Anxiety and sleep disorders are among the most common health problems Americans deal with each year. Millions of U.S. adults struggle to get the sleep they need each night, and anxiety disorders are the most common mental health issue in the country. However, drugs like clonazepam and Xanax are used to treat anxiety, insomnia, and many other mental health problems.
Both clonazepam and Xanax are in a class of drugs called benzodiazepines. Clonazepam is the generic name for Klonopin. Alprazolam is the generic name for Xanax. Both drugs work almost the same way, but there are differences in how long one lasts versus the other, how strong one is over the other, what they treat, and which one is more addictive.
How do these two similar drugs compare? Is it better to take Xanax or clonazepam for anxiety? What is the proper Xanax or clonazepam dosage? Learn more about these two drugs and how they stack up to one another as prescription drugs.
Different Forms and Dosages
Clonazepam is a tablet, which you swallow. It also comes in an orally disintegrating tablet that dissolves in the mouth. It is taken one to three times per day, as prescribed by a doctor.
Xanax is prescribed as immediate-release and extended-release tablets to be swallowed. Its generic form can be given as an oral solution. Immediate-release tablets are taken several times per day. The oral solution is also an immediate-release form of the drug to be taken several times per day. The extended-release pill is only taken once per day.
Most doctors start the medication off with the lowest possible dosage and increase it in small amounts if needed.
Both medications start working within hours or days of the first dose. Clonazepam lasts about two to three times longer than Xanax, which lasts for a few hours.
Clonazepam is prescribed to treat panic disorder and is used to stop seizures. It is sometimes used in combination with other medications. This drug works by increasing the activity levels of gamma- aminobutyric acid (GABA), a chemical that sends signals through the central nervous system. When GABA levels are low, your body will be in an excited state, which could cause panic attacks or seizures. If you take clonazepam, the GABA levels in your body will increase, causing a calm feeling. It can prevent panic attacks and seizures.
Xanax is also used to treat panic disorders, as well as anxiety disorders. It is the most prescribed benzodiazepine in the US. The drug works by boosting the effects of GABA. It slows the movement of brain chemicals down that may be unbalanced. It eases the feelings of nervous tension and anxiety.
Both drugs are central nervous system depressants.
What Do These Drugs Treat?
Benzodiazepines treat several medical issues. They are often used to treat anxiety disorders, which include panic disorder, social anxiety, and phobias. However, they may also be used to treat seizures, insomnia, and muscle spasms.
Clonazepam is prescribed to treat panic disorder and is used to stop seizures. It is sometimes used in combination with other medications.
Xanax is also used to treat panic disorders, as well as anxiety disorders. It is the most prescribed benzodiazepine in the US.
Benzodiazepines aren’t usually first-line treatment options for generalized anxiety disorder. Your doctor may prescribe antidepressants like SSRIs (selective serotonin reuptake inhibitors) first, since they are generally safer and have a lower risk of chemical dependence and addiction. However, if they aren’t effective, your doctor may prescribe a benzodiazepine.
Which Works Better for Anxiety Xanax or Klonopin?
Both clonazepam and Xanax work well in treating anxiety. Clonazepam is better to treat panic disorder than Xanax. The US Department of Veteran Affairs (VA) does not recommend using benzodiazepines for post-traumatic stress disorder (PTSD) as the medication can “cover-up” the feelings or trauma, and you may not ever learn how to manage your trauma. It advises there are better medications for PTSD than benzodiazepines, such as clonazepam or Xanax.
It’s important to note that no one medication will be equally effective for everyone. Finding the right treatment options for your needs may be a trial and error process. For instance, even though Klonopin is often prescribed to help treat panic disorders, it may not be the best option for you. When you start taking a new prescription, it’s important to pay attention to your symptoms and side effects. If you notice new or worsening side effects or persistent symptoms, let your doctor know. They may be able to help you find the right dose or another medication that provides better results.
Which One Starts Working Faster, Lasts Longer?
Both clonazepam and Xanax start working within a few hours or days of the first dose. Xanax lasts for a few hours. It has an elimination half-life of around 11 hours, which means it takes around that time for it to be reduced to half of its initial concentration in your bloodstream. Clonazepam lasts three times longer than that. It has a half-life between 30 and 40 hours. Going by this, clonazepam lasts much longer. Not all of the drug’s effects will be felt throughout their entire half-life. However, half-life can be a good indication of when the drug will no longer be effective.
You are more likely to feel the same effects if you take one or the other drug. However, the effects from clonazepam might be more robust and cause euphoric feelings if misused, which may lead to addiction.
Do They Have the Same Side Effects?
Since Xanax and clonazepam work in the brain in similar ways, they will cause many of the same effects and side effects. However, your experience with either of these drugs probably won’t be identical. Plus, they have different onsets and durations of actions. You may experience clonazepam side effects for much longer than you experience Xanax side effects. Still, Xanax tends to come with a longer list of side effects that are common to experience. It should be noted that side effects are more likely to occur if you misuse or abuse the drugs.
