Xanax vs Ativan for Anxiety
Xanax and Ativan are both members of the benzodiazepine family and are used for the treatment of anxiety related disorders. They can also be used for muscle relaxant and anti-convulsive effect.
For a list of ways to fight anxiety in general, see The Top 25 Anxiety Tips.
How does Xanax vs Ativan compare?
First, they are both high potency. This means that they are relatively strong among their class of medication.
Xanax has a half life of 6-20 hours while Ativan has a half life of 10-20 hours. This means that your body gets rid of both of these medications relatively quickly. By comparison, Valium, another popular benzodiazepine, has a half life of 20-100 hours.
This is both good and bad. It’s good in that you clear the drug out of your system quickly. It’s bad in that it means that drug delivery is relatively quite rapid. When you stop taking the medication, it quickly clears from your body, which can result in horrible withdrawal.
Both are fairly addictive when used for long periods of time.
In a survey of 31 clinicians with detox experience, 84% said that Xanax is “especially problematic” for withdrawal. Ativan is also highly addictive and has similar withdrawal incidences, but has somewhat less of a bad reputation.
Efficacy
Both Ativan and Xanax are highly effective for the short term treatment of anxiety and neither has been indicated for the long term treatment of anxiety. Both work at fairly high rates to treat panic symptoms.
One study of 74 patients showed that the two have similar efficacy for treating of anxiety at around two weeks.
Remember, both have very similar chemical activity and similar half-lives.
Side effects
Both have similar side effects.
Xanax and Ativan both cause some degree of memory impairment. One study showed that Ativan was among the “most frequently associated with amnestic effects” in the benzodiazepine class.
The way that memory impairment is tested for is as follows. Participants are told to memorize a set list of numbers or words then are given the medication and asked to recall them. This, or some variant, is used to show if memory impairment happens.
It’s somewhat artificial and does not replicate the more realistic use of the medications over several weeks. It has been shown that the memory impairment side effect may be attenuated to some degree over time. On the other hand, other studies have shown that long term use of Xanax or Ativan can cause memory and attentional problems.
Both Xanax and Ativan are also both associated with sedation. One study showed that Xanax was among the least sedating of the benzodiazepines while Ativan was among the most sedating.
Another study showed that Ativan has slower onset of sedative and memory effects, but that they lasted longer than with Xanax.
Note
There are very few studies that directly compare Ativan vs Xanax. This is likely because drug companies have no reason to run comparison studies when there is the chance that their medication may come off in a bad light.
Neither of these drugs should be on the market outside of a hospital setting, there are far better ways to treat panic attacks and especially anxiety. Both cause severe and prolonged withdrawal syndrome in at least 50 percent of people who use them for 3-6 months. Long term use at higher doses can result in severe withdrawal symptoms such as hallucinations, seizures, severe muscle pain, twitching, intractable insomnia, vommiting, epigastirc problems, dysphoria and ataxia. Death can occur if you stop taking the drug abruptly. Those are just a few of the brutal withdrawal symptoms I experienced after being on Klonopin and Xanax for a number of years. Stay away from both these medications except for (very) short term use. Shame on the pharm industry for handing out these drugs like candy and the physicians who RX them.
