Xanax vs Ativan: What’s the Difference?

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If you’re dealing with clinical anxiety, you’re probably here because you’re researching medications you think can help. Medications can be helpful in treating anxiety, but they’re more effective when part of an overall treatment plan created by mental health professionals. Some medications for anxiety are intended for short-term use only due to the potential for abuse and addiction. Two popular brands of anxiety medication that are controlled substances are Xanax and Ativan. These two drugs can be prescribed to treat anxiety, but there are differences between the two.

If you’re having trouble understanding the difference between Xanax vs Ativan, this article will help you learn more.

Xanax vs Ativan: What’s the Difference?

Xanax (alprazolam) and Ativan (lorazepam) are both benzodiazepine drugs meant to treat anxiety. However, there are key differences in how they work.

The main differences between Ativan and Xanax include:

  • Potency: Xanax is generally considered to be more potent than Ativan on a per-milligram basis. This means that lower doses of Xanax are needed to achieve a similar effect to Ativan.
  • Onset of Action: Xanax tends to work more quickly than Ativan. It reaches its peak level in the blood within 1 to 2 hours after ingestion, making it effective for the rapid relief of acute anxiety. When compared, Ativan, on the other hand, may take a bit longer to feel its effects, but it also lasts longer in the body.
  • Half-life: Xanax has a shorter half-life (about 11 hours for most individuals) compared to Ativan, which has a half-life ranging from 10 to 20 hours. This means Ativan stays in the body longer and can lead to more prolonged effects.
  • Potential for Addiction: Both Ativan and Xanax are a controlled substance and carry the potential for dependence and addiction. However, Xanax is considered the strongest benzodiazepine. Many people taking Ativan or Xanax report withdrawal symptoms when they stop using the medication. These withdrawal symptoms are often a barrier to getting help when benzo addiction is a problem.


The choice of Ativan vs Xanax will depend on your specific needs. This is a choice best made in consultation with a doctor. It’s crucial to have these medications prescribed by a healthcare provider who can consider these factors and monitor for side effects and potential dependence.

What Are the Side Effects of Benzodiazepines?

Benzodiazepines are powerful medications with the potential for severe withdrawal symptoms when used over a long period or when used in higher doses than prescribed. The physical and psychological side effects of benzodiazepine addiction can prevent people from getting the help they need. Some studies have shown that people taking benzos for a period of more than 3 to 4 weeks can experience withdrawal symptoms when they stop taking the medication.

Here are some of the signs and symptoms of benzodiazepine abuse:

  • Changes in appetite
  • Decreased motor skills
  • Drowsiness and fatigue
  • Respiratory depression
  • Blurred vision
  • Reduced sex drive and performance
  • Dizziness
  • Nausea


The effects of Xanax or Ativan on the central nervous system cause a pleasurable sedative effect that increases the risk that someone misuses the drugs. There are also dangerous drug interactions with substances like opioids and alcohol. Some may combine the drugs with other substances for a more potent effect, but this opens the door for an overdose. Understanding these signs and symptoms can help you recognize that benzos are a problem. Finding help from an anxiety treatment center is the best course of action for those who need assistance.

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Are There Other Anxiety Medications?

There are many anti-anxiety medications used in treatment. As discussed above, one of the main types is benzodiazepines, which work by enhancing the effects of a neurotransmitter called GABA in the brain to promote relaxation and reduce anxiety. Xanax, Ativan, and other types of benzodiazepine carry the potential for dependence, addiction, and withdrawal, especially with long-term use. They should be used with caution in the short term only and under strict medical supervision. When someone develops a physical dependence on benzodiazepines, it can raise someone’s anxiety baseline. That means when not taking benzos, someone will experience worse anxiety than before they started taking the medication. 

Here are some other types of anti-anxiety medications:

  • Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are a class of drugs commonly prescribed for depression and anxiety disorders. They work by increasing the levels of serotonin in the brain, which helps improve mood and reduce anxiety.
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs are similar to SSRIs but also increase the levels of norepinephrine in the brain, offering an additional pathway for treating mood disorders. They are used for depression, anxiety, and sometimes chronic pain.
  • Beta-Blockers: Beta-blockers are primarily used to manage cardiovascular conditions, such as high blood pressure and arrhythmias, but they can also be prescribed off-label to reduce physical symptoms of anxiety, like tremors and rapid heartbeat.
  • Buspirone: Buspirone is an anxiolytic medication that is specifically used to treat generalized anxiety disorder (GAD). It works differently from SSRIs and SNRIs by affecting serotonin receptors directly, and it typically has fewer side effects.

