Ambien vs Ativan (lorazepam) - Uses, Side Effects, and Comparison
With a number of prescription sleep aids available for the treatment of insomnia you will often find yourself asking the question which one is best to help with my sleep problems? Is it ambien vs ativan ? Is it something else?
We’re going to take a look at two common over the counter prescription medications that are marketed as short-term use sleep medications.
As well as the benefits and uses for Ambien and Ativan we’ll also go into the common side effects and withdrawal symptoms associated with taking the drugs and some more serious warning signs.
Whilst online articles can give you great information on this subject, we suggest the best long-term solution for your insomnia lies with your local medical professional.
So first up, let’s take a look at each one in detail.
What is Ambien?
Ambien is the brand name for the drug Zolpidem, comes from a group of sedative-hypnotic drugs that are prescribed as a sleeping pill primarily for the treatment of chronic insomnia.
It works in a similar way to more potent tranquilizers/sedatives like benzodiazepines (e.g., Alprazolam (generic name of xanax) or Valium).
It does this by increasing the availability of the primary inhibitory neurotransmitter in the brain and gamma-aminobutyric acid in the spinal cord.
This neurotransmitter is a chemical that is released by the neurons in the brain and spinal cord that reduces the actions of other neurons in the brain. This leads to its ability to produce sedation.
Essentially, Ambien and drugs like it are what’s referred to as central nervous system depressants.
Since its availability and manufacture in 1992, it has become the number one prescription sleep aid in the United States.
There are two forms of the medication. The original is a quick fix and causes you to fall asleep very quickly. The improved version has a slow release layer to help you stay asleep.
Uses for Ambien
Now we know what Ambien is, let’s take a look at what it is used for in the general marketplace.
As well as being prescribed for insomnia, Ambien is recommended by the American Academy of Sleep Medicine as a potentially beneficial treatment for central sleep apnea (when breathing is disrupted during sleep).
There are also some non-prescribed uses for Ambien for example, it has been used to lessen headache pain from migraines and for anxiety disorders such as panic attacks or panic disorder.
It is important that we note that it’s primary use should always be as prescribed by a qualified healthcare provider and not just bought from an online store.
What makes Ambien good for sleep disorders is that it:
- Is effective at helping get a restful night’s sleep.
- Comes in a slow-release version that is effective at helping people stay asleep (Ambien CR)
- Comes in generic versions ie. non-branded ones that are cheap and easily available.
Guidelines recommend that it be used only after cognitive behavioral therapy for insomnia and behavioral changes, such as sleep hygiene, have been tried. This is to avoid adverse effects, abuse and physical dependence.
Side effects of Ambien
As with any strong prescription medication, Ambien comes with its own warning signs.
It has unsurprisingly over the years been abused and mixed with street drugs, causing potentially deadly side effects.
9 serious side effects of Ambien
- Lethargy, drowsiness, and daytime sleepiness (especially in older adults)
- Dizziness and/or headache
- Nausea and diarrhea
- Cognitive impairment including problems with reaction times and coordination
- Memory problems and next-day drowsiness, similar to the hangover effect
- Rebound insomnia (insomnia that occurs when the person stops using the drug)
- Hallucinations (although these are rare)
- Parasomnias (very rare) ie. sleep walking/talking/daily activities but while asleep in the middle of the night
- The development of physical dependence on Ambien (tolerance and symptoms of withdrawal)
The U.S. Food and Drug Administration (FDA) is warning that patients who take the sleep medication zolpidem extended-release (Ambien CR).
They warn that users should not drive or engage in other activities that require complete mental alertness the day after taking the drug because zolpidem levels can remain high enough the next day to impair these activities.
This is the correct dosage advice as explained by Drugs.com:
The recommended initial dose is 5 mg for women and either 5 or 10 mg for men, taken only once per night immediately before bedtime with at least 7–8 hours remaining before the planned time of awakening.
The total dose of Ambien should not exceed 10 mg once daily immediately before bedtime. Ambien should be taken as a single dose and should not be re-administered during the same night.
Lower doses are necessary for women because zolpidem clearance is lower in women. The male body is able to handle higher doses without the need for additional rest time.