DID I MISS SOMETHING MARK S. ZACHMAN? SURELY YOU MUST BE DR. MARK S. ZACHMAN OR MAYBE MARK S. ZACHMAN PHD.? THE MANNOR IN WHICH YOU WROTE I THOUGHT YOU WERE AN EXPERT BUT THEN I REALIZED YOU WERE MERELY ANOTHER JUNKIE LOOKING TO PLACE BLAME ON ANYONE BUT YOURSELF. IF YOU TRUELY NEDDED THIS MEDICATION AND TOOK IT ONLY AS DIRECTED I DON’T BELIEVE YOU WOULD HAVE HAD SUCH SEVERE WITHDRAWAL.WHAT YOU DESCRIBE DOES NOT ADD UP. WHY DO YOU THINK PEOPLE SHOULD ONLY BE HOSPITALIZED TO BE GIVEN THE MEDS. YOU WERE ON? SO YOU CAN’T BE IN CONTROL?SO YOU DON’T TAKE THEM WHENEVER YOU WANT AND IN WHAT AMOUNT YOU WANT! YOUR NOTHING BUT A JUNKIE WHO CAN’T CONTROL YOURSELF SO WHY IS THAT THE DRUG COMPANIES FAULT? AGAIN,IF YOU TOOK THE MEDS. AS DIRECTED AND SUDDENLY STOPPED THEN YOU “MAY” HAVE SOME MILD PHYSICAL WITHDRAWAL WHICH YOU SHOULD HAVE KNOWN ABOUT BEFORE YOU TOOK A SINGLE PILL…..DID YOU NOT READ ALL THE INFO. THAT COMES W/EA.&EVERY SCRIPT? I THINK YOU KNEW THIS,I THINK YOU KNEW WHAT SUDDEN WITHDRAWAL AT HIGHER DOSES WOULD BE LIKE ALSO BUT WHEN A JUNKIE WANTS A HIGH………NOTHING ELSE MATTERS!!! GROW UP TAKE IT LIKE A MAN AND STOP TRYING TO BLAME ANYONE ELSE YOU WEREN’T FORCED TO TAKE IT……………….
WOW….harsh LOL…..I agree in someways though. I was prescribed Xanax a while back and my Dr was sure to let me know that if I exceeded the recommended dosage I would be at rick of developing a dependency. Maybe Mark should have at least read the warning that comes with the meds. It is however, just a temporary fixer. I was only prescribed it until my SSRI kicked in…which took about a month. Benzos are not ment to be long term aids….Unless all other long term drugs are ineffective (Paxil, Zoloft, Welbutrin…ect).
I don’t think Mark said anything wrong. In my opinion, he clearly stated that with the side effects affecting memory and the sort, that these drugs should NOT be so available. This didn’t indicate to me that he possessed any “junky” tendencies, as you would like to say (BREEIA). Mark was simply stating that with the hars effects it could have on the body; withdrawal, dependency and death inclusive, they should not be available to use. How you took this and claimed he was a junky wanting his next high missed the spider web for me. Mark, I totally agree with what you are saying with memory impairment, as I have been prescribed Klonopin and Xanax. But also know I am a two time graduate that has no record and no medical history of having any harsh adverse effects to these medicines. This has been over the course of 1.5 years. I have gone periods of 3 months or longer not taking these medications only experiencing mild to severe irritability, brain moving faster than my mouth can keep up and axiety. Nothing phsical took place because I work out regularly and I eat somewhat healthy. Everyone is not the same, however Mark shouldn’t have been labeled due to his OPINION on the medications readily available, yet labeled “narcotic”. Doctor or not, his opinion is valid…it doesn’t take initials to see that. Ever took a course where you wrote a thesis statement on a paper? Or maybe a debate that took place in lecture hall? Did you even attend college BREEIA? I think I’ve rested my case here…case/point-think before you speak. Everything that hits your brain isn’t meant to be said. Since you felt you placed Marks opinion below yours, how do you anticipate a rebuttal for mine???
Both of these drugs work tremendously well for sporadic, infrequent panic attacks. That is, NOT long term. Mark’s comments about withdrawal and using for 3-6 months are in regards to people abusing the drug and not following the indicated usage. How the hell was he on Xanax for years? Either he is a junky or he had a doctor who should be in jail. I’m guessing junky. Abusing drugs is abusing drugs. Idiot.
OK… I’m seeing on other sites people who had *doctors* prescribe this stuff for years. That is unbelievable. So that may very well be the case with Mark. If so, that is reprehensible. This stuff is NOT for long term use, *period.* Sorry I called him an idiot if that’s the case and if so his doctor should be in jail for malpractice.
Again, for short term, infrequent use this stuff is great. Anyone going outside of that is looking for trouble.
It scares me if someone has a hard time with a medication and suddenly makes movesw to have everyone else restricted from that horrible medication also. We each have to have control. We can have a family member control the dose hand outs for the day if we fear our own control will fail.
