Ativan (lorazepam) is one of the most commonly prescribed medications for anxiety. While it’s very effective at calming the mind, Ativan also has many side effects and may create a dependency risk.
This has led many people to seek natural alternatives to Ativan, either to supplement it, replace it, or completely negate the need for it in the first place.
Cannabidiol (CBD) is one of these alternatives. CBD is a naturally-occurring cannabinoid in the hemp plant that’s well-known for its balancing effects on the mind. While CBD is not a replacement for Ativan, it may offer some of the same benefits without causing as many side effects — or dependence.
In this article, we discuss the benefits of Ativan and CBD and go more in-depth on the pros and cons of each, so that you can choose the option that’s right for you.
What is Ativan?
Ativan is the brand name for lorazepam (we’ll use “Ativan” in this article for simplicity), a drug used to treat anxiety. It’s used for a variety of anxiety-related issues, including anxiety-related insomnia.
Ativan belongs to a class of drugs known as benzodiazepines, which act on your central nervous system – your brain and nerves – to produce a mentally calming effect.
The Benefits of Ativan for Anxiety
Many studies support the benefits of Ativan for anxiety. One clinical trial from 1978, found that lorazepam rendered a 50% improvement over a placebo in various measures of anxiety [1].
Another study found that lorazepam was more effective than diazepam, another benzodiazepine, for patients with neurotic anxiety [2].
How Does Ativan Work?
Ativan works on the central nervous system (CNS) by increasing the availability of gamma-aminobutyric acid (GABA) to the brain. GABA has a calming effect on the CNS, and it exerts a tranquilizing effect on the mind and body.
Many studies have shown a relationship between higher levels of GABA and feelings of relaxation [3]. By making GABA more available to your brain, medications like Ativan have anxiety-reducing effects.
What is CBD?
Cannabidiol, or CBD, is a compound that naturally occurs in the hemp plant. It’s one of more than 100+ cannabinoids found in hemp, and it has a wide variety of potential therapeutic applications.
Unlike THC, CBD will not get you high. Because it’s able to promote mental and physical stability without being inebriating, CBD is often the first cannabinoid people turn to when they’re looking for natural alternatives to traditional medicine.
The Benefits of CBD for Anxiety
Several studies suggest CBD has therapeutic potential for people with anxiety.
In one 2011 study, CBD reduced anxiety in participants subjected to a public speaking test [4].
A 2019 study conducted by researchers examined the efficacy of CBD for anxiety and sleep troubles. During the first month of the study, 79.2% of participants reported an improvement in how they felt [5].
A 2015 review concluded that CBD has therapeutic potential for anxiety, and that it should be further researched for this use [6].
While more research is needed, the existing literature indicates that CBD has significant therapeutic potential for anxiety.
Still, CBD is not an FDA-approved anxiety treatment, so it can’t be reasonably compared to a medication like Ativan, which is. Instead, CBD can be thought of as a natural, balance-supporting supplement.
How Does CBD Work?
While CBD’s exact mechanism of action for anxiety is still being researched, studies so far show it may promote mental balance in several different ways.
Like other cannabinoids, CBD works in part by interacting with your body’s endocannabinoid system (ECS).
The ECS is a transmitter system in your body that controls most of your vital functions, including the stress and anxiety responses, with its ultimate purpose being to promote homeostasis (balance).
CBD is thought to promote the function of the ECS and prevent the breakdown of endocannabinoids (internal cannabinoids). In this way, CBD may amplify what the ECS already does: keep your mind and body balanced.
Research also suggests that CBD works for anxiety by impacting the transmission of serotonin, which, like GABA, is a neurotransmitter.
A 2019 study found that CBD may cause serotonin to stay between the nerve endings of the brain for longer than normal [7].
Higher serotonin levels are associated with feelings of calm, focus, emotional stability, and happiness.
By supporting your body’s natural processes through its interaction with the ECS, and through its interaction with your neurotransmitters, CBD may comprehensively promote a healthy, anxiety-free mind.
CBD vs. Ativan: How Do They Make You Feel?
Generally, the effects of Ativan are stronger and more easily noticed than those of CBD.
The general consensus around Ativan is that it helps people feel more relaxed, happier, and calmer.
Most people who use CBD, on the other hand, report feeling very few mental effects. However, feeling “nothing” is a good thing in this context.
This difference in effects make sense: Ativan is designed to radically alter how a bodily system works (in this case, the transmission of GABA), while CBD is a natural supplement that promotes overall balance.
CBD vs. Ativan: Adverse Effects
While Ativan is stronger and more scientifically proven, there are more risks associated with using it than with CBD. From a side effects standpoint, CBD is much easier on the body than Ativan.
Ativan side effects & adverse effects
Potential side effects of Ativan include:
- Drowsiness
- Dizziness
- Loss of coordination
- Headaches
- Nausea
- Blurred vision
- Changes in sexual interest or ability
- Constipation
- Heartburn
- Changes in appetite
Ativan may also cause serious long-term side effects. Ativan is habit-forming, which means that it may cause physical or psychological dependence.
It may also cause a slew of withdrawal effects if you try to stop taking it, such as headache, sweating, tremors, difficulty concentrating, increased blood pressure, palpitations, rapid heart rate, nausea, irritability, and more.
Rebound effects also sometimes happen to Ativan users: when they stop taking the drug, they begin experiencing the very things that Ativan is designed to treat, such as anxiety or insomnia.
CBD side effects
Potential side effects of CBD include:
- Dry mouth
- Drowsiness
- Diarrhea
- Reduced appetite
- Fatigue
More research is needed to determine the long-term side effects of CBD.
