Valium vs Ativan (The difference)

In this blog post, we will explain what are the differences between Valium vs Ativan. We also talk about the side effects of both drugs, and the risks of dependency. 

Valium vs Ativan – What is the difference?

Both Valium and Ativan are benzodiazepines. Benzodiazepines are drugs with a medium or minor tranquilizer effect, compared to those with a major effect, used to treat psychosis. Excessively used, benzodiazepines become drugs because they have the same effect as them and have high addictive potential.

They are the most commonly prescribed medications by psychiatrists because they have a wide range of use in many clinical situations. Doctors may legitimately prescribe them for the following conditions:

• Anxiety;
• Insomnia;
• Substance use disorders;
• Epileptic seizures;
• Muscle relaxation;
• Inducing the state of relaxation before certain uncomfortable medical procedures;
• As a medicine before anaesthesia (for example before a surgery).

Benzodiazepine addiction can occur mainly in people suffering from anxiety, sleep disorders or temperament problems. Often, people diagnosed with anxiety or sleep disorders will find this drug use and will gradually increase the doses to maintain or enhance their effects. Thus, addiction occurs, by administering increasing doses, to prevent the onset of withdrawal symptoms.

Ativan (Lorazepam) when and how we should take it

Ativan is a psychotropic that belongs to the group of benzodiazepines and that has anxiolytic, sedative and hypnotic properties. This drug is used very frequently, in fact, it is one of the most prescribed drugs in the UK.

This is due, first, because it is used as a tranquiliser, to modulate and reduce anxiety symptoms that are very common. Second, because it is used to facilitate sleep induction and sleep disorders are very prevalent, especially from a time of life. 

Within the variety of medicines that exist, this one has a quite advantageous position due to the fact that its parameters around half-life, absorption and potency are intermediate, which favours that it may have a very extensive last use.

What risks does Ativan have?

Ativan is a drug that has been in use for decades and has been shown to be very safe and effective. However, it is important to take into account a series of precautions and always take it with a medical prescription.

Being a sedative it also has some effects on cognition. In other words, it can hinder attention and concentration, as well as damage memory and executive function. The ability to organize, plan and decide, for example.

At the level of the nervous system and mobility can have effects of the type of loss of reflexes. This is very important because in elderly or physically disabled people who take Ativan they can have falls and consequences such as broken hips due to inadequate dosage or a lack of caution regarding use.

Another impact it can have is the loss of ability to perform complex tasks, such as driving vehicles and any other action that requires concentration and precision.

Consumption of alcohol and other sedatives is discouraged. The reason is that its effect is enhanced with alcohol, in such a way that the mixture multiplies the potential undesirable effects, both Ativan and of the alcohol itself.

Another of the problems that may arise is that the physical state of the patient does not combine well with the effects of the drug and, for example, in people with respiratory failure or sleep apnea, it worsens your underlying problem when taking Ativan or any other benzodiazepine.

To these possible effects, continued use of lorazepam for long periods of time can also trigger tolerance. That is, the patient’s body gets used to the medicine, and it gradually loses effectiveness. 

The following adverse reactions may also occur frequently: sedation, fatigue, drowsiness, depression, dizziness, fatigue, or muscle weakness. They are not frequent, but the reactions of hypersensitivity, angioedema, anterograde amnesia, psychosis or respiratory failure are more serious.

Does Ativan create dependency?

This drug can cause physical and mental dependence, the risk of which increases when the dose and time of treatment are longer.

In the leaflets, they recommend not to prolong the use for more than 6 weeks or in the worst case for 2/3 months. Although the reality is that there are many people who consume it for life or for many years in the long term.

Addiction is not usually expressed so much in what we call tolerance, which is the need to increase the doses to continue maintaining the effect, but it is noted in what can be rebound symptoms or withdrawal symptoms that often occur if the drug disappears, which is why it always requires a gradual suspension.

Lastly, the effects of this rebound effect are manifested with symptoms such as headaches, increased anxiety, insomnia, confusion or even hallucinations.

It is not necessary to stop taking the treatment abruptly but it is necessary to do it gradually, reducing the daily dose and supervised by a health professional.

Valium (Diazepam): what is it and what are its effects

Diazepam (better known by its brand name Valium) is a drug belonging to the family of anxiolytics and hypnotics. Today, this type of psychotropic derived from benzodiazepines remains one of the most administered (and effective) for the treatment of anxiety, insomnia, panic attacks and as sedatives prior to certain types of interventions.

We have all heard of diazepam. Furthermore, it may have been prescribed to us at some time or it is possible that someone close to us is one of those patients used to having it on their bedside table. The WHO (World Health Organization) itself has it included in its list of essential drugs for a very specific reason: it is one of the most effective and currently used standard benzodiazepines.

What is diazepam?