Medical research has found that some people have the ‘gene’ to get addicted to alcolhol, cigarettes, cocaine, and other substances. Many many people do not have that addiction problems. Not everyohe is the same in hadnkling medicationsl.
It is annoying that Canada and 3rd world countries can get codeine with their cough syrup or aspirin but Americans, the poor idiot sods, can not. They must all be mentally deficient in controlling themselves or something the U.S.A. prohibits many drugs you can buy at the corner store in most countries.
I hate seeing people that are in the addictive group destroy the help these drugs give ourselves and others. I don’t want the government that far in control of my life. Sure, give out the warnings. We need to know. But it is hard to be treated for so many things because the U.S.A. believes we are all incapable for watching out for ouselves. And if one person has a problem, nobody should get the help anymore.
I am truly sorry when someone turns out to have that addiction written into their chromosome and gets hurt. In all my prescriptions, and youthful partying, nothing has addicted me but the cigarettes, and I fell for that because I didn’t understand what an addiction was. Its horrible. And now that the government has increased tobacco product taxes a couple thousand percent, cigarettes are so high that theft may be many peoples only way. That is a problem. Who thought that making cigarettes incredibly expensive would stop smoking??? can you spell addiction? obviously can’t define it.
We have an obligation to control ourselves, not to try to control others who are very probably not just like you. America is goinhg crazy with personal choice limits. Well, that got off limits.
However you can tell hospitals and doctors that you are allergic to any drug you have a problem with and thereby keep yourself from being given the drugs that harm you. A lot easier that trying to make laws for everyone else in the world.
@Vicki,
I totally agree with your point. The thing to realize with benzodiazapines is their highly *physical* addictive property. That is, if you take them for long enough, even if you aren’t someone with addictive traits, you will become addicted, period. And unlike most drugs coming off of these can be extremely *dangerous.* Benzodiazepines are currently a schedule IV drug in the US. But considering the physical addictiveness and how quickly that happens with the dangers associated with withdrawal, it should likely be a Schedule II drug. Trust me, if you were put on these for a month and then quit taking them, you’d be in a world of hurt.
I have been prescribed Ativan for panic attacks for over 10 years. My doctor made me fully aware of the risks and proper usage. My therapist – who is responsible for working with me on my anxiety management – has always said that she would rather I took an ativan once or twice a month than turn to some other form of self-medication, such as alcohol or smoking or other drugs. I set my own personal boundaries around my usage. If I need more than one dose a week, I get a therapy session and go back to the basics of my coping mechanisms… I have never used more than one refill (30 .5 mg pills) in a year, and usually less. For patients with good coping skills and self-discipline, there is no reason not to have this in your tool box for acute/situational anxiety or panic attacks.
You can buy all these drugs online without any problem. No wonder we are so addicted
I have been prescribed and taken as needed, an Ativan dose of 1 milligram, 1 at a time up to 3 times daily, for the last 27 years. I take them when Needed, not at whatever terms the prescription says. It is quite obvious this is not an anti-biotic or life sustaining drug such as Synthroid that must be taken daily as written. My doc was clear on taking them “as needed”, and directed the use of 2 at a time in certain situations, instead of one as was written. I absolutely understood that the prescription terms did not say I was to take that many everyday. Unless I wanted to be institutionalized for treatment.
I take them as a precaution on the few business/social ocassions I need to attend, and I take them on an ‘emergency’ basis, when my brain and all my uncontrolled chemical imbalances are spinning out of control. Ativan has saved my life and marriage thru the years on many ocassions.
I have had a couple experiences with withdrawal symptoms, racing pulse and anxiety, or creepy feelings in muscles. That is a warning that you are having problems. You cut back use and re-evaluate your criteria for taking the drug. if you are not strong enough to control yourself, you immediately call your doctor with the information. Although there may be a feeling of anxiety, it is Not the type of anxiety that caused the drug to be prescribed!.
If you cuse the discomfort as a warning and react immediately, you won’t go through hell months later when physical withdrawal will be horrible.
