Difference between Ativan and Xanax

Updated on May 28, 2019

According to studies, benzodiazepines such as Ativan and Xanax are some of the most commonly abused drugs in the US. While these two drugs bear similarities, specifically in terms of potency and use, there are still several factors that make them distinct.

Summary Table

AtivanXanax
Can be used for patients as young as 12 years oldOnly prescribed to patients who are 18 years and older
Peak time: around 1 to 6 hoursPeak time: around 1 to 2 hours
Half-life time: 14-15 hoursHalf-life time: 11-12 hours
Can be used for patients with recurring seizures that are not attributed to epilepsy, irritability, pre-surgical sedation, and maniaCan be used for patients with panic attacks, essential tremors, irritable bowel syndrome, tinnitus, and extreme premenstrual syndrome
Poses less risk for addictionPoses more risks for addiction
Symptoms of drug intoxication include headache, heartburn, blurred vision, and confusionSymptoms of drug intoxication include rebound insomnia and memory impairment
Available as a pill or liquid medicationAvailable as a pill, liquid, dissolving tablet, or extended release variant
Dosages: 0.5 mg, 1 mg, and 2 mgDosages: 0.25 mg, 0.5 mg, 1 mg, and 2 mg
Safer for patients with liver problemsNot safe for patients with liver problems

Definitions

Ativan
Ativan

Ativan is among the several brand names used for the generic drug lorazepam. Lorazepam is categorized as a benzodiazepine – a drug classification that aims to control anxiety attacks by inhibiting excess nerve stimulation in the brain.

Xanax
Xanax

Xanax, like Ativan, is also a brand name used for a benzodiazepine. Generically known as alprazolam, Xanax is commonly prescribed as a short-term medication for patients suffering from anxiety disorders.

Ativan vs Xanax

Like other benzodiazepines, Ativan and Xanax are both used for the short-term management of psychological disorders such as nervous tension and anxiety. While both are psychoactive drugs that work on the central nervous system, there is still a huge difference between Ativan and Xanax.

Age Group

Between the two, Xanax has more restrictions in terms of usage. Unlike Ativan that can be used for 12-year-old patients, Xanax is only prescribed to those who are 18 years old and older.

Peak Times

Ativan’s peak time is somewhere between 1 to 6 hours, which is longer than the expected peak time for Xanax, which is at around 1 to 2 hours. But while Xanax is the faster-acting drug, Ativan has a longer action time.

Half-Life Times

In pharmacology, half-life time refers to the time it would take for the body to eliminate half of the concentration of the drug. On average, Ativan’s half-life (14-15 hours) is longer than Xanax’s (11-12 hours) by 3 hours.

Indication

Both Ativan and Xanax are commonly prescribed for patients that suffer from anxiety attacks, restlessness and nervous tension. But since Xanax works faster than Ativan, it is the drug of choice for managing panic attacks, which necessitate immediate medical action.

Additionally, there are some conditions that require the use of Xanax instead of Ativan, and vice versa. For instance, Xanax is sometimes included in the treatment plan for essential tremors, irritable bowel syndrome, tinnitus, and extreme premenstrual syndrome. Ativan, on the other hand, can be used for the management of recurring seizures that are not attributed to epilepsy, irritability, pre-surgical sedation, and mania.

Drug Dependency

Ativan and Xanax can cause drug dependency and addiction when used long-term, but between them, Xanax poses more risks for addiction because Ativan leaves the body quicker, lessening risks for drug toxicity. Nonetheless, abruptly stopping the use of either of these drugs can cause withdrawal symptoms that may include dizziness, sedation and problems with memory.

Drug Intoxication

The overuse of either drug can cause drowsiness, dizziness, hypotension (low blood pressure), and dry mouth, but there are still differences between the two in terms of drug toxicity. For one, Xanax is not commonly used for patients with bipolar disorder since it can lead to an increased risk for mania. Other symptoms found in patients that overuse Xanax include, but are not limited to, rebound insomnia and memory impairment. Comparatively, aside from the symptoms mentioned above, Ativan intoxication can also cause headache, heartburn, blurred vision, and confusion.

Form and Dosage

Ativan is available as a pill or liquid medication, which come in a 2 mg, 1 mg, or 0.5 mg dosage. Unlike Ativan, Xanax is available not just in pill and liquid form as it also has dissolving tablet and extended release variants that come in 2 mg, 1 mg, 0.5 mg, and 0.25 mg dosages. Between the two drugs, Ativan is commonly prescribed in higher doses.

Metabolism

Both Ativan and Xanax are metabolized by the liver, but they use different pathways that greatly impact their overall effect on the organ. Ativan does not contain active metabolites, which means that it can be safely used by patients with liver disease. Xanax, by contrast, is not safe for those with hepatic problems as it can lead to the overproduction of liver enzymes, which can eventually damage the liver.

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