The lowest possible dose should be taken in order to achieve the desired effects. High doses and long-term use will increase the chances of serious side effects.
What is Ativan?
Ok, now we’ve covered all of the bases with Ambien, let’s move on to Ativan.
Ativan works by enhancing the activity of certain neurotransmitters in the brain (gamma-aminobutyric acid receptors (GABA). These then work to slow down the central nervous system, this causes a calmness and feeling of relaxation.
Ativan is a prescription medicine primarily used to treat anxiety disorders but also as a means of tackling anxiety.
6 Uses for Ativan
Ativan is FDA-approved for treating several different conditions and is also prescribed by some doctors “off label”. Here are the most common uses for Ativan :
- Ativan for anxiety – as we said above, this is the primary purpose of the drug
- Ativan is FDA-approved in anti-anxiety medications. It’s also commonly used off-label for treating generalized anxiety disorder and panic attacks.
- Ativan is FDA-approved for short-term treatment of insomnia (trouble sleeping) that’s caused by anxiety or stress.
- Some doctors prescribe Ativan for alcohol withdrawal,
- To prevent nausea and vomiting during chemotherapy
- The IV form of Ativan is FDA-approved to cause sleep before surgery.
*Medical advice should be sought before using Ativan or similar drugs for any purpose other than as prescribed.*
The effectiveness of Ativan (lorazepam) in long-term use, that is, more than 4 months, has not been assessed by systematic clinical trials.
Side effects of Ativan
Ativan as with other benzodiazepine use is associated with common side effects.
Some of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
Serious side effects from Ativan aren’t common, but they can occur.
Here are the side effects according to WebMD.
7 Short term side effects of Ativan
- Muscle Weakness and muscle cramps
- Inducing of a relaxed easy state
- Restless leg syndrome
- Slurred speech
5 Infrequent side effects of Ativan
- Behavioral problems
- Low energy
- Generalized weakness
19 rare side effects of Ativan
- Mental illness
- Likelihood of other drug use including alcohol abuse
- Low Blood Pressure
- Decreased Lung Function
- Cognitive problems including Memory Loss
- A skin rash
- Liver problems including liver disease
- Depersonalization, a disconnect from reality
- Decreased interest in sex
- Allergic reaction
- A change in vision (blurred/double vision)
- Nystagmus, A Condition With Involuntary Eye Movements
- Dry Mouth
- Stomatitis, A Condition With Painful Swelling And Sores Inside The Mouth
- Fast heartbeat
Long-term side effects of Ativan
Ativan is FDA-approved for short-term use, up to four months. Long-term use of Ativan should be avoided because it can cause serious side effects. These include:
- Dependence. Ativan is a habit-forming drug. This means that long-term use can cause physical and psychological dependence. It can also cause serious withdrawal symptoms when the medication is stopped.
- Rebound effects. In addition, long-term use of Ativan for sleep or anxiety can cause “rebound insomnia” or “rebound anxiety.” This means that Ativan can make symptoms of these conditions worse over time, which makes it even harder to stop taking the drug.
The usual oral dosage for Ativan tablets is 2 to 6 mg daily. This dosage amount is usually divided and taken two or three times daily.
Ambien vs Ativan - Which is best?
Both Ambien and Ativan have some similar effects in the way that they react with the central nervous system (CNS) in the spinal cord and brain.
They are both considered to work as sedative-hypnotic drugs causing sleepiness and sedation (relaxation).
However, they belong to different drug classes. Ambien belongs to a class of drugs called non-benzodiazepine hypnotics while Ativan is a benzodiazepine.
Whilst Ambien’s primary purpose is to tackle insomnia, Ativan is more likely to be prescribed as an anti-anxiety drug unless otherwise advised by a doctor.
In terms of their side effects, both of them have some pretty nasty side effects if abused, mixed with similar medications or recreational drugs. Ativan certainly seems the riskier of the two if consumed on a long term basis. Older people should avoid both!
Depending on the specific medical condition that you’re looking to fix, whether this is long term insomnia, sleep apnea or insomnia due to anxiety, the best sleeping aid to take will be at the discretion of your doctor.