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  • Ativan Vs. Xanax | What’s The Difference & Which Is Better For Anxiety?

    two pill bottle similarities and differences between ativan and xanax

    Anxiety disorders are among the most frequently diagnosed mental health conditions in the United States. Benzodiazepines, such as Xanax and Ativan, are commonly used to treat several of these conditions.

    Along with Xanax and Ativan, other benzos include:

    • Valium (diazepam)
    • Klonopin (clonazepam)
    • Restoril (temazepam)

    Although both drugs are very similar in many ways, Xanax tends to have a higher risk of abuse and dependence. Since both of these medications are safer as a short-term treatment, you might consider antidepressants as a long-term treatment for anxiety instead.

    What Are Benzodiazepines (Benzos)?

    Benzodiazepines increase the effect of the neurotransmitter gamma-aminobutyric acid (GABA) on the GABA-A receptors in your brain. This results in calming effects, such as relaxation, sedation, and euphoria. 


    Xanax is the brand name for alprazolam and is most commonly prescribed for anxiety disorders that specifically include a panic disorder. Xanax is more effective than Ativan for panic attacks because the onset of effects is quicker. 


    Ativan is the brand name for lorazepam and is most commonly prescribed for anxiety disorders that may include insomnia. Ativan is also commonly used to treat alcohol withdrawal because it interacts with similar receptors in the brain.

    Similarities & Differences Between Xanax & Ativan

    Lorazepam and alprazolam share many qualities, especially their effects on the central nervous system (CNS). Although both of these drugs share several similarities, there are some unique differences between these medications.

    Similar side effects of Ativan and Xanax include:

    • drowsiness
    • dizziness
    • memory impairment
    • coordination problems
    • sedation
    • irritability
    • respiratory depression 

    Xanax and Ativan should never be combined with alcohol or opioids because it can increase these effects and cause a life-threatening overdose.

    Differences In Side Effects

    According to the Food and Drug Administration (FDA), alprazolam may also increase hypomania or mania in individuals with depression. Sharing your medical history with your healthcare provider can help them determine the best treatment for you. 

    Half-Life Of Xanax & Ativan

    Half-life is the time it takes the total concentration of the drug in your system to be reduced by half. Knowing a drug’s half-life can help you determine how long it stays active in your system.

    Xanax Half-Life

    Alprazolam reaches peak concentration levels in your system quickly, about 1-2 hours, and has a half-life of about 11 hours.  

    Ativan Half-Life

    Lorazepam reaches peak concentration levels in your system after at least two hours and has a half-life of about 12 hours, not including its metabolites. Lorazepam tends to be slightly slower-acting than alprazolam, meaning you are less likely to need it as frequently.

    Is Xanax Or Ativan Better For Treatment Of Anxiety?

    The best treatment plan for your anxiety disorder should be determined by your doctor. They will take many factors into consideration before prescribing any medications. 

    Factors that may affect treatment include:

    • family history
    • medical conditions
    • history of alcohol or opioid addiction

    Studies On Xanax & Ativan

    There are several studies that show equal efficacy in treatment with both alprazolam and lorazepam. According to the National Institute of Health (NIH), two separate double-blind studies show both drugs to be similar in effectiveness for treating anxiety. 

    Other studies showed varying results, which is because certain individuals experienced more side effects with one drug over the other. Many factors can impact how intense the side effects of a drug will be, including gender, size, muscle mass, and mental health. 


    While lorazepam and alprazolam are effective for acute anxiety symptoms, taking them long-term can lead to abuse and dependence. 

    An option your doctor may discuss with you is using antidepressants as a long-term treatment for anxiety disorders. Antidepressants have to build up in your system before they take effect, so you may be prescribed benzos to bridge the gap until your new medication is effective.

    Dependence & Withdrawal 

    Both lorazepam and alprazolam should only be used as short-term treatment because of the risk of abuse and dependence. Over time, you may need increasingly higher doses of either drug to produce the same effects. 

    This tolerance can lead to physical dependence, which means you can experience unpleasant withdrawal symptoms if you stop abruptly. 

    Withdrawal from both alprazolam and lorazepam can be dangerous. You can avoid severe withdrawal symptoms by tapering under the care of your prescribing doctor. 

    Learn more about treatment with Ark Behavioral Health by contacting us today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    American Academy of Family Physicians (AAFP) - Generalized Anxiety Disorder
    Food and Drug Administration (FDA) - Ativan (lorazepam) Tablets
    Food and Drug Administration (FDA) - Xanax (alprazolam) Tablets
    National Institute of Health (NIH) - A Double-blind Study of Alprazolam and Lorazepam in the Treatment of Anxiety
    National Institute of Health (NIH) - Lorazepam vs. Alprazolam in the Treatment of Panic Disorder

    Medically Reviewed by
    Kimberly Langdon M.D.
    on July 18, 2022
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