Ativan Vs Xanax: The Similarities & Differences

Ativan and Xanax are known for being effective tools for managing anxiety and the negative symptoms and side effects of having the disorder. But these two drugs are different, have different effects and uses, and should be handled differently. 

The problem is that the people taking these medications often don’t know a lot of the differences between them and only get a little education about how to use the medications most effectively and the risks that come with use. 

So, let’s take a closer look at both Ativan and Xanax, the side effects of both drugs, what withdrawal looks like from both drugs, and possible signs of addiction.

Remember, everyone who uses these drugs needs this information, even people who are taking them with doctor supervision and are taking them exactly as prescribed. Responsible use of medication can still lead to addiction, and you may need to go through withdrawal from these medications even if you aren’t addicted, like if they stop being as effective for you and you need to change which drug you’re using. 

What Is Ativan & What Are Its Side Effects?

Ativan is a commonly used anti-anxiety medication and can also be injected as a treatment for some seizure disorders or as a premedication for some kinds of anesthesia. 

The generic name for Ativan is lorazepam, and, like Xanax, it’s a benzodiazepine. Benzodiazepines are commonly used to help with anxiety disorders, but they also have a high potential for misuse. People who have dealt with substance use disorders should be especially careful when taking any benzodiazepine, including Ativan because these medications are more prone to causing addictions than most. 

Because of the risk of addiction, Ativan and other benzodiazepines are generally tightly controlled and require a good amount of doctor supervision. 

Ativan is a longer-lasting benzodiazepine than most. It reaches peak concentration in your body about 2 hours after you take the drug and generally lasts about 8 hours. Some people can have a longer effective time depending on their metabolism or other factors. 

Side Effects Of Ativan

The side effects of Ativan are largely similar to the ones for Xanax, so don’t be surprised when you see the same list in the next section. 

Common side effects of Ativan include: 

  • Drowsiness
  • Fatigue
  • Confusion
  • Constipation
  • Depression
  • Loss of appetite
  • Difficulty speaking
  • Changes in libido
  • Changes in appetite
  • Fluctuating weight
  • Skin rashes (may require medical attention)
  • Headache 
  • Nausea
  • Blurred vision
  • Memory problems
  • Increased sweating

Some of the side effects of Ativan may be distressing for people around the person taking the medication, but they typically aren’t medically concerning unless they are severe or last more than a few hours. 

What Is Xanax & What Are Its Side-Effects?

Like Ativan, Xanax is a benzodiazepine primarily taken to help manage anxiety or anxiety symptoms from other disorders like depression or PTSD. 

However, compared with Ativan, Xanax, with the generic name alprazolam, is faster but doesn’t last quite as long. It’s often used to help treat generalized anxiety disorder. It’s also commonly used to treat panic disorder thanks to the speed of the medication, which can reach peak concentrations in your body in as little as an hour. 

Like other benzodiazepines, Xanax works in part by calming excess nerve activity in your brain. This can create a feeling of calm, mild euphoria, and drowsiness or forgetfulness. 

Let’s take a closer look at the side effects of Xanax: 

Side Effects Of Xanax

Common side effects of Xanax include:

  • Drowsiness
  • Fatigue
  • Confusion
  • Constipation
  • Depression
  • Loss of appetite
  • Difficulty speaking
  • Changes in libido
  • Changes in appetite
  • Fluctuating weight
  • Skin rashes (may require medical attention)
  • Headache 
  • Nausea
  • Blurred vision
  • Memory problems
  • Increased sweating
  • Swelling of the hands and feet (may require medical attention) 

You’ll note that this list is very similar to the list for Ativan, largely because these two medications are very similar, both in use and in action in your body. 

Let’s talk a little more about the similarities and differences between these two drugs, what happens when you withdraw from them, and how long withdrawal is likely to take.

Similarities & Differences Between Ativan & Xanax: Withdrawal Symptoms & Timeline

In terms of function, Ativan and Xanax are very similar. Both are used to deal with anxiety disorders, though different disorders may preference your prescribing doctor toward one medication or the other. 

For instance, Xanax is commonly used for panic disorder because it kicks in faster, making it more suitable for treating the very fast and often sudden effects of a panic attack. 

However, Ativan might be used for anxiety disorders that lead to longer-lasting or more persistent forms of anxiety because it lasts longer and stays in your system, keeping things calm for longer. It takes longer to kick in, but it might be a slightly better option if you need long-lasting relief. 

There are a couple of important differences, though. 

For instance, people of Asian descent are more likely to be prescribed Ativan because of a known difference in how people of Asian descent metabolize Xanax compared with other populations. People of Asian descent may react to Xanax faster than others, and the concentration of Xanax and byproducts in their bodies may reach higher levels than someone else taking the same dose. 

In the general population, Xanax is prescribed more often than Ativan, partially because intervening in anxiety sooner can often make the intervention more effective and offer better relief for the person experiencing symptoms. 

However, Xanax also comes with a greater risk of abuse and addiction than Ativan, making Ativan a marginally better option for people with anxiety who also have a history of drug abuse or addiction. 

Speaking of addiction, let’s talk about withdrawal and withdrawal symptoms. 

