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Tranxene vs Ativan

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Comparative Analysis


For patients dealing with anxiety disorders, seizures or alcohol withdrawal symptoms, certain drugs that impact the neurotransmitters in the brain can be highly effective. Tranxene and Ativan are two such medications often prescribed to help manage these conditions. Both of these drugs fall under the category of benzodiazepines and work by enhancing the effect of a neurotransmitter called gamma-aminobutyric acid (GABA), which inhibits activity in the brain to reduce anxiety and induce calmness. Tranxene has a longer half-life than Ativan, meaning its effects last longer but it also takes more time to start working. On the other hand, Ativan is quickly absorbed into your system providing faster relief from acute symptoms but may require more frequent dosing due to its shorter duration of action.

Tranxene vs Ativan Side By Side

Brand NameTranxeneAtivan
ContraindicationsMay worsen symptoms of depression. Should not be taken with opioids or barbiturates. Abrupt discontinuation after prolonged use can lead to withdrawal syndrome.May worsen symptoms of depression. Should not be taken with opioids or barbiturates. Abrupt discontinuation can lead to withdrawal symptoms.
CostFor brand name, about $80 for 30 tablets of Tranxene T-Tab (3.75 mg). For generic clorazepate dipotassium, costs start as low as around $.50 per day.For brand name, about $220 for 60 tablets of Ativan (1 mg). For generic lorazepam, costs range from $0.20 to $0.70 per day for dosages around 1mg/day.
Generic NameClorazepateLorazepam
Most Serious Side EffectSymptoms of depression or increased thoughts about suicide, severe nervous system reaction.Allergic reactions, mood changes or mental disturbances, seizures, unusual behavior and cognitive impairment.
Severe Drug InteractionsNegative interactions with opioids or barbiturates causing extreme sedation, respiratory distress, or coma.Negative interactions with opioids or barbiturates causing extreme sedation, respiratory distress, or coma.
Typical DoseOral dosages range from 7.5–30 mg/day, up to a maximum dosage of 60 mg/day divided into multiple doses.Treatment typically begins at a dosage of 1-2 mg/day, which can be taken twice or three times daily, with a maximum recommended daily dose of around 10 mg/day.

What is Tranxene?

Clorazepate (the generic name for Tranxene) is a benzodiazepine, which marked a significant development upon the first class of antianxiety medications. Clorazepate was first approved by the FDA in 1972. Tranxene works by enhancing the activity of GABA, a neurotransmitter that inhibits brain activity, thus effectively "calming" the brain and relieving symptoms of anxiety. It is prescribed for treating different forms of anxiety disorders as well as certain types of seizures.

Lorazepam (the generic name for Ativan), another drug from the benzodiazepine family, has similar effects but acts more rapidly and has a shorter half-life than clorazepate making it suitable for short-term relief. Both drugs have potential side effects like drowsiness and dependency with prolonged use; however, lorazepam can cause more severe withdrawal symptoms when stopped abruptly due to its shorter half-life.

What conditions is Tranxene approved to treat?

Tranxene is approved for the treatment of various anxiety disorders and conditions such as:

  • Acute alcohol withdrawal
  • Anxiety disorder (short-term relief)
  • Partial seizures, when used in conjunction with other medications

Please note that these uses may depend on the specific formulation and dosage of each medication. Always consult your healthcare provider or pharmacist about your individual needs and circumstances.

How does Tranxene help with these illnesses?

Tranxene aids in managing symptoms of anxiety by increasing the amount of gamma-aminobutyric acid (GABA) available in the synapses of the brain. It does this by enhancing GABA's effects, so its calming influence can be maintained for longer periods. GABA is a neurotransmitter that acts as an inhibitory messenger in the brain, playing a crucial role in reducing neuronal excitability and inducing feelings of relaxation and calmness. In individuals with anxiety disorders, it's often found that they have relatively lower levels or decreased activity of GABA. Therefore, by amplifying GABA’s effects, Tranxene can mitigate the negative impacts associated with anxiety disorders and help patients manage their condition better.

What is Ativan?

Ativan, also known by its generic name lorazepam, is a benzodiazepine which enhances the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor resulting in sedative, sleep-inducing (hypnotic), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties. It was first approved by the FDA in 1977. Unlike Tranxene, Ativan does not have any antidepressant capabilities and therefore should not be used as a primary treatment for depression or anxiety disorders that are coupled with depressive symptoms. However, where it excels is in offering quick relief from acute symptoms of anxiety and panic attacks due to its potential for rapid onset of effects. Its side-effect profile can differ from other benzodiazepines such as Tranxene; common side effects can include drowsiness or sedation, dizziness and weakness but it's less likely to cause severe mental/mood changes or abnormal behavior if used correctly under medical supervision.

What conditions is Ativan approved to treat?

Ativan is an FDA-approved medication for the treatment of:

  • Anxiety disorders
  • Short-term relief of symptoms related to anxiety
  • Preoperative sedation and anxiety relief before surgical procedures

It's worth noting that Ativan, or lorazepam, is considered a short-term solution due to its potential for dependence and withdrawal issues. Always consult your healthcare provider about the appropriateness of this medication in your specific situation.

