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Lorazepam vs Xanax: What is the difference?

Medically reviewed by Drugs.com. Last updated on Oct 14, 2024.

Official Answer by Drugs.com

Both lorazepam and Xanax are prescribed for anxiety but is one better than the other?

Lorazepam and Xanax are both benzodiazepines used for the treatment of anxiety, and both are equally effective for this use.

The main differences between Lorazepam and Xanax are:

See also: Drugs.com Compare Tool - Lorazepam vs Xanax

What are Lorazepam and Xanax?

Lorazepam is the generic name of the drug lorazepam. The only branded lorazepam available in the U.S. is Ativan. Xanax is a brand (trade) name for alprazolam. Although both drugs belong to the class of drugs known as benzodiazepines, so have a similar mechanism of action, there are structural differences between them that affect their activity in the body.

Which one works quicker?

Xanax is usually more quickly absorbed than lorazepam with peak concentrations occurring within 1-2 hours following administration, compared to 2 hours for lorazepam. Effects of Xanax last on average 4 to 6 hours although there are wide variations between individuals (see below). Effects of lorazepam last approximately 8 hours, although may persist for longer in some people.

How much Xanax equals 1mg of lorazepam?

Benzodiazepine equivalency tables state that 0.5mg of alprazolam (Xanax) is approximately equivalent to 1mg lorazepam. However, people of Asian descent metabolize Xanax differently to people of other races, and certain disease states such as alcoholism, liver and kidney disease, obesity and even old age can affect how Xanax behaves in the body; so benzodiazepine equivalency tables should be used as a guide only as they do not reflect individual variation. Both lorazepam and Xanax should only be used short-term.

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How do lorazepam and Xanax work?

Both lorazepam and Xanax, like all benzodiazepines, enhance the actions of a neurotransmitter in the brain called GABA (gamma-aminobutyric acid). This neurotransmitter can reduce the activity of nerve cells, so enhancing it has a calming effect which can improve symptoms of anxiety, reduce muscle tension, stop seizures, and induce sleep. Benzodiazepines are also known for their amnesic effect – or ability to disrupt short-term memory – and this makes them useful before surgery. Because of structural differences, some benzodiazepines are more likely than others to make you sleepy, relieve anxiety, stop seizures, relax muscles, or make you forget. Lorazepam and Xanax are both FDA approved for anxiety-relief, and are less likely than some other benzodiazepines (such as diazepam or temazepam) to induce sleep. Sedative effects of lorazepam that did occur were of slower onset but lasted longer than alprazolam in one trial. Lorazepam may also be used in the treatment of seizures.

Which drug is more effective for anxiety?

Trials that directly compared lorazepam and Xanax for the treatment of anxiety have reported no significant differences in their effect, and few differences in their side effects, although mental confusion may be less with Xanax.

Which drug is more addictive?

Both lorazepam and Xanax should only be used short-term due to risk of addiction and dependence. Generally speaking, benzodiazepines with a shorter half life (such as lorazepam and Xanax) are harder to stop than those with a longer half life (such as diazepam). Both lorazepam and Xanax readily enter brain tissue which reinforces drug taking and is generally associated with more severe withdrawal symptoms. Therefore, lorazepam and Xanax are both at high risk of abuse. Research directly comparing lorazepam with Xanax is not available; however, many experts have particularly advised that Xanax be used with caution as it has been associated with particularly severe withdrawal symptoms.

Lorazepam and Xanax are usually not prescribed together.

References
  1. Lorazepam [Package Insert] Revised 07/2016 Major Pharmaceuticals. https://www.drugs.com/pro/lorazepam.html
  2. Xanax (alprazolam) [Package Insert] Revised 03/2015 Pharmacia and Upjohn Company https://www.drugs.com/pro/xanax.html
  3. Benzodiazepine equivalency table Revised April 2007 http://www.benzo.org.uk/bzequiv.htm Accessed 09/2016
  4. Bernardi F, Fossi L, Faravelli C, et al. Alprazolam versus lorazepam in the treatment of anxiety: controlled clinical study. Riv Patol Nerv Ment. 1984 Jan-Feb;105(1):1-13
  5. Botte L, Bienfait J, Dethier J et al. Clinical comparison between alprazolam and lorazepam. A polycentric study in double blind. Acta Psychiatr Belg. 1981 Nov-Dec;81(6):595-608
  6. Greenblatt DJ, Harmatz JS, Dorsey C, Shader RI. Comparative single-dose kinetics and dynamics of lorazepam, alprazolam, prazepam, and placebo. Clin Pharmacol Ther. 1988 Sep;44(3):326-34
  7. Longo LP, Johnson B. Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. Am Fam Physician. 2000 Apr 1;61(7):2121-2128. http://www.aafp.org/afp/2000/0401/p2121.html

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Xanax (alprazolam) will cause sedation, drowsiness and somnolence as a side effect but is not typically prescribed to help with insomnia (trouble sleeping) on a regular basis. Sleepiness after taking Xanax usually occurs within 15 to 45 minutes. Continue reading

How does Xanax make you feel?

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