Timeline And Symptoms Of Xanax Or Ativan Withdrawal

Withdrawal is never comfortable, but it can be an important reality for people who take Xanax and Ativan. Withdrawal from these medications is sometimes necessary before a medication change if your doctor is concerned that you might be becoming addicted or even to see how you do without the medication to see if it’s still necessary. 

That said, withdrawal after addiction is usually more severe, and withdrawal itself can often cause some of the symptoms Xanax and Ativan are prescribed to treat. It’s important to get through withdrawal before evaluating if you still need Xanax or Ativan. 

Common symptoms of withdrawal from these medications include: 

  • Anxiety
  • Depression
  • Panic attacks
  • Paranoia
  • Hallucinations
  • Drug craving
  • Insomnia
  • Vomiting
  • Nausea
  • Muscle twitches
  • Mood swings
  • Tingling in your arms and legs
  • Cognitive differences or difficulty thinking

Rare withdrawal symptoms, which require medical attention, include: 

  • Psychosis
  • Seizures
  • Severe confusion

If any of these symptoms are present, it’s important to get medical attention as soon as possible, and you may need medical supervision throughout the rest of your withdrawal, depending on the severity of the symptoms. 

Unfortunately, benzodiazepines don’t have a set withdrawal timeline. The time it takes to withdraw from these drugs depends on your starting dose, how long it takes to reduce the dose before you stop taking the medication entirely, your metabolism, and other factors. 

Typically, acute withdrawal from benzodiazepines like Ativan or Xanax takes between a week and a month. However, some people experience extended withdrawal from benzodiazepines, in which case the withdrawal effects can take months to subside, and your timeline is likely to be less predictable. 

Addiction Signs To Ativan Or Xanax

If you’re taking Ativan or Xanax under doctor supervision and start to suspect that you might be becoming addicted to the medications, it’s important to talk to your doctor right away. For one thing, your doctor may realize you aren’t addicted since the symptoms of addiction to Ativan or Xanax can often resemble the symptoms of the disorders they’re prescribed to treat.

Even if your doctor agrees that you might be addicted, it’s important to work with them to develop a plan to deal with the addiction. Stopping benzodiazepines cold can be dangerous and generally isn’t a good idea. 

That said, here are some of the signs and symptoms of addiction to Ativan or Xanax: 

  • Taking the drug more often than you used to or more often than prescribed
  • Feeling like you’re out of control without the medication
  • Worrying about how much medication you have left or consistently running out before you can refill the prescription
  • Feeling like you aren’t yourself without the medication
  • Feeling out of control without the medication
  • Getting distracted by the thought of taking your medication, even when you shouldn’t need it or while you are still on an active dose. 
  • Feeling like you need to hide your use, even from people who know you take the drug
  • Considering buying the medication from the black market
  • Stealing or considering stealing to get money for the medication
  • Concealing information from your doctor to prevent them from stopping the prescription
  • Excessive worrying or fear that your prescription will be withdrawn or canceled

Now, let’s talk about getting help. 

How To Get Help For An Addiction To Ativan Or Xanax

Getting help for addiction to Ativan or Xanax can be frightening and a big step. These medications are typically used for people with anxiety, which can complicate recovery, especially while alternative medications or coping mechanisms help you deal with your anxiety. 

For all those reasons, as well as the strong possibility of chemical dependence among people who use benzodiazepines, it’s important to work closely with medical professionals when you need help with an addiction to Ativan or Xanax. 

The first step is usually speaking with the prescribing doctor or your primary care provider. Let them know what’s going on, why you’re concerned, and that you’d like help overcoming the addiction. Remember, your doctor might not always agree that you have an addiction, especially if you take the prescribed medication. 

Your doctor will then work with you to develop a plan for dealing with the medication and withdrawal and figuring out alternatives for your anxiety. 

One good option you should consider and that your doctor may bring up is going to residential treatment. This can be a good option because treatment centers can help bridge the gap between benzodiazepine withdrawal and figuring out new medications or coping mechanisms and can keep you safe and in a lower-stress environment. 

If you’re looking for a residential treatment center to help with Ativan or Xanax withdrawal, contact the Epiphany Wellness treatment center. We’re here to help you, using cutting-edge techniques and the best information science has available about benzodiazepine addiction, anxiety disorders, and recovery from addiction. 

No matter how you got here, you deserve the help you need to get better. 

Sources: 

  1. Vidaurri VA. Ativan vs. Xanax: Similarities and differences. Published November 9, 2022. Accessed October 21, 2022. https://www.medicalnewstoday.com/articles/325771
  2. Drugs.com. Ativan vs Xanax – What is the difference? Drugs.com. Published April 4, 2022. Accessed October 21, 2022. https://www.drugs.com/medical-answers/ativan-vs-xanax-3029943/
  3. Cunha JP. Ativan vs. Xanax: What’s the Difference? RxList. Accessed October 21, 2022. https://www.rxlist.com/ativan_vs_xanax/drugs-condition.htm
  4. Lin KM, Lau JK, Smith R, Phillips P, Antal E, Poland RE. Comparison of alprazolam plasma levels in normal Asian and Caucasian male volunteers. Psychopharmacology (Berl). 1988;96(3):365-369. doi:10.1007/BF00216063

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