Klonopin (clonazepam) vs. Ambien (zolpidem)

  • 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.

Clonazepam vs. Ambien: What’s the difference?

What are clonazepam and Ambien?

Clonazepam is an anti-anxiety drug primarily used for treating panic disorder and preventing certain types of seizures, and for short-term relief of anxiety symptoms. Clonazepam belongs to the benzodiazepine class, which also includes diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), and flurazepam (Dalmane). Clonazepam and other benzodiazepines enhance the effects of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. Research shows excessive activity in the brain may lead to anxiety or other psychiatric disorders.

Ambien (zolpidem) is a sedative/hypnotic used to treat insomnia. Conventional tablets are used for short-term treatment of insomnia associated with difficulty falling asleep. Long-acting tablets are used for treating insomnia associated with difficulty falling asleep or staying asleep. Ambien improves initiation of sleep and keeps patients asleep longer.

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What are the side effects of clonazepam and Ambien?

Clonazepam

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.

Ambien

The most common side effects of zolpidem are:

  • Drowsiness
  • Headache
  • Weakness
  • Dizziness
  • A "drugged" feeling, which probably reflect the action of the drug

Other side effects include:

Zolpidem can cause withdrawal symptoms (muscle cramps, sweats, shaking, and seizures) when the drug is abruptly discontinued. Zolpidem can cause abnormal behavior with confusion, paradoxical insomnia or "complex sleep-related behaviors," which may include sleep-driving (driving with no memory of having done so). If these side effects occur, zolpidem should be discontinued.

What is the dosage of clonazepam vs. Ambien?

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.

Ambien

  • The recommended adult dose of zolpidem conventional tablets or spray is 5 mg for females, the elderly, or fragile individuals, and 5 to 10 mg for males.
  • The maximum dose is 10 mg daily.
  • For females and the elderly, give 6.25 mg of extended-release tablets; and males should receive 6.25 to 12.5 mg.
  • The maximum dose of extended-release tablets is 12.5 mg daily.
  • Elderly patients have decreased ability to eliminate zolpidem from the body, and accumulating zolpidem may cause side effects.

QUESTION

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What drugs interact with clonazepam and Ambien?

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.

Ambien

  • The recommended adult dose of zolpidem conventional tablets or spray is 5 mg for females, the elderly, or fragile individuals, and 5 to 10 mg for males.
  • The maximum dose is 10 mg daily.
  • For females and the elderly, give 6.25 mg of extended-release tablets; and males should receive 6.25 to 12.5 mg.
  • The maximum dose of extended-release tablets is 12.5 mg daily.
  • Elderly patients have decreased ability to eliminate zolpidem from the body, and accumulating zolpidem may cause side effects.

Are clonazepam and Ambien safe to use while pregnant or breastfeeding?

Clonazepam

Ambien

  • There are no adequate studies of zolpidem use in pregnant women.
  • Zolpidem is excreted in human breast milk and may adversely affect the infant.

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Summary

Klonopin (clonazepam) and Ambien (zolpidem) are used to treat insomnia. Clonazepam is primarily used for treating panic disorder and preventing certain types of seizures, Lennox-Gastaut syndrome, and for short-term relief of anxiety symptoms. Clonazepam and Ambien belong to different drug classes. Clonazepam is a benzodiazepine class anti-anxiety medication and Ambien is a sedative/hypnotic.

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Medically Reviewed on 4/26/2019
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