Baclofen vs. Clonazepam

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What's the Difference Between Baclofen vs. Clonazepam?

What Are Baclofen and Clonazepam?

Baclofen is a skeletal muscle relaxant. Baclofen is chemically related to gamma-aminobutyric acid (GABA), a naturally occurring neurotransmitter in the brain. Neurotransmitters are specialized chemicals used by nerves to communicate with each other. When GABA is released by some nerves, the activity of other nerves decrease. It is believed that baclofen may act like GABA by blocking the activity of nerves within the part of the brain that controls the relaxation and contraction of skeletal muscles.

Clonazepam is an anti-anxiety medication in the benzodiazepine class, the same drug class that includes diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), and flurazepam (Dalmane). Clonazepam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain 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.

What Are the Side Effects of Baclofen and Clonzepam?

Baclofen

Common side effects of baclofen are:

Abrupt discontinuation of oral baclofen may cause seizures and hallucinations. Abrupt discontinuation of intrathecal baclofen may result in:

  • high fever,
  • rebound spasticity,
  • muscle rigidity, and
  • rhabdomyolysis (muscle breakdown) that can progress to failure of several organs, including the kidney, and even death.

Clonzepam

The most common side effects associated with 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, and
  • Sleep disturbance
  • Lack of inhibition
  • Fatigue
  • Amnesia
  • Confusion
  • Changes in sexual desire
  • Rash
  • Irritability

Other serious side effects of clonazepam include:

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.

What Is the Dosage of Baclofen vs. Clonazepam?

Baclofen

The usual starting dose of oral baclofen for treating spasticity in adults is 5 mg given three times daily. Based on the response, the dose can be increased by 5 mg every three days to a maximum of 80 mg/day in divided doses.

Clonazepam

The dose of 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.

Are Baclofen and Clonazepam Safe to Use While Pregnant or Breastfeeding?

Baclofen

The use of baclofen by pregnant women has not been evaluated.

Baclofen can be detected in the breast milk of mothers taking oral baclofen. No information is available on the presence of baclofen in the breast milk of mothers receiving baclofen intrathecally.

Clonazepam

Clonazepam and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester. Clonazepam is best avoided in the first trimester and probably throughout pregnancy.

Benzodiazepines are secreted in breast milk. Mothers who are breastfeeding should not take clonazepam.

What Drugs Interact with Baclofen and Clonazepam?

Baclofen

Use of baclofen with other drugs that also depress the function of nerves may lead to additional reduction in brain function.

In addition to the risk of depressing brain function, the use of baclofen and tricyclic antidepressants (for example, amitriptyline [Elavil, Endep], doxepin [Sinequan, Adapin]) together may cause muscle weakness.

Use of baclofen and monoamine oxidase inhibitors (for example, phenelzine [Nardil], tranylcypromine or [Parnate]) can result in greater depression of brain function as well as low blood pressure.

Because baclofen can increase blood sugar, doses of antidiabetic drugs may need to be adjusted when baclofen is begun.

Clonazepam

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.

Are Baclofen and Clonazepam Safe to Use While Pregnant or Breastfeeding?

Baclofen

The use of baclofen by pregnant women has not been evaluated.

Baclofen can be detected in the breast milk of mothers taking oral baclofen. No information is available on the presence of baclofen in the breast milk of mothers receiving baclofen intrathecally.

Clonazepam

Clonazepam and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester. Clonazepam is best avoided in the first trimester and probably throughout pregnancy.

Benzodiazepines are secreted in breast milk. Mothers who are breastfeeding should not take clonazepam.

Summary

Baclofen (Lioresol, Gablofen) is a skeletal muscle relaxant. Clonazepam (Klonopin) is an anti-anxiety medication in the benzodiazepine class. Both drugs are similar chemically to gamma-aminobutyric acid (GABA), a naturally occurring neurotransmitter in the brain.

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Medically Reviewed on 2/14/2018
References
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