There is NO excuse for taking any drug blindly as ordered. You can NOT rely on or blame your doctor for your problems, in most cases. It is your life and your responsibility to inform your doctor of any problems, physical or emotional, with a drug the doc has prescribed you. If you omit info or lie, your doctor or family members are not at fault for believing you. Nobody can read your mind.
Having the drug available does not “cause” your addiction. Your lack of wanting to take control of your life, or active pursuit of and abuse of a drug because it feels good is the cause of your addiction. Nobody else but you knows and can control your presription use and need.
Getting the drug on line absolutely does NOT cause or validate addiction. You are actively abusing the drug if you order online. In fact those drugs coming from other countries have no manufacturing controls, they may not even contain any of the drug you order. They might have plaster of paris as the combining material, not good for your body. Many of these on-line drugs contain animal tranquilizers.
Think, get info on the internet on any drug you are given.
I have been prescribed and taken as needed, an Ativan dose of 1 milligram, 1 at a time up to 3 times daily, for the last 27 years. I take them when Needed, not at whatever terms the prescription says that I am allowed. I often take 1/2 and wait 30 minutes to see if it will work. why screw up a helpful medication by causing it to quit working due to overuse?
It is quite obvious this is not an anti-biotic or life sustaining drug such as Synthroid that must be taken daily as written. My doc was clear on taking them “as needed”, and directed the use of 2 at a time in certain situations, instead of one as was written. I absolutely understood that the prescription terms did not say I was to take that many everyday. Unless I wanted to be institutionalized for treatment.
I take them as a precaution on the few business/social ocassions I need to attend, and I take them on an ‘emergency’ basis, when my brain and all my uncontrolled chemical imbalances are spinning out of control. Ativan has saved my life and marriage thru the years on many ocassions.
Through the years I have taken 30 in a month, or none, or 1 or 2. Even Ativan can start to make you feel dull and out of it, why would I take a drug continuously that made me feel like I was living a half life?
I have had a couple experiences with withdrawal symptoms, racing pulse and anxiety, or creepy feelings in muscles. That is a warning that you are having problems. You cut back use and re-evaluate your criteria for taking the drug. if you are not strong enough to control yourself, you immediately call your doctor with the information. Although there may be a feeling of anxiety, it is Not the type of anxiety that caused the drug to be prescribed!.
If you use the discomfort as a warning and react immediately, you won’t go through hell months later when physical withdrawal will be horrible.
There is NO excuse for taking any drug blindly as ordered. You can NOT rely on or blame your doctor for your problems, in most cases. It is your life and your responsibility to inform your doctor of any problems, physical or emotional, with a drug the doc has prescribed you. If you omit info or lie to your doctor, your doctor or family members are not at fault for believing you. Nobody can read your mind.
Having the drug available does not “cause” your addiction. Your lack of wanting to take control of your life, or active pursuit of and abuse of a drug because it feels good is the cause of your addiction, not the doctor or the drug itself. Nobody else but you knows and can control your presription use and need.
Getting the drug on line absolutely does NOT cause or validate addiction. You are actively abusing the drug if you order online. In fact those drugs coming from other countries have no manufacturing controls, they may not even contain any of the drug you order. They might have plaster of paris as the combining material, not good for your body. Many of these on-line drugs contain animal tranquilizers.
Think, get info on the internet on any drug you are given. There is so much info available now to research before you take a prescription drug. There is incredible info passed around in daily life, friends, radio, TV, that talks about addictions. there is no excuse of not knowing.
If you don’t take control of your use or abuse, your doctor will, probably by cutting off your prescription immediately No doctor wants to be targeted by the DEA, or lose their license to practice medicine because a patient doesn’t bother to take care of themselves.
Sorry about the double post, i skipped ahead for info, came back to make a note, i didnt realize it would print the note, and when i came back, my note in progress was still in the writing box ooops
FYI, No one has ever isolated a gene in relation to addiction.
Golly a lot of angry people here. Name calling and all…
I disagree with Mark that these drugs should only be used in hospitals. Sorry he had to endure such horrific withdrawals.
