Understanding Valium & Ativan
Valium is a brand name of the benzodiazepine diazepam, while Ativan is a brand name of the benzodiazepine lorazepam.[1,2]
Benzodiazepines are a class of prescription drugs with a variety of legitimate medical uses. They are also associated with abuse and addiction potential.
They should only ever be taken as prescribed. Both Valium and Ativan have the potential to lead to a life-threatening overdose if abused, especially if taken in combination with other substances like alcohol or opioids.
How Do Valium & Ativan Drugs Work?
Broadly, both Valium and Ativan work by reducing abnormal activity in the brain. Taken as prescribed, they can help to slow the speed at which signals travel to and from the brain.[1,2] This can help a person relax, and it can also sometimes help with other medical conditions related to abnormal brain activity, such as cerebral palsy and several other neurological disorders.
Valium vs. Ativan: Comparing Medications
The following table highlights some key points of comparison between these two medications:[1-5]
|Typical Schedule||2–3 times daily / once daily for extended-release||1–4 times daily|
|Prescribed For||Anxiety and temporary periods of stress||Anxiety, agitation caused by alcohol withdrawal, symptoms of certain neurological disorders, and some seizure disorders|
|Onset of Effect||Slower than Valium||Rapid|
|Duration of Effect||Multiple hours||Shorter than Ativan|
|Half-life||~12 hours||~30–56 hours|
|Abuse Potential||Significant — benzodiazepine abuse is currently at epidemic levels||Significant — benzodiazepine abuse is currently at epidemic levels|
|Safe for Children||Some accepted uses but prescribed with significant caution||Some accepted uses but prescribed with significant caution|
|Will Insurance Cover Cost?||Usually (if prescribed by a doctor)||Usually (if prescribed by a doctor)|
Which Medication Is More Addictive?
There don’t appear to be any definitive studies on whether lorazepam or diazepam are more addictive to humans. As two benzodiazepines, both should be treated as having significant abuse and addiction potential, especially if you’ve struggled with drug abuse in the past.
At the same time, both Valium and Ativan have legitimate medical uses. If warranted, they are safe to take as prescribed.
Which Medication Works Better?
Neither Valium nor Ativan are “best” in all circumstances. Valium may have more use cases compared to Ativan, but that doesn’t make it “better.”
Ativan is used to help treat anxiety and temporary periods of significant stress, and its use is accepted for that purpose. Ativan isn’t typically used to treat some symptoms of neurological disorders like Valium is. Valium can also be used to help reduce stress and anxiety.
Whether either medication might be a good option for you should be a decision made by your doctor. Some patients with comparable issues may react differently to one medication or the other.
Key Differences Between Valium & Ativan
Again, Valium and Ativan are both benzodiazepine medications used for anxiety and panic disorders. However, Valium is long-acting with a slower onset and a longer half-life, while Ativan is intermediate-acting with a quicker onset and shorter half-life.[1,2]
Valium can be used to treat a wider variety of medical conditions, often used in combination with other drugs, but both Valium and Ativan are able to help treat anxiety and stress. Neither drug should ever be used except as prescribed by a medical professional.
Valium is associated with several side effects, including these:
- Dry mouth
- Difficulty urinating
- Muscle weakness
- Changes in sex drive or ability
- Frequent urination
Lorazepam can cause similar side effects, with nausea, diarrhea, and blurred vision also notable potential side effects.
Warnings & Dangers
Both medications can sometimes cause more serious side effects that warrant calling a medical professional immediately. These include the following:[4-6]
- Trouble talking
- Yellowing of the skin or eyes
- Irregular heartbeat
- Persistent tremors
- An inability to sit still
- Odd, shuffling walk
- A general loss of control over the body
- Slowed or difficulty breathing
- Development of a rash, hives, or swelling, especially on the face, eyes, and mouth
If you experience any of these symptoms, call 911 or seek emergency medical assistance.
- Diazepam. MedlinePlus. Published May 15, 2021. Accessed August 7, 2023.
- Lorazepam. MedlinePlus. Published February 15, 2021. Accessed August 7, 2023.
- Dundee JW, McGowan WA, Lilburn JK, McKay AC, Hegarty JE. Comparison of the actions of diazepam and lorazepam. British Journal of Anesthesia. 1979 May;51(5):439-46. doi:10.1093/bja/51.5.439. PMID: 36117
- Schmitz A. Benzodiazepine use, misuse, and abuse: A review. The Mental Health Clinician. 2016 May 6;6(3):120-126. doi:10.9740/mhc.2016.05.120. PMID: 29955458; PMCID: PMC6007645
- Diazepam. National Highway Traffic Safety Administration. Published March 27, 2017. Accessed August 7, 2023.
- Ativan. U.S. Food and Drug Administration. Published March 2007. Accessed August 7, 2023.