How does Ativan help with these illnesses?

Ativan is a benzodiazepine, which works by enhancing the effect of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain. This results in sedative, anti-anxiety and muscle-relaxant properties that can provide significant relief for individuals struggling with symptoms of anxiety or panic disorders. Ativan specifically has a relatively short half-life and rapid onset of action compared to other drugs in its class, such as Tranxene. This makes it particularly effective for acute treatment of severe anxiety episodes or panic attacks where immediate symptom relief is desired. However, due to these same characteristics, Ativan may be more likely than Tranxene to lead to physical dependence if used long-term or at high doses.

How effective are both Tranxene and Ativan?

Both clorazepate (Tranxene) and lorazepam (Ativan) are benzodiazepines, a class of medications that act on the central nervous system to produce calming effects. They were initially approved by the FDA only 5 years apart, with Tranxene being approved in 1972 and Ativan in 1977. As they both increase GABA activity in the brain, they may be prescribed under similar circumstances such as anxiety disorders or seizure disorders.

In comparing their effectiveness for treating acute anxiety episodes, a double-blind clinical trial from 1984 showed no significant differences between Tranxene and Ativan; both drugs exhibited comparable efficacy in managing symptoms of anxiety as well as similar safety profiles. In this study, none of the different metrics studied to measure efficacy differed significantly between patients receiving clorazepate and those receiving lorazepam.

A review article published in The American Journal of Psychiatry indicated that clorazepate is effective for long-term treatment of anxiety starting from the first week onwards due to its extended half-life compared to other benzodiazepines like Lorazepam. Its side effect profile is generally favorable over many other anxiolytics because it has been reported to cause less daytime sedation or cognitive impairment.

On the other hand, while lorazepam appears also efficacious for short-term relief from acute symptoms of anxiety, its use beyond four weeks continuously should be carefully considered due to potential risks associated with long term use including dependency and withdrawal syndrome upon abrupt discontinuation which can lead to rebound insomnia or increased feelings of stress. Nonetheless, due to its rapid onset action, lorazepam might be an optimal choice for patients who require immediate relief from severe bouts of panic attacks or agitation.

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At what dose is Tranxene typically prescribed?

Oral dosages of Tranxene range from 7.5–30 mg/day, depending on the individual and the condition being treated. In most cases, a dose of 7.5-15mg/day is sufficient for treating anxiety disorders in adults. However, if needed, this dosage can be increased under medical supervision after a few weeks up to a maximum dosage of 60 mg/day divided into multiple doses throughout the day. For Ativan, oral dosages typically range from 1–6 mg/day divided into multiple doses; however, as with all medications it should be tailored to patient response and tolerability. The maximum dosage that should not be exceeded in any case is generally considered to be around 10 mg per day but may vary based on individual circumstances.

At what dose is Ativan typically prescribed?

Ativan treatment typically begins at a dosage of 1-2 mg/day, which can be taken twice or three times daily. Based on the patient's response to the drug and tolerance, this dose may be increased gradually every two to four days until an appropriate therapeutic level is achieved. The maximum recommended daily dose for adults is generally around 10 mg/day divided into several doses throughout the day. If there is no significant response after several weeks of reaching an optimal dose, alternatives should be considered as Ativan might not work effectively for everyone.

What are the most common side effects for Tranxene?

Common side effects of Tranxene can include:

  • Drowsiness
  • Fatigue or weakness
  • Dry mouth
  • Nausea, constipation, diarrhea
  • Decreased libido (sex drive)
  • Memory issues and confusion, particularly in older adults
  • Balance problems or coordination challenges

Comparatively, Ativan has similar side effects but may also induce:

  • Insomnia
  • Changes in appetite leading to weight changes
  • Skin rash or other allergic reactions
  • Impotence

It's important to note that both medications have the potential for addiction and withdrawal symptoms if stopped abruptly after long-term use. Always consult your healthcare provider before making any changes to your medication regimen.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Tranxene?

While Tranxene is generally well-tolerated, there are potential serious side effects that individuals should be aware of:

  • Any symptoms of depression or increased thoughts about suicide
  • Signs of an allergic reaction: hives, difficult breathing, swelling in your face or throat
  • Changes in vision, including blurred vision or seeing halos around lights
  • Rapid heartbeats, fluttering in your chest, shortness of breath and sudden dizziness (feeling like you might faint)
  • Low sodium levels - headache, confusion, slurred speech, severe weakness,vomiting and loss of coordination
  • Severe nervous system reaction - very stiff (rigid) muscles, high fever,sweating confusion fast uneven heartbeats tremors feeling like you might pass out.

If any such symptoms appear while using Tranxene it's crucial to seek medical help immediately.

What are the most common side effects for Ativan?

