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Anti Anxiety

What is the Difference between Lorazepam and Alprazolam?

14 Sep 2023

ImageWhat is the Difference between Lorazepam and Alprazolam?

Lorazepam and Alprazolam both treat anxiety and other psychiatric disorders. They are in the benzodiazepine family of drugs, which help inhibit excessive nerve stimulation in the brain. Researchers believe excess neural firing in the brain leads to anxiety.


How they work, exactly, needs to be clarified. Still, scientists believe Lorazepam, Alprazolam, and other benzodiazepines act by improving the effects of GABA in the brain. By influencing GABA, benzodiazepines decrease the activity of nerves in the brain.


Both drugs belong to the class of benzodiazepines, so they have a similar mechanism of action. Still, there are structural differences between them that affect their mechanism of action in the body.


What Is Lorazepam?

Lorazepam is indicated for managing anxiety disorders or for the short-term relief of anxiety symptoms or anxiety associated with depressive symptoms. Anxiety or tension related to everyday stress usually does not need treatment with an anxiolytic.


Side Effects of Lorazepam

Most adverse reactions to benzodiazepines, including CNS effects and respiratory depression, are dose-dependent, with more severe effects occurring with high doses.

·         Drowsiness

·         Dizziness

·         Tiredness

·         Muscle weakness

·         Headache

·         Blurred vision

·         Insomnia

·         Loss of balance or coordination

·         Forgetfulness or amnesia

·         Difficulty concentrating

·         Nausea

·         Vomiting

·         Constipation

·         Changes in appetite

·         Skin rash


What is Alprazolam?

Alprazolam is indicated for managing anxiety disorders and the short-term relief of anxiety symptoms in adults. Xanax is also indicated for treating panic disorder in adults with or without a dread of places and situations that might cause helplessness, panic, or embarrassment (agoraphobia).


Side Effects of Alprazolam

Common side effects of Alprazolam include:

·         Drowsiness

·         Tiredness

·         Dizziness

·         Insomnia

·         Memory problems

·         Poor balance or coordination

·         Slurred speech

·         Trouble concentrating

·         Irritability

·         Diarrhoea

·         Constipation

·         Increased sweating

·         Headache

·         Nausea

·         Vomiting

·         Upset stomach

·         Blurred vision

·         Appetite or weight changes

·         Swelling in your hands or feet

·         Muscle weakness

·         Dry mouth

·         Stuffy nose

·         Loss of interest in sex


How do Lorazepam and Alprazolam Work?

Both Lorazepam and Alprazolam enhance the actions of a neurotransmitter in the brain known as GABA (gamma-aminobutyric acid). GABA reduces the activity of nerve cells, so enhancing it has a calming effect which may improve anxiety symptoms, reduce muscle tension, stop seizures, and induce sleep. Benzodiazepines are also known for their amnesic impact or ability to disrupt short-term memory, making them useful before surgery. Due to structural differences, some benzodiazepines cause sleepiness, relieve anxiety, relax muscles, stop seizures, or make you forget. Lorazepam and Alprazolam are both FDA-approved for anxiety relief. However, they are less likely than some other benzodiazepines, like diazepam or Temazepam, to induce sleep.


Difference between Lorazepam and Alprazolam

  • The significant difference between Lorazepam and Alprazolam is that Lorazepam leaves a person's system more quickly, reducing the chance of toxicity or side effects.
  • Alprazolam has a faster onset of effect but a shorter duration of action (4-6 hours) than Lorazepam's 8 hours.
  • Sedative and performance-impairing effects may also occur sooner with Alprazolam but dissipate quicker than with Lorazepam.
  • Lorazepam also has fewer unfavourable interactions with other medications when compared to Alprazolam.
  • The activity of Alprazolam is more likely to be affected by race. Asian people achieve higher concentrations, and the activity of Alprazolam lasts longer. The other factors that might affect it are concurrent liver or kidney disease, obesity, and alcoholism. In contrast, Lorazepam is less likely to be affected by age or race.


The Difference in Drug Forms

Alprazolam comes in the following forms and dosages:

  • Liquid: 1 milligram per milliliter (mg/ml)
  • Immediate-release tablet: 0.25mg, 0.5mg, 1mg, & 2mg 
  • Disintegrating tablet: 0.25mg, 0.5mg, 1mg, & 2mg
  • Extended-release 24-hour tablet: 0.5 mg, 1 mg, 2 mg, 3 mg


Lorazepam comes in the following forms and dosages:

  • Liquid: 2 mg/ml
  • Injections: 2 mg/ml, 4 mg/ml
  • Tablets: 0.5 mg, 1 mg, 2 mg


Which One Works Quicker?

Alprazolam is more quickly absorbed than Lorazepam, with peak concentrations within 1-2 hours following administration, compared to 2 hours for Lorazepam. The effects of Alprazolam last 4-6 hours, although there are wide variations between individuals. Effects of Lorazepam last around 8 hours, although they may persist longer in some individuals.


How Much Alprazolam Equals 1mg of Lorazepam?

Benzodiazepine equivalency tables show that 0.5mg of Alprazolam is approximately equivalent to 1mg of Lorazepam. However, people of Asian descent metabolise Alprazolam differently than other races. In addition, certain disease states, like alcoholism, kidney and liver disease, obesity and even old age, can affect how Alprazolam behaves in your body, so use benzodiazepine equivalency tables as a guide only as they do not reflect the individual variation. Therefore, both Lorazepam and Alprazolam should only be used short-term.


Which Drug is More Effective For Anxiety?

Trials that directly compared Lorazepam and Alprazolam to treat anxiety showed no significant differences in the effect and few differences in their adverse effects. However, mental confusion may be less with Alprazolam.


Which Drug Is More Addictive?

Lorazepam and Alprazolam should only be used short-term due to the risk of addiction and dependence. Generally speaking, benzodiazepines with a shorter half-life (such as Lorazepam and Alprazolam) are more challenging to stop than those with a longer half-life (such as diazepam). Both Lorazepam and Lorazepam readily enter brain tissue, reinforcing drug taking and generally associated with more severe withdrawal symptoms. Therefore, Lorazepam and Alprazolam are both at high risk of abuse. Experts have remarkably advised using Alprazolam cautiously as it has severe withdrawal symptoms.


What is the probability of Withdrawal and Misuse?

The properties of each drug play a significant role in how common and adverse the withdrawal symptoms can be and the drugs' potential for abuse. In general, Lorazepam causes fewer withdrawal symptoms and has less potential for misuse than Alprazolam. This is likely because Lorazepam has a more prolonged effect and slower elimination rate than Alprazolam.


It is more possible that missed doses or abruptly stopping Alprazolam can cause rapid withdrawal effects, including anxiety, insomnia, and panic attacks.



Lorazepam and Alprazolam are both benzodiazepines. Both have similar effects and side effects and can cause withdrawal symptoms. Despite the similarities between them, their properties result in some differences. However, one may work much better for some people than the other.