When choosing between Xanax vs Ativan or any other anti-anxiety drug, it’s important to consider your health history, the specific anxiety disorder you have, and the potential risks, including the risk of addiction. This is best done in consultation with a healthcare professional.

Are There Different Kinds of Anxiety?

There are two kinds of anxiety. The first is characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. These feelings are situational and usually pass with time. Everyone feels this kind of anxiety from time to time. It’s a normal human emotion with subconscious roots in helping keep us safe.

However, when a person regularly feels disproportionate levels of anxiety, and those levels don’t seem to abate, regardless of circumstance or time, that’s when it becomes a medical issue. This is what’s known as clinical anxiety.

The experience of clinical anxiety can vary greatly from person to person.

Common signs and symptoms of clinical anxiety include:

  • Restlessness or feeling wound up or on edge
  • Being easily fatigued
  • Difficulty concentrating or having one’s mind go blank
  • Irritability
  • Muscle tension
  • Difficulty controlling worry
  • Sleep problems (difficulty falling or staying asleep, or restless, unsatisfying sleep)
  • For someone with an anxiety disorder, the anxiety does not go away and can worsen over time. The feelings can interfere with daily activities such as job performance, schoolwork, and relationships.

Anyone can suffer from clinical anxiety, but things like genetics and family history can raise a person’s likelihood. Evidence suggests that experiencing trauma during childhood can raise someone’s risk of experiencing anxiety as an adult. Regardless of why someone feels more anxiety than other people, the best thing to do is find safe and effective treatment rather than turn to drugs or alcohol to self-medicate. This can actually make anxiety worse over time as your brain chemistry is affected by substance abuse.

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What Is the Best Treatment for Anxiety?

Anxiety disorders are typically treated through a combination of therapy and medication. The exact approach will depend on the needs of the client.

One of the most common therapies for anxiety is cognitive behavioral therapy, which teaches individuals to identify and challenge negative thought patterns and behaviors that cause or exacerbate anxiety symptoms. Through CBT, clients learn coping strategies to manage and reduce their anxiety.

While therapy attacks root causes, medications treat symptoms to provide more immediate relief. One of the most common classes of anti-anxiety medications is benzodiazepines. These are sedatives that can help relax your muscles and calm your mind. However, they are typically prescribed for short-term relief of anxiety symptoms due to their potential for dependence and withdrawal.

It’s important to note that while benzodiazepines can be effective for short-term relief, they are not typically recommended for long-term use due to risks of dependence, tolerance, and withdrawal, as well as potential cognitive effects. Always consult a healthcare professional when choosing between Xanax vs Ativan.

Who Can Prescribe Anxiety Medication?

Only a certified professional can prescribe anxiety medication. While the tight controls around these medications can make getting them legitimately a hassle, they’re there for a reason.

Trying to get anxiety medication online is a bad idea because not only are these drugs potentially addictive, but when you buy online, you have no idea if what you are getting is pure or not. Oftentimes, dealers sell contaminated drugs, cut with other substances as a cost-saving measure. These substances can make what you are taking significantly more dangerous than it otherwise would be.

It’s essential to consult a qualified medical professional when seeking medication for anxiety. Discuss your symptoms, medical history, and treatment preferences when considering Xanax vs Ativan. Your healthcare provider will evaluate the best course of action based on your individual needs and suggest the most appropriate medication for short-term relief or long-term management of anxiety symptoms.

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If you or a loved one are struggling with anxiety but wonder how long addiction treatment takes or have other questions, call us at 866-881-1184 or fill out our quick and easy contact form. Our highly qualified staff will be happy to help give you an idea of what to expect from your addiction recovery timeline, verify your insurance, and assist with any other questions you may have.

Pierce Willans
Kelly McIntyre
Medically Reviewed by Kelly McIntyre, MS, LMFT
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