Ativan (lorazepam) vs. Valium (diazepam)

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Ativan vs. Valium comparison

  • Ativan (lorazepam) and Valium (diazepam) are both members of the benzodiazepine family of drugs used mainly to treat anxiety and other psychiatric disorders.
  • Researchers believe both Ativan and Valium – like other members of the benzodiazepine group – work by enhancing the effects of a neurotransmitter that helps inhibit excess brain activity. Excessive activity of nerves in the brain may affect mental health to cause anxiety and other psychological disorders, according to the current understanding of neuroscience.
  • The central difference between lorazepam and diazepam is lorazepam leaves a person's system more quickly, reducing the chance of toxicity or side effects, a few of which are:
  • Ativan also has fewer unfavorable interactions with other medications when compared to Valium. Both drugs, however, can cause dangerous increased sedation when consumed with alcohol.
  • Both drugs also have the potential for addiction. Stopping either Ativan or Valium abruptly can cause dangerous withdrawal symptoms, depending on how long a person has been using the drug.

What are Ativan and Valium?

Lorazepam and diazepam are both benzodiazepines. They affect gamma-aminobutyric acid (GABA) is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another that reduce the activity of nerves in the brain. It is thought that lorazepam, diazepam, and other benzodiazepines like Xanax (alprazolam) or Klonopin (Clonazepam)  may act by enhancing the effects of GABA in the brain to reduce activity, and thus reduce anxiety.

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What are the uses for Ativan and Valium?

Ativan and Valium are both benzodiazepines, a class of medications used for treating anxiety disorders. Anxiety disorders cause a variety of symptoms, including unrealistic dread and worry, trembling, shortness of breath, and symptoms that mimic cardiovascular problems.

What are the side effects of Ativan and Valium?

Both Ativan and Valium, like other benzodiazepines, can cause drowsiness, loss of balance, sedation, and sleep disturbance. More rare but more serious side effects of both medications include respiratory depression and psychological depression -- People prescribed Ativan have even reported suicidal thoughts.

Lorazepam can cause extrapyramidal symptoms, which include a variety of drug-induced involuntary muscle movements.

Diazepam, can cause neutropenia, which is a dangerous reduction in the body's white blood cell count. Neutropenia compromises the body's ability to fight off infection and maintain health.

Diazepam, unlike lorazepam, can also cause muscle spasms and double vision.

This is not a full list of possible side effects. Please consult a doctor for further information if you are taking this drug.

Can I become addicted to Ativan and Valium?

Both drugs can cause physical dependence and addiction. When stopping therapy, your doctor should taper off the dosage. Stopping abruptly can lead to feeling a loss of self-worth, agitation, sweating, muscle cramping, and insomnia.

What are the withdrawal symptoms of Ativan and Valium?

If you take lorazepam or diazepam continuously for longer than a few months, stopping therapy suddenly may produce serious withdrawal symptoms like:

How should Ativan and Valium be taken (dosage)?

Ativan

  • The usual dose for treating anxiety is 2 mg to 6 mg orally in pill form every day, divided in doses every 8 to 12 hours as needed. Usual individual doses range from 0.5 mg to 2 mg per dose.
  • Insomnia is treated with 2 mg to 4 mg given at bedtime.

Valium

  • Diazepam for treatment of anxiety may be taken with or without food.
  • Diazepam is disposed of by the liver and excreted mainly by the kidney, therefore; dosage may need to be lowered in patients with kidney problems.
  • The usual oral pill diazepam dose for anxiety or seizures is 2 mg to 10 mg given 2-4 times each day.
  • The usual dose for the suppository version is 0.2mg/kg to 0.5 mg/kg, depending on the recipient's age.

Which drugs interact with Ativan and Valium?

Don't take either lorazepam or diazepam - like all benzodiazepines - in conjunction with depressants, tranquilizers, or other drugs that slow brain processes. Drugs such as alcohol, barbiturates, narcotics, and tranquilizers can magnify dangerously the sedating effect of both lorazepam and diazepam.

In addition to avoiding alcohol and other depressants, people taking Valium should take precautions when using certain antibiotics, antacids, and SSRI antidepressants. People may need a reduced dose of diazepam if taking them in conjunction with these medications. These specific medications prolong effects of diazepam by blocking the liver enzymes that break it down. The drugs include:

Conversely, the following drugs promote production of the liver enzymes that break down Valium, and so reduce its effectiveness:

Are Ativan and Valium safe to take if I'm pregnant or breastfeeding?

Lorazepam and diazepam cause problems with the developing fetus when used during pregnancy, pregnant woman with anxiety disorders should avoid these medications.

Neither should breastfeeding women used these medications. Both drugs are also secreted in breast milk and can harm infants who consume it.

REFERENCE: FDA Prescribing Information.

Last Editorial Review: 2/14/2017

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Reviewed on 2/14/2017
References
REFERENCE: FDA Prescribing Information.

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