One of our most popular columns is our 'Fact Or Fiction' column, where we investigate certain rumors or misconceptions out there regarding anything pharmacy. In our latest edition, we discuss if one drug is better than the other: Ativan Vs. Xanax

Fact Or Fiction


Ativan (Lorazepam) and Xanax (Alprazolam) are two medications that are in the same class of drugs, known as benzodiazepines. The benzodiazepine class is very broad, containing over 15 different medications.

They have a variety of different uses and indications including anxiety, insomnia, alcohol dependence and panic attacks. While all of the medications within the class work in the body the same, they differ in various attributes including their onset of action, duration of action and how long the actual drugs stays in the body.

Ativan (Lorazepam) and Xanax (Alprazolam) are two of the most commonly used medications in the benzodiazepine class. Many people want to know, what is the difference between the medications. Ativan Vs. Xanax, which one is better?

Xanax (Alprazolam) Information

Xanax (Alprazolam) is distinctive due to its' rapid onset of action and its' short duration of action. Xanax (Alprazolam) is rapidly absorbed in the gut following administration. Peak levels in the blood are reached within 1—2 hours of taking the medication.

The onset of action usually occurs within 15—30 minutes. The half life of the medication is usually put around 15 hours. A very important point to realize about Xanax (Alprazolam) is that it has active metabolites. This means that over time, the drug can accumulate in the body with continuous dosing.

For this reason, it is usually not recommended in the elderly or in those that may have trouble metabolizing the medication. Xanax is typically dosed 2-4 times a day.

Ativan (Lorazepam) Information

Ativan (Lorazepam), like Xanax (Alprazolam), has a rapid onset of action with effects occuring within 15-30 minutes after administration. The duration of action in most patients does last a little longer when compared to Xanax (Alprazolam). 

The half life of the medication is typically around around 18 hours. The main benefit for using Ativan (Lorzepam) over Xanax (Alprazolam) is the fact the Ativan does not have any active metabolites and is not mainly metabolized through the liver. The drug is therefore a better choice in the elderly and in those with some sort of liver dysfunction.

Ativan Vs. Xanax

There is no clear a winner in this one as they are both very similar medications. Choosing a benzodiazepine always depends on why you are taking the medication and what you need from it. Both Ativan and Xanax are rapid acting medications and are mainly used for panic attacks, anxiety and trouble falling asleep.

Ativan does tend to last a little while longer in patients. Ativan is a better choice in patients that are elderly due to the fact that there are no active metabolites when our body breaks it down. Ativan is also a better choice in those with liver disease since it is not primarily metabolized through the liver.

It is important to note that since both Ativan and Xanax have a rapid onset of action and a relatively short half live, they have a higher risk of dependence and withdrawal symptoms vs. other benzodiazepines.

Ativan Vs. Xanax Summary

  • Both Ativan and Xanax are fast acting. However, Xanax may be slightly faster onset.
  • Ativan has a longer duration of action.
  • Ativan has no active metabolites, and may be preferred in the elderly.

Result: Fiction - Each drug has a different profile and is used in appropriate situations.