Diazepam is a psychotropic drug. That is, it is a depressant of the central nervous system. Therefore, whether we like it or not, what the famous Valium does like all other benzodiazepines is to “slow down” brain activity.

They achieve this by acting in different areas of the limbic system, the thalamus and the hypothalamus. Also, one of its main advantages is that it does not interact with the peripheral autonomic nervous system. In other words, it will not produce any extrapyramidal side effect (motor problems such as dyskinesias or dystonia).

Neuroscientists deduce that its action is initiated by binding to GABA receptors to inhibit their activity. After that, the functioning of certain areas of the brain slows down to experience a prolonged state of drowsiness, decreased anxiety and relaxation of the muscles.

What is diazepam used for?

Diazepam, given its sedative and hypnotic effects, have multiple uses, they are as follows:

• Short-term treatment of insomnia.
• It is also used to treat anxiety, panic attacks, and restless states.
• Treatment of the epileptic state.
• Initial management for various mood disorders such as mania. It is usually used in combination with lithium, valproate or neuroleptics.
• Diazepam is also used to treat alcohol and opioid withdrawal.
• Diazepam is used along with other antidepressants in patients who develop suicidal thoughts.
• It is effective for various painful muscle conditions.
• It is also used to treat various muscular paresis due to injury or brain problems.
• Diazepam is always present in outpatients or hospitals to be used as sedation prior to an operation.

How does diazepam work?

Diazepam can be taken orally, intravenously, intramuscularly, or rectally. Its oral administration is always recommended because it is absorbed quickly and well. It reaches the bloodstream in a short time and its mechanism of action begins after 15 or 45 minutes.

Once in the blood, it is redistributed by all the tissues. Soon it reaches our brain and the entire nervous system by crossing the blood-brain barrier.

Once here, and as we already know, it facilitates the inhibitory action of the neurotransmitter gamma-aminobutyric acid (GABA). In this way, we benefit from its relaxing and hypnotic effect.

Also, it should be remembered that the metabolism of diazepam is carried out in the liver. This drug has a fairly long life (between 30 and 60 hours), therefore we need this organ to be healthy in order to metabolize it effectively.

What side effects does diazepam have?

We pointed it out at the beginning: the duration of the treatment should be short, supervised by our doctor, not to exceed 8-12 weeks and never exceed the prescribed doses. Beyond this period of time and if we exceed the recommended doses (or if we combine them with others on our own) the consequences can be serious.

Let’s now see what side effects diazepam has, which, and as we can deduce, are common to most benzodiazepines.

Most common diazepam side effects:

• Drowsiness.
• Impaired motor function.
• Coordination problems.
• Balance problems.
• Dizziness.
• Dry mouth.
• Small memory lapses.

Diazepam effect due to a principle of slight dependence:

• Tremors and more obvious coordination problems.
• Nervousness, irritability.
• Insomnia.
• Headaches
• Muscle cramps.
• Problems driving safely.
• Difficulty speaking fluently.
• Concentration problems.
• Anterograde amnesia.

Serious symptoms of diazepam dependence:

• Tachycardia
• Paradoxical states of consciousness.
• Irregular, fast, or slow breathing.
• Lack of coordination.
• Loss of consciousness.
• Muscular weakness.
• Extreme drowsiness
• Muscle pain.
• Bluish nails due to a lack of oxygen in the blood.

What contraindications does diazepam have?

• Diazepam is not recommended in patients with liver problems.
• Neither in patients with respiratory problems or with sleep apnea.
• It is not recommended during pregnancy or lactation.

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Conclusions

In this blog post, we explained what are the differences between Valium vs Ativan. We also talked about the side effects of both drugs, and the risks of dependency. 

Ativan is a psychotropic that belongs to the group of benzodiazepines and that has anxiolytic, sedative and hypnotic properties. Ativan is a drug that has been in use for decades and has been shown to be very safe and effective. However, it is important to take into account a series of precautions and always take it with a medical prescription.

Diazepam (better known by its brand name Valium) is a drug belonging to the family of anxiolytics and hypnotics. Today, this type of psychotropic derived from benzodiazepines remains one of the most administered (and effective) for the treatment of anxiety, insomnia, panic attacks and as sedatives prior to certain types of interventions.

If you have any comments or questions on the content, please let us know!

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References

Hardman J. G., Goodman L. S., Gilman A. (1996) The pharmacological basis of therapeutics. Vol. I. Pages. 385-398. Madrid: MacGraw-Hill Interamericana.

Robert Whitaker, (2015) Anatomy of an Epidemic, Madrid: Captain Swing

Sophie Billioti, Yola Moride, Thierry Ducruet (9-09-2014) Benzodiazepine use and risk of Alzheimer’s disease: a case-control study. British Medical Journal, 349, pp 205-206