I started taking Klonpin and moved my way up to Xanax bc the milder and lower doses were not working. When it got to that point my PC sent me to a psychiatrist to manage my anxiety. Which is the responsible thing to do. And my psychiatrist was very cautious with me when I first came to him. Unlike all the others, he actually sat down and discussed my issues past & present. Rather than sitting behind his desk w/ his script pad wanting to know what I needed. He even did a tox screen to make sure i wasn’t using anything else.
I am prescribed 2mg 1/2 -1 3x daily. No, I like others have stated do not take that dosage. During the day if I feel like I need one I start w/ only a quarter. And there are times when I need a whole pill. But I will say this I do have to take one every night. Sometimes I can get by with half that nightly dose for weeks and when I go back to the higher dose it is bc something is going on. I have severe anxiety. Both my doctor and I know that I cannot quit cold turkey bc of withdrawals. He has informed me plus I educated myself about what I am taking. Xanax does not get me high or make me feel euphoric, I can function normally. If I did not have it I would probably end up hospitalized. You have to be your own advocate and be responsible for yourself. If a doctor is all to eager to prescribe you whatever w/out doing follow ups to see if you still need it, then maybe that should raise a red flag…. find a new doctor. My doctor knows what is happening in my life & reevaluates me often.
I THINK SOMEONE NEEDS A XANAX!!!! or maybe just therapy. LOL
I took Klonopin for about 8 years for severe panic attacks. I gradually weaned myself off of it. In certain instances, these medicines are wonderful. I occasionally now, when I can’t sleep through the night, take a half of a .05 of it. The lack of sleep is one of the most destructive things, will make an anxiety so much worse.
I was on Lexapro for about two years, weaned myself off at Christmas, and by August I had to be hospitalized for severe anxiety. Went back on the Lexapro and ativan .5 mg morning and night for about a year and a half and felt quite normal. The weight gain was terrible, so I weaned off the lexapro again at Thanksgiving, but stayed on the Ativan. The farther away I get from the lexapro, the more anxious I feel, but that morning and evening dose of ativan takes it away in 30 minutes. I am very afraid I will never feel normal again without drugs. If I could take .5 mg of Ativan 2 or 3 times a day, things would be manageable, but I need to know if this is dangerous. I’m confused because some of you have such strong opinions about NOT taking this drug ever, but it helps me cope. I want my life back. My Dr. seems to think I could be on this for an extended time without adverse affects. She said the same thing about the lexapro. People who don’t suffer with this can’t understand we can’t just “snap out of it” or “think positive” to get over this. I’m trying 50 mg of 5HTP today to see if that helps.
One mg of lorazapam( Attivan ) and 10 mg of paxil gave me back my life. I have been taking these 2 drugs for 15 years. I have not had a panic attack in that period. If I forget to take the attivan, I do feel anxious and keep an emergency pill in my wallet. However feeling anxious and having a panic attack where you feel as if you are going to fall over and die from lack of oxygen are two distict feelings.The horrors I faced every day are gone forever. I can only speak for my own situation. Mark may be far more sensitive than myself?
I have been on celexa (daily) for 4 years. Im also perscribed ativan for 4 years as well. mine usually expire casue im sure not to tthke the but smaybe 4 or5 times a month because of the addiction warning. Im to scared of addiction so im sure to only take them if i cant get my panic under control.
Wow. Wasn’t going to comment until I saw breeia’s judgmental response to poor Mark there. One, he never said he was an addict and 2, since you appear to be so knowledgable about all this Breeia, and you’re spew against addicts apparently didn’t know that alcoholism and addiction are recognized medical diseases as stated by the AMA. And since you appear to be playing doctor, let me also. You’re actions sound as if you came from an alcoholic/ addiction home. You have all of the characteristics of an alkie/addict, without actually using. We call that a dry drunk. Everyone reacts to meds differently. (I’m moving on just to let you know)….where Ativan gives me a buzz,Xanax and klonopin do not…klonopin makes me more tired than the other two. Don’t ever take advice from lay people, like myself…what works for me , may kill you. We are not doctors ….and Breeia, I’ll say a special prayer for you ;)