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What Is the Difference between Clonazepam and Alprazolam?

By Lee Johnson
Updated: May 17, 2024
Views: 19,271
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The differences between clonazepam and alprazolam are fairly minor, because the drugs are both in the benzodiazepine family and have similar actions. Both treatments are used for anxiety disorders, but clonazepam is often prescribed for seizures as well. The dosages of these medications are also different in some cases. For example, if a patient is taking alprazolam for panic disorders, he or she would require 0.5 milligrams (mg) three times per day, but if the same patient is taking clonazepam he or she would only be given 0.25 mg twice a day.

Clonazepam and alprazolam can be most easily differentiated by the conditions they are typically used to treat. While both treatments are suitable for use in patients with anxiety disorders, clonazepam can also be used to treat patients suffering from seizure disorders. The drug can be used to treat petit mal seizures, akinetic seizures, and myoclonus. Conversely, alprazolam is only used to treat anxiety disorders and panic attacks. This difference in the effects of clonazepam and alprazolam can be explained by the difference in their chemical structures and content.

Dosages of these medications can differ, even when used to treat the same conditions. Panic attacks are one condition that both treatments can be used for, and this condition demonstrates the difference in the dosages of the drug. A patient taking alprazolam for panic attacks requires 0.5 mg dosages three times per day. Clonazepam dosages are generally lower and need to be administered less often. While both can be increased as needed, the starting clonazepam dosage is only 0.25 mg twice per day, overall amounting to a difference of 1 mg per day.

Similarities between clonazepam and alprazolam are more evident than their differences, because the drugs fall into the same general class. Benzodiazepine drugs accentuate the effects of gamma-aminobutyric acid (GABA), which is a neurotransmitter found within the brain. Neurotransmitters can basically be thought of as chemical messengers, and doctors believe them to be directly related to anxiety and mood disorders. GABA is a neurotransmitter which works to slow down the brain’s activity. In patients with panic or anxiety disorders, excessive brain activity can be a catalyst for attacks.

This effect of both clonazepam and alprazolam to decrease overall brain activity can lead to several side effects. For example, both treatments can cause general sedation, even at low doses, and alprazolam at higher doses can also cause speech and memory problems and overall fatigue. Both treatments can also cause withdrawal symptoms if taken for a long period of time and then discontinued.

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Discussion Comments
By anon944780 — On Apr 09, 2014

@candyquilt: Reduce your dose and then you will start being able to focus more and more every day. Rivotril 2mg works wonders. It makes me sleep eight hours straight. I cut it to 1mg and still I can sleep seven hours, which is cool and I'm able to focus at work even though I feel chilled and tired.

By candyquilt — On Jun 14, 2013

@literally45-- You're right about the half-life but I can't function when I'm on clonazepam. It makes me so tired and sleepy. I feel relaxed, but I can't concentrate on anything. At least with alprazolam, I can get things done.

By literally45 — On Jun 14, 2013

@burcinc-- Unfortunately dependence, addiction and withdrawal side effects are very common with benzodiazepine medications in general.

But if I were to choose one over the other, I would definitely choose clonazepam. Clonazepam has a much longer half-life than alprazolam, almost twice as much. It takes longer for clonazepam to take effect, but it also leaves the body more slowly. So you are less likely to have issues when you miss your dose or when you're intentionally withdrawing.

If your doctor is considering these drugs for you, then definitely mention your issues with withdrawal. I think he will prescribe clonazepam.

By burcinc — On Jun 13, 2013

Benzodiazepine group medications work great for anxiety but I always have mood swings when I'm on them. If I miss even one dose, I feel terrible and get all kinds of different side effects.

I'm guessing that clonazepam and alprazolam are the same in this sense?

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