Ativan Side Effects

Ativan vs. Xanax

In many senses the discussion of Ativan versus Xanax is one where the real answer is that not a lot of difference. Ativan and Xanax are both members of the benzodiazepine class of medications and when compared there are many more similarities in Ativan versus Xanax than there are differences. Both Ativan and Xanax are considered short acting benzodiazepines with serum half-life that are quite similar. The serum half-life of Ativan is approximately 15 hours worth the serum half-life of Xanax approximately 12 hours and in different individuals the actual serum half-life may be higher for either of these medications. In a milligram for milligram dosing Xanax is approximately twice as potent as Ativan so is 0.25 mg dose of Xanax is approximately equal to 0.5 mg dose of Ativan.

In considering the potential for physical dependence of Ativan versus Xanax because the serum half-life the very similar there’s probably very little difference. Both lead to the majority of the medication being out of the system and less than 24 hours and if a person has developed physical tolerance to the medication minor withdrawal symptoms could be expected in less than a day after last dose. For this reason both Ativan and Xanax are considered more psychologically addicting than some of longer acting benzodiazepines, although all benzodiazepines have the potential for abuse, dependence and addiction.

When Xanax first came to market it was felt to be less likely to lead to depression than Ativan but there’s very little evidence in the literature this is actually the case. Ativan seems to be used more frequently in patients who need therapy for acute alcohol withdrawal symptoms then Xanax although again from a pharmacologic standpoint there’s probably little reason to choose one over the other. Some experts recommend a longer acting benzodiazepines these indications like Valium or Librium because they will function for longer period of time and have less abrupt withdrawal issues.

Neither Ativan nor Xanax have FDA indications for insomnia although many patients prescribed either Ativan or Xanax for anxiety disorder end up using them for sleep and are sometimes continued on these medications for the hypnotic benefit. Because of their half-life of 12 hours or more morning drowsiness with use of these medications at bedtime is frequently a problem and shorter acting drugs are usually considered better choices for chronic insomnia.

From a cost standpoint both Ativan and Xanax are available as a generic molecules, lorazepam and alprazolam respectively. As a generic both drugs are relatively inexpensive and so cost is not usually a consideration in the Ativan versus Xanax decision for therapy.

Neither Ativan nor Xanax is ideal for long-term therapy. Both can lead to physical dependence as well as psychologic dependence and addiction so both are better used for short-term anti-anxiety effect. Even better is to use either of these medications infrequently and therefore avoid any concern of dependence or withdrawal.


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