Xanax and Ativan: How Are They Different? Your Questions Answered

I can feel it in my chest. My heart is racing, tightening. There’s stiffness in the back of my neck. There’s a tingling sensation running down my arms and legs. I’m sweating bullets. I’m terrified.

Am I having a heart attack? Am I dying? What’s happening to me?

Do I need to go to the emergency room? Will I make it there? What should I do? Who should I call?

For those who suffer from anxiety and panic attacks, that first one feels like you’re trapped in a box, breathless, scratching and clawing to just feel oxygen hit your lungs. In those moments, it feels as though there’s no end in sight. They can be crippling, frustrating, and can wreak havoc on just about anyone.

Do I just have to live this way?

Over the years, doctors started prescribing medications to combat the effects of anxiety and panic.

Both Xanax (the brand name for alprazolam) and Ativan (the brand name for lorazepam) are used to treat anxiety and panic disorders. These medications are what are known as benzodiazepines. 

As with any prescribed medication, it’s important to only use these under the supervision of a medical professional. Don’t take Xanax or Ativan without a prescription, or at dosages higher than recommended. Any carelessness can lead to misuse or addiction.

Even though they fall under the same benzodiazepine classification, there are differences between the two.

What Exactly is Xanax?

According to the U.S. National Library of Medicine, Xanax “is used to treat anxiety disorders and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Alprazolam (Xanax) is in a class of medications called benzodiazepines. It works by decreasing abnormal excitement in the brain.”

Xanax is also used to treat depression, agoraphobia (fear of open spaces), and premenstrual syndrome. 

Xanax comes in tablet form and is taken by mouth. Typically, it’s taken once per day in the morning.

As noted earlier, Xanax is only available if prescribed by a medical professional. It’s important to maintain routine visits with your doctor. Experts also recommend providing your doctor with a list of medications you’re already taking before starting Xanax.

You can find a list of precautions here. Don’t hesitate to ask your doctor questions or raise any concerns before taking Xanax.

OK, So What Is Ativan?

As mentioned earlier, both Xanax and Ativan are benzodiazepines.

We’ll once again reference the U.S. National Library of Medicine, which says Ativan is used to relieve anxiety. Ativan works by slowing activity in the brain to allow for relaxation.

Ativan can also be used to treat irritable bowel syndrome, insomnia, epilepsy, symptoms caused by cancer treatment, and to help control symptoms caused by alcohol withdrawal.

Much like Xanax, Ativan comes in tablet form and is taken by mouth. It’s usually taken two to three times a day with or without food.

Just as you would with Xanax, take Ativan only as prescribed, and stay in contact with your doctor. And as always, speak up if you have questions. A list of precautions to follow for Ativan can be found here.

Xanax Vs. Ativan: Spotting the Differences

While the two have their similarities, they also have their differences. A keen eye may have caught a few differences earlier, but let’s take another look.

Xanax is primarily prescribed to combat anxiety and panic disorders, as well as agoraphobia and premenstrual syndrome.

Ativan is prescribed to relieve anxiety and can also be used to treat conditions like irritable bowel syndrome, epilepsy, and insomnia. It can also be used to help with side effects caused by cancer treatment and symptoms of alcohol withdrawal.

Another key difference is the number of times the medications are taken each day. Those who are prescribed Xanax will typically take one dose in the morning. Ativan is usually taken two to three times a day. 

Also, according to the U.S. Food and Drug Administration, it takes around 11 hours for a half dose of Xanax to leave the body. Xanax can also be detected in your hair for 90 days, urine for 4 days, saliva for 2.5 days, and blood for just a day.

In comparison, it takes around 18 hours for a half dose of Ativan to leave the body. After ingestion, Ativan can be detected in your hair for 90 days, urine from 6 to 10 days, saliva for 6 to 8 hours, and blood from 6 hours to 3 days.

Although the two medications have their differences, one crucial similarity remains: Both pose a risk for misuse and addiction. 

The Facts About Xanax Misuse and Addiction

Misuse is usually defined as taking more than your prescribed dosage, taking the drug more often than prescribed, or even taking it without a prescription.

Xanax slows down the central nervous system, which can be calming even for those without a prescription. This is one of the reasons the drug is misused, leading to potential addiction.

When Xanax is misused, it may be taken in its normal tablet form, snorted, injected, or smoked. 

It’s important to know the signs of Xanax misuse for not only yourself, but also in case you’re concerned about a loved one. Signs include:

• Running out of prescriptions early
• Sedation
• Unmarked pill bottles lying around
• Powder (residue) on personal items
• Tinfoil and lighters if it’s being smoked
• Rolled papers, straws, and pens if it’s being snorted
• Tourniquets, needles, or spoons if it’s being injected

Side effects of Xanax misuse are:

• Dizziness
• Dry mouth
• Headaches
• Depression
• Memory problems
• Confusion
• Insomnia (can’t sleep)
• Sleepiness

There are other potential consequences of Xanax misuse, including the risk of potential overdose. In 2016 alone, there were a reported 10,000 benzodiazepine overdoses in the United States. Xanax overdoses are common when the drug is mixed with other substances such as opioids and alcohol. About 80% of Xanax overdose deaths in 2016 involved opioids. Mixing the substances together can cause too much sedation, which could result in falling into a coma, being unable to breathe, and sometimes death.

A Look at Ativan Misuse and Addiction

Just like Xanax, Ativan can be misused, dangerously. As mentioned earlier, if you’re taking the drug too much, without a prescription, or to simply get high, you’re putting yourself at risk for addiction or an overdose.

