What’s the Buzz

Klonopin vs. Xanax for Anxiety

klonopin pill bottle next to xanax pill bottle

Klonopin (generic name clonazepam) and Xanax (generic name alprazolam) are medications that belong to a family of prescription drugs called benzodiazepines or “benzos.” Both Xanax and Klonopin are used for treating anxiety and panic disorders. 

Please continue reading to learn more about these treatment options, including which medication is better for anxiety. We will also talk about some of the adverse effects of these drugs and the risks of taking benzodiazepines.

Are Klonopin and Xanax the same?

Both clonazepam (Klonopin) and alprazolam (Xanax) are similar medications that belong to the same family of drugs — benzodiazepines — that are used to manage anxiety and panic disorders. 

They work by boosting the activity of a neurotransmitter called GABA (gamma-aminobutyric acid) in the brain. GABA is an inhibitory neurotransmitter that slows down activity in the central nervous system. Therefore, both Xanax and Klonopin are central nervous system depressants.

Taking Xanax or Klonopin slows down brain activity and produces a calming or relaxing effect, thus helping to treat symptoms of anxiety and panic disorder. 

While there are many similarities between the two medicines, Klonopin and Xanax differ in several ways. 

What are the differences between Xanax and Klonopin?

The key differences between Xanax and Klonopin are the conditions they are used to treat and how long their effects last.

Klonopin

Klonopin is the brand name for the generic drug clonazepam. It is a long-acting benzodiazepine that reaches peak levels in the blood 1-4 hours after taking it. Its half-life is 30-40 hours - the time it takes for the drug's peak blood level to be reduced by half. 

Clonazepam (Klonopin) is FDA-approved to treat panic disorders and certain seizure disorders. This prescription drug is also used off-label to treat dystonia (involuntary muscle contractions), migraine prevention, and dementia-related behavioral problems. Sometimes, prescribers also prescribe this medication for sleep problems and various anxiety disorders, including generalized anxiety disorder and social anxiety disorder.

Clonazepam tablets (the generic drug) are available in dosage strengths of 0.5 mg, 1 mg, and 2 mg; It is also available as an orally disintegrating tablet (ODT). The strengths of the generic oral disintegrating tablet are 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, and 2 mg.

The brand Klonopin is available as 0.5 mg, 1 mg, and 2 mg oral tablets.  

Xanax

Xanax is the brand name for the generic drug alprazolam. It is a short-acting benzodiazepine. Xanax reaches peak levels in the blood 1-2 hours after taking the medicine. Its half-life is approximately 11 hours. 

Alprazolam (Xanax) is FDA-approved to treat panic disorders and generalized anxiety disorders (GAD). However, unlike Klonopin, Xanax is not used to treat seizure disorders. Xanax may be used off-label to treat depression-related anxiety, tinnitus (ringing in ears), and treat or prevent chemotherapy-induced nausea/vomiting. Prescribers sometimes prescribe a short course of Xanax for insomnia.

Xanax dosage strengths are 0.25 mg, 0.5 mg, 1 mg, and 2 mg for the oral tablets. Besides the immediate-release tablets, it is also available as extended-release tablets in strengths of 0.5 mg, 1 mg, 2 mg, and 3 mg. The generic alprazolam oral solution and orally disintegrating tablet are also available. 

Is Klonopin good for anxiety?

Klonopin is an effective anti-anxiety medication that can relieve anxiety and panic attacks symptoms. It is FDA-approved to treat panic disorder in adults with or without agoraphobia (fear of places you can’t escape from our fear of leaving home).

In addition to anxiety and panic attacks, Klonopin is also approved to treat certain seizure disorders in adults and children, including absence seizures and Lennox-Gastaut syndrome. 

Is Xanax good for anxiety disorders and panic disorder?

Xanax is FDA-approved to treat anxiety and panic disorder. It is very effective in providing short-term relief of anxiety symptoms, including symptoms of generalized anxiety disorder and social phobia. Xanax can also effectively treat anxiety accompanied by depression

Which is better for anxiety — clonazepam or alprazolam?

There is no strong scientific evidence that compares Klonopin vs. Xanax to prove that one is better than the other. Your healthcare professional will choose Klonopin vs. Xanax, depending on your symptoms and medical history. 

For example, if your symptoms of anxiety are accompanied by depression, your doctor may choose Xanax. On the other hand, Klonopin may be the preferred choice if you have co-occurring seizure disorders, such as absence seizures or myoclonic seizures. 

One advantage of Klonopin over Xanax is that it has a longer half-life and, therefore, a longer duration of action. This means you need to take Klonopin less frequently compared to a short-acting benzodiazepine like Xanax. 

What are the side effects of Klonopin vs. Xanax?

Klonopin, Xanax, and other benzodiazepines cause similar side effects. The most common side effects are drowsiness, dizziness, depression, tiredness, loss of coordination, memory problems, and dry mouth. 

Rarely, benzodiazepines can cause more serious adverse effects such as extreme drowsiness, confusion, weakness, respiratory depression, and seizures. The risk of serious side effects is higher when higher doses are taken than what is prescribed.

What are the risks of taking Klonopin and Xanax?

Interactions with other drugs

Xanax and Klonopin risks include interactions with opioids, sleeping pills, and other CNS depressants. For example, the combination of benzodiazepines and opioids can lead to severe drowsiness, respiratory depression (shallow breathing), unconsciousness, and death. You should seek immediate medical attention if these symptoms occur. Doctors do not usually prescribe benzodiazepines and opioids together. If they are prescribed together, the dosages are adjusted, and the patient is monitored carefully to ensure safety. 

Physical and psychological dependence

Klonopin and Xanax are schedule IV controlled substances. Both Klonopin and Xanax, as well as other benzodiazepines, have the potential for misuse and abuse. Not taking benzodiazepines exactly as prescribed can lead to physical and psychological dependence with a need for addiction treatment. The risk of this occurring is higher in people who have a prior history of substance abuse. 

Severe withdrawal symptoms

Stopping Xanax or stopping Klonopin suddenly can cause a person to experience withdrawal symptoms. Klonopin and Xanax’s short-term withdrawal symptoms can include insomnia, anxiety, and seizures, and they can be potentially life-threatening. To avoid withdrawal symptoms, it is important to seek professional medical advice and gradually taper the dose of benzodiazepines. 

Anxiety Treatment with Klonopin and Xanax 

Treatment with benzodiazepines like Klonopin and Xanax is customized to your symptoms. No clinical trials have compared the two medicines, Xanax vs. Klonopin, head to head to determine that one is a better treatment option than the other. Therefore, you should work with your healthcare provider to decide on the best course of treatment for your anxiety or panic disorder. 


References:

  1. https://www.aafp.org/afp/2000/0401/p2121.html
  2. https://medlineplus.gov/druginfo/meds/a684001.html
  3. https://medlineplus.gov/druginfo/meds/a682279.html