Klonopin vs Xanax: Benzodiazepine Side Effects, Withdrawal & Dosage

Klonopin (clonazepam) vs. Xanax (alprazolam) review

• Klonopin (clonazepam) and Xanax
  (alprazolam) belong to a class of drugs called benzodiazepines.
• Benzodiazepines are medications that
  cause drowsiness (sedation) and inhibition of nerve signals within the brain
  (central nervous system or CNS). They also are used for sedation during surgery.
• Both Klonopin and Xanax are prescribed
  to treat anxiety. Symptoms of anxiety include:
  • Headaches
  • Sleep problems
  • Becoming tired easily
  • Irritability
  • Muscle tension
  • Restlessness or feeling edgy
  • Trouble concentrating
• Klonopin also is prescribed to treat
  certain types of seizures and Lennox-Gastaut syndrome.
• Since both Klonopin and Xanax are
  benzodiazepines, they can cause physical dependence (addiction). Withdrawal
  symptoms from suddenly stopping taking these medications can include insomnia,
  headaches, nausea, vomiting, sweating, tremors, and seizures.
• Examples of common side effects of
  benzodiazepines like Klonopin and Xanax include
  • Constipation
  • Dry mouth
  • Reduced libido
  • Vomiting
  • Memory impairment
  • Confusion
• Klonopin and Xanax interact with
  alcohol, barbiturates, narcotics, and other drugs or substances that slow the
  brain’s processes. Xanax also interacts with several other
  drugs.
• Both Klonopin and Xanax are not
  recommended during pregnancy due to the risk of fetal abnormalities. Both drugs
  also are secreted in breast milk and can affect nursing infants. Therefore they
  should not be used by women who are nursing.

What are Klonopin and Xanax?

What is Klonopin (clonazepam)?

• Klonopin (clonazepam) is an
  anti-anxiety
  medication in the
  benzodiazepine family, the same family that includes, for example:
  • diazepam (Valium)
  • alprazolam (Xanax)
  • lorazepam (Ativan)
  • flurazepam (Dalmane)
• Klonopin and other
  benzodiazepines act by enhancing the effects of
  gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a
  chemical that nerve cells use to communicate with each other) that inhibits
  brain activity. It is believed that excessive activity in the brain may lead to
  anxiety or other psychiatric disorders. Clonazepam is primarily used for
  treating
  panic disorder and preventing certain
  types of seizures.
• The FDA
  approved clonazepam in June 1975.

What is Xanax (alprazolam)?

• Xanax (alprazolam) is an anti-anxiety medication in the benzodiazepine family, the same family that includes,
  for example:
  • diazepam (Valium)
  • clonazepam (Klonopin)
  • lorazepam (Ativan)
  • flurazepam (Dalmane)
• Xanax and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders.
• The FDA approved
  Xanax in October 1981.

What generic names are available for Klonopin and Xanax?

• Clonazepam is the brand name for Klonopin available for in the US.
• Alprazolam is the brand name for Xanax available in the US.

What are the uses for Klonopin (clonazepam) vs. Xanax (alprazolam)?

Klonopin (clonazepam) uses

Klonopin (clonazepam) is used for:

• The treatment of panic disorder
• Certain types of seizures, specifically petit mal
  seizures, akinetic seizures, and myoclonus, as well as Lennox-Gastaut syndrome.
  Klonopin maybe used alone or together with other medications for these
  seizure
  disorders.
• The short-term relief of symptoms of anxiety.

Xanax (alprazolam) uses

Xanax (alprazolam) is used for the treatment of
anxiety disorders and panic attacks. Anxiety disorders are characterized by:

• Unrealistic worry and apprehension
• Symptoms of restlessness
• Aches
• Trembling

• Shortness of breath

• Smothering sensation

• Palpitations

• Sweating

• Cold clammy hands

• Lightheadedness

• Flushing
• Exaggerated startle responses
• Problems concentrating

• Insomnia

Panic attacks occur either unexpectedly or in certain situations (for example, driving), and can require higher dosages of
Xanax.

Panic attacks are repeated attacks of fear that can last for several minutes.
See Answer

What are the side effects of Klonopin (clonazepam) vs. Xanax (alprazolam)?

Klonopin (clonazepam) side effects

The most common side effects associated with Klonopin (clonazepam)
are sedation, which is reported in approximately half of patients. Dizziness is
reported in one-third of patients.

