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Ativan vs Lexapro
Introduction
For patients who are experiencing symptoms of anxiety disorders or depression, certain medications that modify the levels of neurotransmitters in the brain can be beneficial for symptom management and mood stabilization. Ativan and Lexapro are two such drugs commonly prescribed for these conditions. Both impact different neurotransmitters in the brain but have been shown to assist with mood regulation in patients with anxiety and depressive disorders.
Ativan, also known as Lorazepam, is classified as a benzodiazepine primarily influencing gamma-aminobutyric acid (GABA) neurotransmitters to provide a calming effect. On the other hand, Lexapro or Escitalopram belongs to a category of drugs called selective serotonin reuptake inhibitors (SSRIs), which work by increasing levels of serotonin in your brain.
Ativan vs Lexapro Side By Side
| Attribute | Ativan | Lexapro |
|---|---|---|
| Brand Name | Ativan | Lexapro |
| Contraindications | Should not be taken with or recently after using monoamine oxidase inhibitors (MAOIs). | Should not be taken with or recently after using monoamine oxidase inhibitors (MAOIs). |
| Cost | Brand name: Around $420 for 60 tablets (1 mg). Generic: From $0.16/day to about $3.00/day. | Brand name: About $356 for 30 capsules (10 mg). Generic: From $.07/day to roughly $4.00/day. |
| Generic Name | Lorazepam | Escitalopram |
| Most Serious Side Effect | Increased thoughts about suicide or self-harm, signs of allergic reaction, vision changes, cardiac symptoms, hyponatremia, severe nervous system reactions. | Increased risk of suicidal thoughts or behavior, serotonin syndrome, unusual bleeding/bruising, vision changes. |
| Severe Drug Interactions | Concurrent use with MAOIs. | Concurrent use with MAOIs. |
| Typical Dose | 1-2 mg per day, can increase based on physician's instructions. | Starts at 10 mg/day, can be increased to a maximum of 20 mg/day after at least one week. |
What is Ativan?
Lorazepam (the generic name for Ativan) falls into the benzodiazepine class of medications, which have been widely used since their introduction in the 1960s. Lorazepam was first approved by the FDA in 1977. It is primarily prescribed to treat anxiety disorders and symptoms, but it can also be utilized as a short-term remedy for insomnia due to its sedative properties. Ativan works by enhancing the effect of GABA, a neurotransmitter that slows brain activity down, leading to relaxation and reduced anxiety.
On the other hand, Escitalopram (the generic name for Lexapro), belongs to a newer class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). The FDA first approved Escitalopram in 2002. Lexapro helps increase free levels of serotonin—a neurotransmitter involved in mood regulation—by preventing its reabsorption back into neurons; thus "trapping" it within synapses or gaps between nerve cells where communication occurs. This medication is mainly prescribed for generalized anxiety disorder and major depressive disorder.
While both drugs affect brain chemistry and are used to manage mental health conditions, they differ significantly in terms of primary uses and mechanisms of action—the key difference being that Ativan targets GABA while Lexapro influences serotonin levels.
What conditions is Ativan approved to treat?
Ativan is approved for the treatment of various mental health and neurological disorders, including:
- Anxiety disorders
- Panic attacks
- Insomnia due to anxiety or stress
- Status epilepticus (a potentially life-threatening condition where seizures last too long or occur close together)
- It's also used as a premedication for anesthesia in surgical procedures.
How does Ativan help with these illnesses?
Ativan helps to manage anxiety by increasing the amount of gamma-aminobutyric acid (GABA) available in the synapses of the brain. It does this by enhancing its effects, which inhibit excessive brain activity and produce a calming effect. GABA is a neurotransmitter, a chemical that acts as a messenger in the brain and throughout the body, that plays an important role in behavior, cognition, and the body's response to stress. People with anxiety may have relatively lower levels or reduced function of GABA. Therefore, by boosting GABA's effects, Ativan can limit symptoms of anxiety and help patients manage their condition.
On the other hand, Lexapro works differently: it increases serotonin levels like Prozac but also has some influence over norepinephrine receptors which are thought to play an additional role particularly in generalized anxiety disorder (GAD). This difference means Lexapro might be chosen for long-term management of depression or GAD whereas Ativan use is more often limited due to risks associated with longer term use including dependency.