Side effects of Ativan misuse can sometimes mimic those of someone who is drunk. Symptoms of Ativan misuse or addiction are:

• Dizziness
• Sleepiness
• Restlessness
• Blurred vision
• Dry mouth
• Shuffling walk
• Fever
• Yellowing of skin or eyes
• Difficulty breathing or swallowing
• Irregular heartbeat

Similar to Xanax, Ativan is extremely dangerous when mixed with other substances. Such mixing is one of the leading causes of Ativan-related overdose deaths. More serious symptoms of Ativan misuse and addiction include extreme respiratory depression, seizures, memory problems, falling into a coma, and too much sedation.

Those addicted to Ativan may have behavioral changes that can lead to tensions between family and friends, financial problems, not following up on responsibilities, and recklessness.

Dealing with Xanax Withdrawal

Because Xanax can become physically and mentally addictive, it can create a dependence that may lead to withdrawal symptoms when the drug isn’t taken or the dosage is reduced.

Withdrawal symptoms usually begin four days after the last dose. Symptoms include, but are not limited to:

• Muscle cramps
• Sweating
• Tremors
• Vomiting
• Seizures
• Heart palpitations
• Anxiety
• Panic attacks
• Hallucinations (seeing or hearing things that aren’t there)
• Suicidal thoughts

It’s extremely important to seek professional help to address a Xanax addiction. The withdrawal symptoms can be not only very uncomfortable but very dangerous. Treatments like medically assisted detox programs can help with the safety of the individual. Medications may be used to ease the withdrawal process. Therapy may also be recommended or offered to help prevent relapses from occurring.

What You Should Know About Ativan Withdrawal

Ativan withdrawal is similar to withdrawal from its benzodiazepine counterpart, Xanax. However, Ativan withdrawal can occur just hours after the last dose.

Symptoms include:

• Insomnia
• Headaches
• Tremors
• Panic attacks
• Blood pressure changes
• Vomiting
• Confusion
• Depression
• Memory problems

Again, seek professional help if you’re addicted to Ativan. Treatments may be similar to those for Xanax addiction. Don’t hesitate to reach out for help. You deserve a safe, comfortable environment to address your Ativan addiction.

What Is a Detox?

A detox involves eliminating drugs and alcohol from the body. Factors that will affect the detox process include which drug or substance was used, how long it was used, and how it was used. A detox will also allow the individual to safely manage their withdrawal symptoms. Before treatment, it’s important to know the following:

• Dosage and how the drug was taken
• When the substance was last used
• If the individual has recovered from addiction before
• Outcomes of past attempts at recovery

A medical detox includes:

• Medication to help with withdrawal symptoms
• Monitoring heart and breathing rates
• Emergency care if needed
• Support in tapering off the substance at hand

Following detox, an inpatient treatment program may be necessary. This could be long-term or short-term. Short-term programs may last from 28 to 30 days, while long-term programs can last 90 days or more. Others may choose an outpatient program.

According to the National Institute on Drug Abuse, “Although medically assisted detoxification can safely manage the acute physical symptoms of withdrawal and can, for some, pave the way for effective long-term addiction treatment, detoxification alone is rarely sufficient to help addicted individuals achieve long-term abstinence. Thus, patients should be encouraged to continue drug treatment following detoxification. Motivational enhancement and incentive strategies, begun at initial patient intake, can improve treatment engagement.”

Drug misuse is a mental disorder and can occur with other mental health disorders. Individuals may be assessed for these, and along with treatment providers will then decide which route to take. There are ways to combat these disorders.

Help Is Out There

Your addiction doesn’t define you. You can live a life free from Xanax or Ativan misuse. You are worthy of proper care and treatment. The first step is reaching out for help.

Treatment should address everything surrounding the addiction. This includes any problems with anxiety or depression. The goal should be to give you the proper tools to live a life of lasting recovery. Remember, despite how you may feel, you’re never alone.

You can seek treatment for Xanax or Ativan misuse today. Call 888-341-4325. Calls are free and confidential.

RehabCenter.net can help bridge the gap between those who need treatment and the quality facilities that provide it. By reaching out, you can speak with a treatment specialist who will determine what treatment options may be needed.

Frequently Asked Questions

Is Ativan stronger than Xanax?

The half-life of Ativan reportedly lasts longer than the effects of Xanax. It takes around 11 hours for a half dose of Xanax to leave the body, while it takes around 18 hours for a half dose of Ativan to leave the body. Detection time varies between the two medications. As mentioned earlier, Ativan can be detected in your hair for 90 days, urine for 6 to 10 days, saliva for 6 to 8 hours, and blood from 6 hours to 3 days.. Xanax can be detected in your hair for 90 days, urine for 4 days, saliva for 2.5 days, and blood for just a day.

Which is better for anxiety: Xanax or Ativan?

You should consult with your doctor to determine which medication is right for you. Since everyone’s situation is different, the decision should be left to a medical professional. As reported by the U.S. National Library of Medicine, Xanax “is used to treat anxiety disorders and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks).” Ativan can help relieve anxiety and can also be used to treat irritable bowel syndrome, epilepsy, and insomnia. It may also help with side effects caused by cancer treatment and symptoms of alcohol withdrawal.

What works better: Xanax or lorazepam?

Both medications are used to treat anxiety. Lorazepam is also known by the brand name Ativan. Depending on your situation, you may be prescribed one or the other. Lorazepam has uses that may differ from those of Xanax, which is why it truly depends on which will work better for you. Discuss your symptoms with a doctor, and they will determine the right course of action. Remember, just because one may last longer or work faster doesn’t necessarily mean it’s better for you.

What is the strongest benzodiazepine for anxiety?

According to the U.S. National Library of Medicine, alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan) are all high-potency benzodiazepines used to treat symptoms of anxiety. It also reports alprazolam and clonazepam are the only benzodiazepines prescribed for the treatment of panic disorder in the United States. Drugs affect people differently. If you notice any symptoms, or if the medication is too strong, consult with your doctor.