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- Take the Panic Attacks Quiz!
- Generalized Anxiety Disorder (GAD) Slideshow
- Klonopin (clonazepam) vs. Xanax (alprazolam) review
- What are Klonopin and Xanax?
- What generic names are available for Klonopin and Xanax?
- What are the uses for Klonopin (clonazepam) vs. Xanax (alprazolam)?
- What are the side effects of Klonopin (clonazepam) vs. Xanax (alprazolam)?
- What are the withdrawal symptoms of Klonopin (clonazepam) vs. Xanax (alprazolam)?
- How should Klonopin (clonazepam) vs. Xanax (alprazolam) be taken (dosage)?
- Which drugs interact with Klonopin (clonazepam) vs. Xanax (alprazolam)?
- Are Klonopin and Xanax safe to take during pregnancy or while breastfeeding?
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:
- 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
- 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:
- 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,
- 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
- Shortness of breath
- Smothering sensation
- Cold clammy hands
- Exaggerated startle responses
- Problems concentrating
Panic attacks occur either unexpectedly or in certain situations (for example, driving), and can require higher dosages of Xanax.
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
- Sleep disturbance
- Lack of inhibition
- Changes in sexual desire
Other serious side effects of Klonopin include:
- Respiratory depression
- 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:
Other side effects include:
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:
- Muscle cramping
- 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:
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.
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.
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.
Even though both of these drugs are benzodiazepines they are prescribed slightly differently. Klonopin and Xanax are both prescribed to treat anxiety disorders; however, Klonopin also is prescribed to treat certain types of seizures and Lennox-Gastaut syndrome. Side effects of both drugs are similar because they belong to the same drug class. Side effects of benzodiazepines include:
Both Klonopin and Xanax may cause physical dependence (addiction) so abrupt withdrawal is not recommended. Drug interaction and pregnancy and breastfeeding safety of these two drugs should be reviewed prior to taking the medication.
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
FDA Prescribing Information. "XANAX® alprazolam tablets, USP." Revised March 2011.
FDA Prescribing Information. "KLONOPIN® Tablets (clonazepam); KLONOPIN® WAFERS (clonazepam orally disintegrating tablets)." PI Revised: Apr 2009.
United States Drug Enforcement Administration. "Drug Schedules."
United States Drug Enforcement Administration. "Drug Fact Sheet. Benzodiazepines."