What is Lexapro?
Lexapro, the brand name for escitalopram, is a selective serotonin reuptake inhibitor (SSRI), implying that it boosts levels of serotonin in the brain by reducing its reabsorption. This action on serotonin helps to alleviate symptoms of depression and anxiety. Escitalopram was first approved by the FDA in 2002. Unlike Ativan, which belongs to a class of medications known as benzodiazepines and acts primarily on GABA receptors rather than serotonin pathways, Lexapro's specific action on serotonin means its side-effect profile differs from those of drugs like Ativan. It does not cause significant sedation or physical addiction risk seen with benzodiazepines but might lead to weight changes and sexual dysfunction (commonly reported side effects with SSRIs). Its efficacy in treating depression and generalized anxiety disorder can be beneficial especially for patients who do not respond well to other classes of drugs such as benzodiazepines like Ativan.
What conditions is Lexapro approved to treat?
Lexapro, or escitalopram, is FDA-approved for the treatment of:
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
It's a selective serotonin reuptake inhibitor that helps to restore balance in the brain's chemicals and can significantly improve mood and feelings of well-being.
How does Lexapro help with these illnesses?
Serotonin is a neurotransmitter that plays key roles in many processes within the body, including mood regulation, sleep cycle control, and digestion. Low levels of serotonin have been linked with depression and anxiety disorders. Lexapro works by increasing the available levels of serotonin in the brain, thereby alleviating some symptoms associated with these conditions. Its selective action on serotonin receptors makes it a Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant. Since it primarily affects serotonin levels without significantly influencing other neurotransmitters like norepinephrine or dopamine, Lexapro can be an effective treatment for patients who do not respond well to benzodiazepines such as Ativan or may even be combined with them under certain circumstances.
How effective are both Ativan and Lexapro?
Both lorazepam (Ativan) and escitalopram (Lexapro) are effective in treating different facets of mental health disorders, and they were cleared by the FDA within several years of each other. As they influence distinct neurotransmitters, their prescription conditions vary. Lorazepam is a benzodiazepine that works on GABA receptors to produce its calming effects while escitalopram is an SSRI antidepressant which increases serotonin levels in the brain.
A 2005 study compared the effectiveness of lorazepam and escitalopram for generalized anxiety disorder; both drugs showed comparable efficacy in managing symptoms with similar safety profiles. However, this study highlighted that patients receiving lorazepam had more immediate relief but also exhibited potential dependency issues associated with long-term use of benzodiazepines.
Escitalopram has been shown through multiple studies as effective from the first week of treatment at alleviating symptoms related to depression and various forms of anxiety disorders. Its side effect profile appears favorable unless when used concurrently with certain medications or substances such as alcohol or MAO inhibitors due to possible dangerous interactions.
Lorazepam's effectiveness against acute symptoms makes it essential in crisis situations where quick symptom control is needed, however, it isn't typically considered a first-line long-term treatment because of concerns around tolerance development and withdrawal upon discontinuation. It can be used alongside SSRIs like Lexapro during initial stages until SSRIs take full effect after few weeks into therapy or intermittently for sudden surge in anxiety symptoms if recommended by healthcare providers ensuring close monitoring for any abuse potential.
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At what dose is Ativan typically prescribed?
Ativan (lorazepam) is usually administered orally in doses ranging from 1-2 mg per day, but this can increase based on your physician's instructions and tolerability. The dose may be split throughout the day for managing anxiety symptoms or taken as a single dose at bedtime to aid with sleep. For Lexapro (escitalopram), the typical starting dosage is 10mg daily, which can be increased to a maximum of 20mg daily if needed after several weeks. However, adolescents and elderly patients often start on a lower dose of 5mg daily. It should be noted that individual responses vary greatly and these medications should always be used under direct supervision of a healthcare professional.
At what dose is Lexapro typically prescribed?
Lexapro treatment typically begins with a dose of 10 mg/day. If needed, the dose may be increased to a maximum of 20 mg/day after at least one week. The dosage should not exceed this limit and must be taken as a single dose, preferably in the morning or evening. It's crucial to remember that it might take up to four weeks or longer before you start feeling better; therefore, keep taking Lexapro even if you feel well right away. As always, any changes to your medication regimen should only be made under the guidance of a healthcare professional.
