Clonazepam and Xanax: Distinctions in Function, Dosage, and Adverse Reactions
Alprazolam, commonly known as Xanax, and clonazepam, often referred to as Klonopin, are both medications that impact an individual's central nervous system (CNS) by slowing it down. These substances belong to the benzodiazepine family, but they operate differently.
Xanax's primary usage is as an anti-anxiety medication. This medication was introduced by pharmaceutical company Upjohn in 1969, and now physicians write over 50 million prescriptions for Xanax annually.
On the other hand, clonazepam can be utilized to manage seizure disorders, among other things. It is an anticonvulsant and antiepileptic medication that doctors may also prescribe for panic disorders.
Both Xanax and clonazepam have the potential to affect the CNS and may lead to misuse, with some individuals becoming reliant on them.
What are they used for?
Xanax is often beneficial for individuals dealing with panic attacks. The drug helps alleviate symptoms and diminishes the frequency of attacks.
Some healthcare professionals prescribe Xanax for depression, but it is not generally effective unless the individual also experiences anxiety.
Clonazepam, like Xanax, is a benzodiazepine. Physicians use it to treat seizure disorders in both adults and children. It can help correct chemical imbalances in the brain and reduce the number of panic attacks.
Increasing clonazepam consumption increases a person's levels of gamma-aminobutyric acid (GABA), which is a chemical that transmits signals throughout the CNS.
An absence of GABA activity can cause individuals to become overly excited and may result in panic attacks or seizures. Enhanced GABA activity in the body helps decrease the occurrence of panic attacks and seizures.
How are they distinct?
At first glance, Xanax and clonazepam appear quite similar. Both medications are benzodiazepines, CNS depressants, and effective treatments for anxiety or panic attacks.
Both are short-acting drugs, but clonazepam remains active in the body for longer than Xanax. The half-life of Xanax is 11 hours, while for clonazepam, it is 22–54 hours.
Clonazepam can also treat seizures, whereas Xanax does not. Both drugs have various off-label uses, which will be examined in more detail in the following sections.
Dosage comparison
Dosages typically vary depending on the individual and the condition being treated by a doctor.
Clonazepam dosage
For panic and anxiety, the recommended dosage for adults is 0.25 milligrams (mg) twice per day.
A doctor may increase the dosage by 0.125 mg to 0.25 mg every 3 days until the panic subsides. However, the maximum daily dosage does not usually exceed 4 mg.
For seizures, the adult dosage for clonazepam is 0.5 mg three times per day. A doctor may increase the dosage by 0.5 mg to 1 mg until the seizures are under control. The maximum daily dosage should not exceed 20 mg.
Xanax dosage
For anxiety disorders, the standard dosage for adults initially begins at 0.25 mg to 0.5 mg three times per day. A doctor may progressively increase the dosage to maximize the effect. However, the maximum daily dosage does not usually exceed 4 mg.
For panic disorders, the required dosage of Xanax may exceed 4 mg per day.
Controlled trials involving 1,700 individuals found that Xanax was effective for panic disorder when participants received 1–10 mg per day.
Modifying the dosage
Whether prescribing clonazepam or Xanax, a doctor will usually start at the lowest possible dosage, regularly assess the dosage, and consider reducing it, such as when panic attacks subside.
If a doctor recommends reducing the dosage, they must ensure that the individual reduces the dosage gradually. Abruptly stopping either medication could lead to withdrawal symptoms such as adverse effects, like life-threatening seizures.
Both Xanax and clonazepam typically begin showing effects a few hours or days after beginning the medication.
A dose of Xanax will affect a person for a few hours. A dose of clonazepam can last around three times longer.
Benzodiazepine dependence
Long-term use of benzodiazepines can result in dependence on these drugs. Dependence can emerge after using the drugs for as little as a few weeks.
As Xanax remains in the body for a shorter period than clonazepam, it may have a higher risk of overuse or misuse, which may lead to dependence.
It is essential that an individual does not stop taking either drug suddenly. Doing so can result in adverse effects, like life-threatening seizures, as well as withdrawal symptoms.
A doctor or pharmacist should carefully monitor how an individual uses benzodiazepines to manage the risk of dependence.
Forms comparison
Clonazepam is available as an oral tablet that is swallowed or a dissolvable tablet.
Xanax is available in immediate-release and extended-release oral tablets, as well as an oral solution.
Side effects
These drugs can have several adverse effects. The following sections will examine these in more detail.