Other common side effects include:

• A feeling of
  depression
• Loss of orientation

• Headache

• Weakness

• Unsteadiness

• Sleep disturbance

• Lack of inhibition
• Fatigue
• Amnesia
• Confusion
• Changes in sexual desire
• Rash
• Irritability

Other serious side effects of Klonopin include:

• Respiratory depression
• Fainting
• Enlarged liver
• Withdrawal symptoms (if stopped suddenly)
• Increased heart rate
• Low blood pressure
• Blood disorders

Other serious adverse reactions:

• Antiepileptic medications have been associated with an increased risk of
  suicidal thinking and behavior. Anyone considering the use of antiepileptic
  drugs must balance this risk of
  suicide with the clinical need for the
  antiepileptic drug. Patients who begin antiepileptic therapy should be closely
  observed for clinical worsening,
  suicidal thoughts or unusual changes in
  behavior.

Xanax (alprazolam) side effects

The most common side effects of Xanax taken at lower doses are:

• Drowsiness

• Fatigue

Other side effects include:

• Fatigue

• Memory problems
• Speech problems

• Constipation

• Changes in weight

• Addiction (dependency)

What are the withdrawal symptoms of Klonopin (clonazepam) vs. Xanax (alprazolam)?

Klonopin (clonazepam) withdrawal symptoms

• Like all benzodiazepines,
  Klonopin can cause physical dependence.
• Suddenly
  stopping therapy after a few months of daily therapy may be associated with a
  feeling of loss of self-worth, agitation, and
  insomnia.
• If Klonopin is taken
  continuously for longer than a few months, stopping therapy suddenly may produce:
  • Seizures

  • Tremors

  • Muscle cramping

  • Vomiting

  • Sweating

• Therefore,
  discontinuation usually is accomplished by reducing the dose gradually.

Xanax (alprazolam) withdrawal symptoms

Addiction is more likely to occur at high doses given over prolonged periods of time. Abrupt discontinuation of
Xanax after prolonged use can lead to symptoms of withdrawal such as:

• Insomnia

• Headaches

• Nausea,

• Vomiting

• Lightheadedness
• Sweating
• Anxiety
• Fatigue

Seizures can occur in more severe cases of withdrawal. Consequently, patients on
Xanax for extended periods of time should slowly taper the medication under a doctor’s supervision rather than abruptly stopping the medication.

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How should Klonopin (clonazepam) vs. Xanax (alprazolam) be taken (dosage)?

Klonopin (clonazepam) dosage

The dose of Klonopin (clonazepam) is tailored to the patient's needs.

• For
  seizures in adults the initial dose is 1.5 mg daily in 3 divided doses.
• Dosage
  may be increased by 0.5 to 1 mg daily every 3 days until seizures are controlled
  or side effects preclude further increases in dose.
• The maximum dose is 20 mg
  daily. The initial dose for panic disorders is 0.25 mg twice daily.
• The dose may
  be increased to the target dose of 1 mg daily after 3 days.

Xanax (alprazolam) dosage

Xanax may be taken with or without food.

Which drugs interact with Klonopin (clonazepam) vs. Xanax (alprazolam)?

Klonopin (clonazepam) drug interactions

• Klonopin (clonazepam), like all other benzodiazepines, accentuates
  the effects of other drugs that slow the brain's processes, such as
  alcohol,
  barbiturates, and narcotics and leads to increased sedation.

Xanax (alprazolam) drug interactions

Xanax (alprazolam) interacts with

• Ketoconazole (Nizoral)
• itraconazole (Sporanox)
• nefazodone (Serzone)
• cimetidine (Tagamet)
• fluvoxamine (Luvox)

These increase concentrations in the blood of Xanax and therefore may increase the side effects of
Xanax.
Xanax interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.

Carbamazepine
(Tegretol, Tegretol XR, Equetro, Carbatrol) and rifampin reduce the effect of
Xanax by increasing metabolism and elimination of
Xanax in the liver.

Are Klonopin and Xanax safe to take during pregnancy or while
breastfeeding?

Klonopin (clonazepam) pregnancy and breastfeeding safety

• Klonopin (clonazepam) and other benzodiazepines have been associated with
  fetal damage, including
  congenital malformations, when taken by
  pregnant women
  in their
  first trimester.
  Klonopin is best avoided in the first trimester and
  probably throughout
  pregnancy.
• Benzodiazepines are secreted in
  breast milk. Mothers who are
  breastfeeding should not take
  Klonopin.

Xanax (alprazolam) pregnancy and breastfeeding safety

• Benzodiazepines, such as Xanax, can cause fetal abnormalities and should not be used in
  pregnancy.
• Xanax is excreted in
  breast milk and can affect nursing infants. Therefore, it should not be used by women who are nursing.