What are the most common side effects for Ativan?
Some of the common side effects that patients may experience when taking Ativan or Lexapro include:
- Drowsiness, fatigue or a general feeling of weakness
- Increased feelings of nervousness and anxiety
- Difficulties sleeping (insomnia)
- Dry mouth
- Nausea, indigestion and other gastrointestinal issues such as diarrhoea
- Decreased sex drive (libido), abnormal ejaculation, impotence in men
- Sweating more than usual
- Experiencing unusual dreams
- Skin rash or itching
It's also possible to have symptoms mimicking those of flu-like syndrome. Inflammation in areas like the back of your throat (pharyngitis) or sinus cavities (sinusitis). And lastly, an increase in yawning.
Remember it is important to consult with a healthcare professional if you are experiencing any adverse effects after starting these medications.
Are there any potential serious side effects for Ativan?
While both Ativan and Lexapro are used to treat anxiety disorders, they do have potential side effects that need to be considered:
-
Increased thoughts about suicide or self-harm: Similar to many medications used for treating mental health conditions, there is a risk of increased suicidal thoughts especially in adolescents.
-
Signs of allergic reaction or severe skin reaction: These may include hives, difficulty breathing, swelling in your face or throat. In rare cases, you might experience fever with associated sore throat, burning eyes and skin pain leading to a red or purple skin rash with blistering and peeling.
-
Vision changes: You might experience blurred vision or tunnel vision; eye pain or swelling; seeing halos around lights could also occur.
-
Cardiac symptoms: Fast heartbeats can occur along with fluttering feelings in the chest. Shortness of breath and sudden dizziness may indicate an imminent fainting episode.
-
Hyponatremia (low sodium levels): This condition can cause headache, confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady
-
Severe nervous system reactions: These involve very stiff muscles high fever sweating confusion fast uneven heart beats tremors feeling like you will pass out
If any adverse symptoms appear while taking either medication consult your doctor immediately.
What are the most common side effects for Lexapro?
Lexapro, an antidepressant medication, can cause a range of side effects. Some individuals may experience dry mouth or a sore throat, as well as nasal congestion. Other potential side effects include changes in vision such as blurriness. Digestive issues like nausea, vomiting, abdominal pain and loss of appetite are also common with Lexapro use; some people might even experience constipation. Sleep problems like insomnia could arise from using this medication. A few other physical symptoms to be aware of include tremors, sweating excessively and feeling unusually anxious or nervous. In rare cases, Lexapro might lead to increased heart rate or cause confusion and agitation; hostility is less common but still possible with this drug's usage. Skin rash is another potential side effect along with weight loss due to decreased appetite caused by the medicine itself. Moreover, Lexapro may increase urination frequency in some patients while causing headaches or dizziness in others - these are all relatively typical reactions within the central nervous system. Lastly but importantly: if you're using Lexapro and experiencing any muscle or joint pain that seems out of ordinary for you then it’s advised to consult your healthcare provider promptly about these issues.
Are there any potential serious side effects for Lexapro?
While Lexapro is generally well-tolerated, it can cause severe side effects that need immediate medical attention. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face, lips, tongue or throat
- Increased risk of suicidal thoughts or behaviour particularly in young adults under the age of 25 during the initial stages of treatment
- Serotonin syndrome which may cause symptoms like agitation, hallucinations, rapid heartbeat, fever or excessive sweating
- Unusual bleeding/bruising (signs of low sodium levels)
- Changes in sexual desire and ability -Severe nausea vomiting, diarrhea -Vision changes such as seeing rainbows around lights at night.
Always remember to promptly consult a healthcare provider if you observe any unusual side effects after starting Lexapro.
Contraindications for Ativan and Lexapro?
Both Ativan and Lexapro, like many other medications for anxiety and depression, may potentially intensify symptoms of depression in some individuals. If you observe your depressive symptoms becoming worse or an increase in thoughts of self-harm or suicide while taking these medications, seek immediate medical attention.
Neither Ativan nor Lexapro should be taken if you are concurrently using, or have been recently using monoamine oxidase inhibitors (MAOIs). Always inform your healthcare provider about all the medications you are currently on; MAOIs need a period of approximately 5 weeks to completely clear from your system before introducing either Ativan or Lexapro to avoid harmful interactions.