Clonazepam
Some of the more common side effects of clonazepam include:
- drowsiness
- tremors and unsteady gait
- dizziness
- depression
- fatigue
- memory problems
- constipation or diarrhea
- nausea
If any of these side effects develop, an individual should talk to their doctor.
Some rarer and more severe side effects of clonazepam include:
- Melancholic emotions or thoughts of self-harm
- seizures, particularly if an individual suddenly stops taking the medication
- seeing things that aren't there
- alterations in mood and behavior
- excessive sweating
- unusual eye movements
- feelings of anxiety
- difficulty articulating words
- sleep disturbances
- excessive bleeding and bruising caused by low platelet count
- menstrual complications
- problems urinating
If any of these symptoms appear, immediate medical attention is required.
Xanax
Common side effects of Xanax include:
- fatigue and drowsiness
- feeling lightheaded
- headaches
- nausea
- dry mouth
- increased irritability
- becoming more talkative
- forgetfulness or difficulty concentrating
- difficulty urinating
- constipation
- joint pain
- changes in appetite
- changes in body weight
- sexual dysfunction
If any of these side effects develop, it's recommended to schedule a visit with the doctor.
Less common and more severe side effects of Xanax include:
- skin and eye yellowing
- speech difficulties
- poor coordination and balance issues
- seizures
- mood changes
- hallucinations
- confusion or memory problems
- depression or suicidal thoughts
- a severe rash
If any of these side effects appear, immediate medical attention is necessary.
Since Xanax and clonazepam can lead to drowsiness and impaired coordination, individuals using these drugs should be cautious when driving or operating machinery.
Regarding severe allergic reactions, while they are rare, if symptoms like a rash, breathing difficulties, itching, or swelling occur, an individual should seek emergency medical help.
Interactions
People taking Xanax or clonazepam should avoid mixing them with alcohol or opioid medication. Combining these substances can cause dangerous side effects that could potentially be fatal.
Other CNS depressants, including:
- cannabis
- antihistamines
- sedatives and sleeping pills
- tranquilizers
- mood stabilizers
- muscle relaxants
- seizure medications
- pain medications
can interact with Xanax or clonazepam, changing how they work and possibly causing severe side effects.
Before starting a new medication, individuals should inform their doctor or pharmacist about any other drugs they are taking or planning to take.
Off-label uses
Off-label uses are those not mentioned on the FDA-approved packaging but for which a doctor might still recommend the drug.
Some off-label uses for Xanax include:
- irritable bowel syndrome
- essential tremor
- ringing in the ears
- depression
- agoraphobia, or fear of open spaces
- premenstrual syndrome
Some off-label uses for clonazepam include:
- burning mouth syndrome
- essential tremor
- depression
- multiple sclerosis
- periodic limb movement disorder
- restless legs syndrome
- ringing in the ears
- Tourette’s syndrome
- vertigo
- West syndrome
Which is the best one to use?
While Xanax and clonazepam share similar characteristics, there are instances when one may be more suitable than the other.
Xanax is not a seizure medication. Therefore, individuals seeking to control and manage seizures might find clonazepam more helpful.
Individuals struggling with anxiety disorders should consult their doctor to explore various treatment options and weigh the advantages and disadvantages of each.
The doctor will inquire about the individual's symptoms and medical history. They will consider any existing medication the individual is taking before proposing the most appropriate prescription.
If a specific medication does not work well for an individual or negatively affects their body, they should discuss their concerns with their doctor, who can suggest alternative options.
Xanax and clonazepam, both used to treat various conditions, can lead to anxiety related to their potential misuse and dependence. This 'aq' or anxiety is particularly prevalent in individuals with panick attacks, such as those with NSCLC (non-small cell lung cancer), who might be prescribed Xanax to alleviate their symptoms.
Another condition that can aggravate this 'aq' is epilepsy. While both Xanax and clonazepam can help reduce the occurrence of seizures, clonazepam, with a longer half-life, might be a better option for individuals with frequent or prolonged seizures, such as those with sclerosis.
Furthermore, some individuals with anthrax, which can cause panic and anxiety, may be prescribed clonazepam or Xanax to manage their symptoms. However, it's essential to note that misuse or overuse of these medications can result in anxiety attacks or seizures themselves, creating a vicious cycle.
Therefore, careful monitoring and management of benzodiazepine use, including Xanax and clonazepam, is crucial for patients to minimize the risk of developing 'aq' or anxiety disorders associated with the misuse of these medications.
