AboutJason Bhan Expertise Insights into and general advice on the diagnosis, management and care to children and adolescents with behavior disorders, mood disorders, drug addiction, or social adjustment disorders.
I will not give specific treatment recommendations or perform online consultations.
Experience I am a board certified Family Physician with a special interest in pediatric and adolescent health. I have experience with pediatric and adolescent mood disorders (including ADD, ADHD, depression, Autism, and Autism spectrum disorders.
Organizations American Medical Association
American Academy of Family Physicians
Education/Credentials MD - 2000
Board Certification ACFP (American College of Family Physicians) - 2003
Expert: Jason Bhan Date: 2/13/2008 Subject: difference?
Question QUESTION: What is the difference between Lorazepam and oxazepam??
Thank you very much for your time and help.
Yona
ANSWER: Yona,
I will first highlight their similarities. Both Lorazepam and Oxazepam are in the class of medications know as Sedative/Hypnotics. Theses are a group of medications that are generally used as 1) Anxiolytics (for anxiety or panic disorders), 2) Hypnotics (for sleep) and 3) Anticonvulsants (to stop seizures). Both of these (and many others in the class) carry the potential for tolerance (over time, one needs a higher and higher dosage to achieve the same effect) and addiction (there is a significant and dangerous withdrawal from the drug if taken for some time and then abruptly discontinued.) Both drugs can be dangerous if taken to excess and fatal if mixed with alcohol.
These drugs are often used to treat panic attacks and anxiety disorders. They are in fact 'depressants' and similar in effect to alcohol. They should be used with caution, and in theory, not for long term. Because of their alcohol-like effect, they are often used to treat people who are withdrawing from alcohol, experiencing agitation due to drugs or psychiatric illness.
To your question, the difference between Lorazepam and Oxazepam is basically the half-life, or more simply, the duration of action - how long the drug stays in your body - which is sometimes, but not always related to how long the drugs effects last. Lorazepam, depending on the person has a half-life of about 10-20 hours. Oxazepam has a half-life of about 4-15 hours. So one might expect Oxazepam to be used in a situation where there was a need for a quick, and short term need for a medicine to suppress anxiety (panic attack). Lorazepam, with its longer duration of action might be seen in use when one might want to suppress an ongoing, or multiple, recurrent issues with anxiety. The Lorazepam might be taken 1-3 times a day to suppress or prevent symptoms while the Oxazepam might only be taken on an as-needed basis for anxiety. The milligram dosing of the drugs are quite different. One (1) milligram of Lorazepam is equal to twenty (20) milligrams of Oxazepam. This does not mean that one is or more/less effective than the other. This difference reflects something called 'potency' which is taken in consideration when companies determine the milligram dosage of a drug.
That being said, there are many providers that will use these and others in the class (alprazolam, clonazepam, etc) interchangeably.
I hope this has been helpful. Best Regards.
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QUESTION: Thank you so so much Dr. I am so sorry to bother you again. I dont understand a few things:
1-Ativan has a longer half-life so is stays in your blood longer so shouldnt ativan have a faster effect when taken than Serax or that has nothing to do?
2-Serax takes faster to relieve the anxiety and insomnia than Ativan?
3-If Ativan stays longer in the body how come you have to take it more often than the serax? shouldnt be the opposite?
I apologize for all que questions and I thank you again for all your time and help. I really appreciate it.
4-The building of tolerance between the 2 after a certain period of time is the same?
5- I understand that the results are the same and the effect same as well. I am just confused with which one gets to relief the anxiety, insomnia, panic attacks, etc faster
I apologize for all the questions and I thank you again for all your time and help. I really appreciate it.
Answer The half-life does not determine the time of onset of effect - or as you said - speed of effect. Both of these drugs are considered to have intermediate onset of action (taken by mouth) - for Lorazepam (Ativan, taken orally, it is about 120 minutes) and for Oxazepam, maybe 1/2 to 1/3 of that time. It is very important to note, that the time to effect depends on the individual as well. How long the drug has been taken, other drugs that have been taken, or other drugs taken with these drugs can all effect this. Both drugs have similar recommended dosing schedules, but Lorazepam's official labeling recommends 2-3 times a day while Oxazepam's label recommends 3-4 times a day. This may vary based on the individual and the treating physician.
Tolerance between the two is similar, and because they are in the same drug class, and act upon the same place in the body, you can take one and build tolerance to the entire class (all the others).
Because every person is different, and each drug is different, the drug that works for one person may not work for the next. These medications often take some trial and error before getting dosages and timing correct. In general, the Lorazepam (Ativan) has a slower onset of action, a longer time of effect, and is not as useful in an 'Acute Panic Attack'. Oxazepam and Alprazolam (Xanax) are more often used in this role.