How much do Ativan and Lexapro cost?
For the brand name versions of these drugs:
- The price of 60 tablets of Ativan (1 mg) averages around $420, which works out to approximately $7–14/day depending on your dose.
- The price of 30 capsules of Lexapro (10 mg) is about $356, working out to approximately $12/day.
Thus, if you are in the higher dosage range for Ativan (i.e., 2 mg/day or higher), then brand-name Lexapro may be less expensive on a per-day treatment basis. However, cost should not be a primary consideration when determining which drug is right for you.
In terms of generic options:
- Lorazepam (generic version of Ativan) is available in packs from 30 up to 180 tablets with approximate costs ranging from as low as $0.16/day up to about $3.00/day based on various dosages and package sizes.
- Escitalopram Oxalate (generic version of Lexapro), can come in quantities between 5 and 500 tablets with prices starting at around $.07 cents a day if buying larger packaging upfront and potentially going up towards roughly $4.00 per day depending upon individual dosage requirements and pack size purchased.
Popularity of Ativan and Lexapro
Ativan, known generically as lorazepam, was estimated to have been prescribed to about 14.2 million people in the US in 2020. It is a commonly used benzodiazepine medication that accounted for around 20% of all prescriptions within its drug class last year. Ativan has remained fairly stable in terms of prescription prevalence over the past decade and is often utilized for short-term treatment of anxiety disorders and insomnia.
On the other hand, Lexapro (escitalopram), an SSRI antidepressant, had approximately 27 million prescriptions filled in the USA during 2020. This accounts for nearly a quarter of all SSRI prescriptions given out last year and slightly more than one-tenth of overall antidepressant scripts written. The popularity of escitalopram has seen an upward trend over recent years due largely to its efficacy not just in treating depression but also generalized anxiety disorder.
Conclusion
Both Ativan (lorazepam) and Lexapro (escitalopram) have a well-established history of use in the field of mental health. They are supported by many clinical studies demonstrating their effectiveness over placebo treatments. However, they work differently: Ativan is a benzodiazepine used for short-term relief from severe anxiety and panic attacks, while Lexapro belongs to the selective serotonin reuptake inhibitors (SSRIs) class of drugs, which is primarily used to treat depression and generalized anxiety disorder over long periods.
In some cases, these medications can be prescribed together but only under strict medical supervision due to potential interactions between them. While both are available as generics—providing cost-effective options for those paying out-of-pocket—it's important to note that each medication may take time before its effects become noticeable.
Side effect profiles differ significantly between Lexapro and Ativan: SSRIs like Lexapro often cause sexual dysfunction or weight changes; benzodiazepines like Ativan commonly lead to drowsiness or dependency issues if misused. For either drug, patients should closely monitor any changes in mood or behavior when starting treatment and seek immediate medical attention if symptoms worsen dramatically or suicidal thoughts occur.
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Refrences
- Stein, D., Andersen, H. F., & Goodman, W. (2005, April 1). Escitalopram for the Treatment of GAD: Efficacy Across Different Subgroups and Outcomes. Annals of Clinical Psychiatry. Portico.http://doi.org/10.1080/10401230590932335
- Kusturica, J., Zulić, I., Loga-Zec, S., Mulabegović, N., Loga, S., & Kapić, E. (2002, February 20). Frequency and characteristics of side effects associated with antidepressant drugs. Bosnian Journal of Basic Medical Sciences. Association of Basic Medical Sciences of FBIH.http://doi.org/10.17305/bjbms.2002.3575
- Kirino, E. (2012, December). Escitalopram for the management of major depressive disorder: a review of its efficacy, safety, and patient acceptability. Patient Preference and Adherence. Informa UK Limited.http://doi.org/10.2147/ppa.s22495
- Waugh, J., & Goa, K. L. (2003). Escitalopram. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00023210-200317050-00004
- Kantor, S., Graf, M., Anheuer, Z. E., & Bagdy, G. (2001, February). Rapid desensitization of 5-HT1A receptors in Fawn-Hooded rats after chronic fluoxetine treatment. European Neuropsychopharmacology. Elsevier BV.http://doi.org/10.1016/s0924-977x(00)00126-7