Clonazepam comes with several adverse side effects, which may last for the first few doses of the medicine.
- Constipation or diarrhea
- Unsteady gait and shaky movements
- Memory problems
Xanax comes with a longer list of side effects. However, not all of them will be felt and not all of the time when taking the drug. A few of the side effects experienced are the same for clonazepam.
- Forgetfulness (memory problems)
- Trouble concentrating
- Dry mouth
- Becoming talkative
- Trouble urinating
- Appetite changes
- Weight changes
- Joint pain
- Sexual dysfunction
Both drugs may interact negatively with other substances. As central nervous system depressants, they shouldn’t be mixed with alcohol or other depressants, but they may also be dangerous when mixed with opioids. Mixing these drugs together could cause them to potentiate one another, which risks an overdose. Fatal benzodiazepine overdose is much more likely when the drugs are mixed with other substances.
Interactions with other drugs can cause different effects. Some can interfere with how clonazepam or Xanax work; others can cause increased side effects.
These drugs can increase the side effects of clonazepam:
Other benzodiazepine medications, such as lorazepam (Ativan), midazolam (Versed), triazolam (Halcion), which in combination with clonazepam can increase the sedated and drowsiness effects
Opioids like codeine and hydrocodone (Vicodin). When taken with clonazepam, it causes extreme drowsiness, slowed breathing, coma, or death.
Barbiturate and non barbiturate sleep drugs, such as amobarbital (Amytal Sodium), butabarbital (Butisol), and pentobarbital (Nembutal), can intensify side effects. Increased side effects are also possible when taking “z-drugs,” such as eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).
Tricyclic antidepressants, such as amitriptyline and nortriptyline (Pamelor)
Anti-seizure drugs, such as gabapentin and pregabalin
These drugs can affect how Xanax works or increase its side effects:
- Birth control pills
- Cimetidine (Tagamet)
- Digoxin (Lanoxin) for people 65 years and above
- Erythromycin (Erythrocin)
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)
- HIV protease inhibitors, such as ritonavir (Norvir)
- Imipramine (Tofranil) and desipramine (Norpramin)
- Itraconazole (Sporanox)
- Ketoconazole (Nizoral)
- Propoxyphene (Darvon)
Additionally, it is best to avoid using the substances below when taking clonazepam or Xanax:
- Muscle relaxants
Both drugs have the capability to be addictive. Clonazepam is a stronger drug, so the possibility of becoming addicted to it is real. Xanax is taken more often on a daily basis, and you might find that its beneficial effects are not being felt anymore if you take it for an extended time. This could cause you to take more of it, thus leading to dependence or addiction.
Which Drug Can Cause Dependence More?
You might find that you develop a tolerance to clonazepam quicker, as its effects wear off faster than Xanax. You may want to feel that euphoric feeling the drug gives again; therefore increasing the dosage. That great feeling from clonazepam is short-lived.
Xanax might make some people feel slightly “buzzed.” As the immediate-release tablets are taken one to three times per day, tolerance to Xanax can occur soon; thus compelling the person to take more of the drug to feel that same “buzzed” feeling.
Tolerance and dependence do not necessarily lead to addiction. The National Institute on Drug Abuse (NIDA) notes that tolerance occurs “when a person no longer responds to a drug in the way they did at first.” So they take more of it to get the same effect as when they first took it.
Dependence is feeling withdrawal symptoms from a substance when a person stops taking it, as noted by NIDA. This can occur even if you take a prescription drug every day for a long time. This does not mean you are addicted to the drug, though.
Addiction is a disease, chronic in nature, that can result in taking drugs repeatedly. If you keep using the drug despite negative consequences, you may be addicted to it.
Which Drug Has More Severe Withdrawal Symptoms?
Xanax withdrawal is known to be very challenging to experience. It is also known that the drug comes with more severe rebound and withdrawal symptoms than clonazepam. Xanax has a short half-life of nine to 20 hours. Half-life means the time it takes for half of the drug to leave your body. The shorter the half-life; the less time is in your body.
Clonazepman has a longer half-life (19 to 60 hours). Therefore, it stays in the body longer. The longer it stays in the body; the less severe withdrawal symptoms will be, according to Drugs.com.
Xanax physical withdrawal symptoms:
- Muscle spasms
- Racing pulse
Xanax psychological withdrawal symptoms: (alphabetically)
- Difficulty concentrating
- Feelings of unreality
- Panic attacks
Both prescription drugs are safe when taken as prescribed. Clonazepam is meant to be taken in treating panic disorders and some types of seizures. Xanax is usually prescribed on a short-term basis for anxiety and anxiety disorders. Neither drug is meant to be taken for the long-term. Long-term use of either drug can cause tolerance, dependence, and possibly addiction.
People who have become addicted to the drugs may try to find them on the illicit drug market and unknowingly buy pills that have been cut with cheaper and/or harmful ingredients, such as fentanyl. Taking illicitly bought clonazepam or Xanax can lead to overdose or a fatality.