Pros and Cons of Ativan for Anxiety
Ativan has several upsides and downsides to consider for use with anxiety:
Pros
- Very effective: Ativan has been an FDA-approved, scientifically-proven anxiety medication for decades, and lots of research supports its efficacy at reducing anxiety. It’s commonly prescribed in cases of severe anxiety for which no other drug will work.
- Science-backed: Compared to CBD, Ativan is more proven from a research standpoint, as there have been an abundance of clinical trials and reviews showing that it works for anxiety.
Cons
- May cause dependency and addiction: Ativan is a habit-forming drug and may cause physical or psychological dependency if you use it long-term, which can lead to addiction.
- May cause rebound & withdrawal effects: If you stop using Ativan, there is a chance you may begin experiencing anxiety or insomnia, the things it is designed to treat. Ativan may also cause a variety of adverse withdrawal effects.
- Requires a prescription: Ativan requires a prescription, whereas CBD does not. This is not a downside from a therapeutic perspective – Ativan is a powerful drug that should only be used in select circumstances – but it is a logistic obstacle.
Pros and Cons of CBD for Anxiety
CBD has several upsides and downsides to consider for use with anxiety:
Pros
- Research-backed: Multiple studies suggest CBD has therapeutic potential for anxiety. Anecdotally, it may promote mental balance and relaxation. However, as compared to FDA-approved medications, CBD is not a proven treatment for anxiety, and more research is needed for us to understand how well it works.
- Has fewer side effects than many prescriptions: The potential side effects of CBD include dry mouth, drowsiness, diarrhea, reduced appetite, and fatigue. Compared to the side effects of Ativan, these side effects are very minor (and unlikely to be felt, with careful dosing).
- Doesn’t require a prescription: CBD is an over-the-counter natural health supplement, making it ideal if you’re not experiencing severe anxiety and just need something to promote balance.
Cons
- Poorly regulated: The CBD industry isn’t regulated by the FDA as the pharmaceutical industry is, and the vast majority of products you’ll find online and in-store have not been evaluated by clinical trials. While safe, high-quality CBD products exist, you’ll need to shop carefully to find them since poor-quality options also abound.
- May interact with prescriptions: CBD may affect how your body metabolizes certain medications, including Ativan. Using CBD together with some prescription medications may create side effects such as sleepiness, fatigue, and even falls and accidents while driving, according to Harvard Health.
- Not legal in all states: Every form of CBD may not be legal in every state in the US, and as a result, you might have trouble legally purchasing and using it.
You deserve better. That's why we only carry high-strength, American-made CBD products that have been 3rd-party lab tested.
Conclusion: Can CBD Replace Ativan?
CBD has therapeutic potential for a variety of uses, including anxiety. However, it is not a treatment for anxiety, and more research is needed to investigate its benefits.
CBD may promote mental relaxation, and some people have used it to supplement or replace Ativan and other anxiety medications, like Xanax, Zoloft, and Wellbutrin.
However, if you’re currently using Ativan, we don’t recommend making the switch without consulting with your doctor first – they can help you do it safely, and only if it makes sense for you.
At Natural Ways CBD, we encourage everyone to try CBD and see how it helps them – just remember that it’s a supplement to, not a replacement for, Ativan and other medications.
CBD vs. Ativan: Frequently Asked Questions
Here are some questions our customers frequently ask us about the differences between CBD and Ativan.
Is CBD similar to Ativan?
CBD may promote mental relaxation and calming, similar to Ativan. However, its effects aren’t typically as strong or noticeable. The relative efficacy of CBD for anxiety as compared to Ativan hasn’t been studied.
Is CBD a good alternative to anxiety medication?
CBD may supplement anxiety medications, but we recommend seeking guidance from your doctor on how best to use it if you’re already on a medication.
Can CBD replace benzodiazepines?
Some people have replaced benzodiazepines with CBD, but we don’t recommend trying this without talking to your doctor first. Ativan and other benzodiazepines have a slew of withdrawal effects, and CBD may not do everything these medications can.
Can you take CBD and Ativan together?
No, you should not take CBD and Ativan at the same time. While both CBD and Ativan are generally considered safe, they may not be safe when used together. If you plan to use both, you’ll need to space them out – we recommend seeking professional medical advice if you’re going to do this.
Sources
[1] Ellison, R J Jr, and L A Cancellaro. “A study in the management of anxiety with lorazepam.” Journal of clinical pharmacology vol. 18,4 (1978): 210-9. doi:10.1002/j.1552-4604.1978.tb01595.x
[2] Valarino, F, and R Perez-Lopez. “Lorazepam and diazepam in the treatment of neurotic anxiety: a double-blind trial.” Diseases of the nervous system vol. 37,2 (1976): 58-61.
[3] Hepsomali, Piril et al. “Effects of Oral Gamma-Aminobutyric Acid (GABA) Administration on Stress and Sleep in Humans: A Systematic Review.” Frontiers in neuroscience vol. 14 923. 17 Sep. 2020, doi:10.3389/fnins.2020.00923
[4] Bergamaschi, Mateus M et al. “Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients.” Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology vol. 36,6 (2011): 1219-26. doi:10.1038/npp.2011.6
[5] Shannon, Scott et al. “Cannabidiol in Anxiety and Sleep: A Large Case Series.” The Permanente journal vol. 23 (2019): 18-041. doi:10.7812/TPP/18-041
[6] Blessing, Esther M et al. “Cannabidiol as a Potential Treatment for Anxiety Disorders.” Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics vol. 12,4 (2015): 825-36. doi:10.1007/s13311-015-0387-1
[7] De Gregorio, Danilo et al. “Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain.” Pain vol. 160,1 (2019): 136-150. doi:10.1097/j.pain.0000000000001386
