Ativan (lorazepam) and Valium (diazepam) are two benzodiazepine medications that are used to treat anxiety disorders, seizures, and other related conditions. Although similar, there are many differences between the medications. This article will discuss the differences between Valium and Ativan. You will learn:
- Valium’s side effects and uses
- Ativan’s side effects and uses
- The key differences between the two drugs
If you or someone you love are addicted to benzodiazepines, please contact First Step Behavioral Health today to discuss your treatment options.
What is Valium (Diazepam)?
Valium is the brand name for diazepam, a benzodiazepine medication that was approved by the U.S. Food and Drug Administration (FDA) for the treatment of anxiety disorders in 1963. Between 1968 and 1982, it was the best-selling medication in the United States.[1,2]
Today, it is prescribed to treat a range of conditions including anxiety disorders, muscle spasms, alcohol withdrawal symptoms, seizures (such as epilepsy), and as a sedative before medical procedures.
Valium has a relatively fast onset of action when taken orally, typically within 30 to 60 minutes. Common side effects of Valium include drowsiness, dizziness, confusion, impaired coordination, and muscle weakness.
What is Ativan (Lorazepam)?
Ativan is the brand name for lorazepam, a benzodiazepine medication that was approved by the FDA in 1977 for the short-term treatment of anxiety or anxiety associated with depression.[3] It may also be prescribed to treat panic attacks, insomnia, seizures (such as epilepsy), and as a sedative before medical procedures.
Ativan has a relatively rapid onset of action when taken orally, typically within 30 to 60 minutes. The duration of action is generally between 6 to 8 hours, making it suitable for short-term relief of symptoms.[4]
Common side effects of Ativan include drowsiness, dizziness, confusion, impaired coordination, and muscle weakness. It can also cause memory impairment, especially at higher doses or with prolonged use.
Side Effects
Benzodiazepines work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. GABA is an inhibitory neurotransmitter that reduces neuron activity to calm the central nervous system. By enhancing GABA’s effects, benzodiazepines produce a range of anxiolytic and sedative side effects.
Ativan and Valium share many similar side effects, including:[1,3,5]
- Drowsiness
- Dizziness
- Sedation
- Impaired coordination
- Nausea
- Fatigue
- Confusion
- Irritability
- Constipation
- Low blood pressure
- Reduced libido
- Headache
- Slurred speech
- Muscle weakness
Side effects are typically mild and subside as the body adjusts to the medication. Higher doses are associated with more severe side effects.
Potentially serious side effects are rare, but possible. These include allergic reactions, severe drowsiness, unusual behavior, and difficulty breathing. Contact a healthcare professional immediately if any of these side effects arise.
Valium vs Ativan: Key Differences
Although Valium and Ativan have similar uses and side effects, there are several differences between the two.
Potency and Duration of Effects
Ativan is considered more potent than Valium. It also has a faster onset of action, providing rapid symptom relief. However, Valium is longer-lasting, so it can prove symptom relief for longer periods of time than Ativan.
Indications Separate From Anxiety
While both medications are used to treat anxiety disorders, their other uses differ slightly. Lorazepam is used to treat anxiety associated with depression and anxiety related to surgery. It can also be given in injection form for seizures that last longer than five minutes.
Diazepam, on the other hand, is often used to treat alcohol withdrawal syndrome and muscle spasms from conditions like cerebral palsy. It is also used as an add-on to other medications to treat seizure disorders.
Side Effects
While these medications share many similar side effects, Valium is more likely to cause daytime drowsiness and next-day sedation because it has a longer duration of action. People also report more muscle weakness and fatigue when on Valium. Adverse reactions, such as anxiety, restlessness, or aggression are also possible.
Ativan is considered more potent and faster-acting than Valium, so it is more likely to cause dizziness, sedation, and impaired cognition. Ativan is also more likely to lead to rebound anxiety and withdrawal symptoms if it is abruptly stopped.
Dosages & Formulations
Ativan comes in both tablet and injection form. The tablets come in 0.5 mg, 1 mg, and 2 mg strengths.
Valium is not available as an injection. It only comes in tablet form in 2 mg, 5 mg, or 10 mg doses.
Potential for Misuse and Addiction
Both diazepam and lorazepam have black box warnings, which are the most serious type of warning given by the U.S. Food and Drug Administration (FDA). These warnings discuss the potential for severe side effects, including:
- An increased risk of serious side effects like sedation, respiratory depression, coma, and death when combined with opioid medications.
- The potential for misuse and addiction.
- The possibility of physical dependence which causes withdrawal symptoms if you suddenly stop taking the medication after a period of regular use.
Both classified as Schedule IV controlled substances, Valium and Ativan can be addictive if they are abused.[6,7] These medications have a rapid onset of action, producing quick anxiety relief and euphoria.
Similarities Between Ativan and Valium
In addition to the potential for abuse and addiction, Ativan and Valium share many similarities:
- Belong to a class of medications called benzodiazepines
- Are approved by the FDA and can be legally prescribed by a licensed physician
- Given orally, in tablet form
- Works quickly to provide anxiety relief
- Requires a prescription to obtain
- Classified as Schedule IV controlled substances
- Can cause adverse effects including respiratory depression
Risks, Drug Interactions, and Other Considerations
Ativan and Valium are safe and effective when taken as directed. However, there are certain interactions and risks to consider:
- Mixing benzodiazepines with other central nervous system (CNS) depressants like alcohol or opioids can increase the sedative effects and potentially lead to an overdose. Ativan and Valium should not be combined with each other or other benzodiazepines, including Klonopin (clonazepam) and Xanax (alprazolam).[8]
- Taking benzodiazepines during pregnancy can have harmful effects on the baby, such as sedation, lethargy, depression, and withdrawal symptoms.[9]
- Benzodiazepines, especially in high doses, can cause sedation and drowsiness, which can impact cognitive functioning. These side effects can impair certain tasks and activities.
- Elderly individuals are at an increased risk of sedative effects when taking benzodiazepines. This can increase the risk of cognitive impairment, muscle loss, and accidental falls or injuries.
Make sure to consult a doctor and obtain a prescription before taking Ativan, Valium, or any other prescription medication.
Get Help for Benzodiazepine Addiction Today
First Step Behavioral Health is a licensed dual-diagnosis long-term addiction treatment facility that is accredited by the Joint Commission. We focus on the physiological rebalancing of the individual through medical, physical, emotional, mental, and spiritual care.
If you or someone you love is struggling with benzodiazepine addiction, please don’t hesitate to reach out for help. Our admissions team is available now to help you get started with a confidential, risk-free assessment. Contact us today to get started.
References:
- National Institute of Health (NIH): Classics in Chemical Neuroscience: Diazepam (Valium)
- National Institute of Health (NIH): Diazepam
- U.S. Food and Drug Administration (FDA): Ativan Injection Final Safety Review
- National Institute of Health (NIH): Lorazepam
- American Academy of Family Physicians (AAFP): Risks Associated with Long-Term Benzodiazepine Use
- Psychiatry Online: Benzodiazepine Use and Misuse Among Adults in the United States
- United States Drug Enforcement Administration (DEA): Drug Scheduling
- Science Direct: Central Depressant Agent
- JAMA Psychiatry: Benzodiazepine Use During Pregnancy and Risk of Miscarriage
