimize withdrawal effects.

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