Ativan, a widely used anti-anxiety medication, can often lead to side effects such as:

  • Dry mouth or increased salivation
  • Feeling light-headed or dizziness
  • Nausea and vomiting
  • Changes in appetite, potentially leading to weight changes
  • Blurred vision
  • Sleep disturbances including insomnia or excessive sleepiness
  • Muscle weakness or lack of coordination
  • Persistent headache
  • Unusual feelings of restlessness or agitation
    While these are common side effects, if any become severe it's important to consult with your healthcare provider.

Are there any potential serious side effects for Ativan?

While Ativan is generally considered a safe medication, severe side effects can occasionally occur. These may include:

  • Allergic reactions, such as hives, difficulty breathing or swallowing, swelling in the face or throat
  • Mood changes or mental disturbances; this could be increased feelings of depression or suicidal thoughts
  • Seizures (convulsions)
  • Unusual behavior and cognitive impairment - confusion, hallucinations
  • Vision problems: blurred vision, eye pain
  • Heart issues: irregular heartbeats which may feel too fast/too slow.

If you notice any of these symptoms after starting Ativan treatment it's crucial to seek immediate medical attention. Likewise if you experience signs similar to those seen during a manic episode — racing thoughts, unusually high energy levels, reckless behavior etc., consult with your healthcare provider as soon as possible.

Contraindications for Tranxene and Ativan?

Both Tranxene and Ativan, as with most other benzodiazepines, may worsen symptoms of depression in some individuals. If you notice your depressive symptoms intensifying or an increase in suicidal ideation, thoughts, or behavior while taking these medications, please seek immediate medical attention.

Neither Tranxene nor Ativan should be taken if you are using or have recently used certain types of medications such as opioids or barbiturates. Always inform your physician about any medications you are currently taking; these substances could interact negatively with Tranxene and Ativan and cause potentially life-threatening side effects like extreme sedation, respiratory distress or even coma. Additionally, abrupt discontinuation after prolonged use can lead to withdrawal syndrome characterized by seizures among other symptoms. Therefore it is important to follow the doctor's instructions for dose reduction.

How much do Tranxene and Ativan cost?

For the brand name versions of these drugs:

  • The cost of 60 tablets of Ativan (1 mg) averages around $220, which works out to approximately $3.67–$7.33/day depending on your dose.
  • The price for 30 tablets of Tranxene T-Tab (3.75 mg) is about $80, working out to roughly $2.67/day.

Hence, if you are consuming a higher dosage range for Ativan (i.e., 2mg/day or more), then brand-name Tranxene is less expensive on a per-day treatment basis. Remember that cost should not be the primary determinant in choosing between these two medications.

For generic lorazepam and clorazepate dipotassium, costs are relatively lower:

  • Lorazepam (1 mg tablet) comes in packs from 30 capsules and up, with approximate costs ranging from $0.20 to $0.70 per day when taking dosages around 1mg/day or between $.40 and $1.40 per day if your typical dose ranges between 2 -4 mg daily.

  • Clorazepate dipotassium is available in packages starting from 15 up to several hundred tablets (3.75mg), with prices beginning as low as around $.50 per day continuing upwards based on quantity purchased upfront without exceeding roughly about $.90/day at most drugstores.

Popularity of Tranxene and Ativan

Clorazepate, also known by the brand name Tranxene, is a benzodiazepine medication often used in the treatment of anxiety disorders and acute alcohol withdrawal. It was estimated to have been prescribed to about 1 million people in the US in 2020. Clorazepate accounted for just over 2% of all benzodiazepine prescriptions in the US during that time period.

Lorazepam, commonly known under its brand name Ativan, is another type of benzodiazepine medication often used for treating anxiety disorders and insomnia induced by stress. In contrast to clorazepate, lorazepam was prescribed to approximately 14 million people in the USA in 2020. Thus it accounted for nearly one-third of all benzodiazepine prescriptions within that same year. Lorazepam has remained relatively steady over recent years regarding prescription prevalence.


Both Tranxene (clorazepate) and Ativan (lorazepam) have been used extensively for the management of anxiety disorders, with numerous clinical studies attesting to their efficacy over placebo treatments. Occasionally, these medications may be combined under careful physician supervision despite potential drug interactions due to their similar mechanisms of action. Both Tranxene and Ativan are benzodiazepines that work by enhancing the effect of a neurotransmitter in the brain called GABA, thus producing a calming effect.

Tranxene is often prescribed as an initial treatment option due to its long half-life which enables prolonged therapeutic effects with fewer doses. On the other hand, Ativan might be considered as an add-on therapy to enhance tranquilizing benefits or for patients who did not respond optimally to clorazepate or those needing rapid onset relief from acute symptoms.

Both drugs come in generic forms providing significant cost savings especially for patients paying out-of-pocket. It's important to note that both Tranxene and Ativan require some time before their full effect can be felt.

The side-effect profile is generally comparable between both drugs; they're well-tolerated but may cause drowsiness, dizziness and dependence if misused. For both medications, patients should vigilantly monitor any shifts in mood or behavior—especially when starting treatment—and seek immediate medical help if feelings of depression worsen or suicidal thoughts emerge.