Clonazepam Vs. Xanax: Differences, Dosage, And Side Effects

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What is the difference between clonazepam and Xanax?

Medically reviewed by Alan Carter, Pharm.D. — Written by Bethany Cadman — Updated on December 22, 2023

Uses
Differences
Dosage comparison
Forms comparison
Side effects
Interactions
Off-label uses
Which is the best one to use?

Alprazolam (Xanax) and clonazepam (Klonopin) are both medications that affect a person’s central nervous system (CNS) by slowing it down. They are both benzodiazepines but work in different ways.

The most common use of Xanax is as an antianxiety medication. Pharmaceutical company Upjohn created this drug in 1969, and doctors now write more than 50 million prescriptions for Xanax each year.

Clonazepam can help treat seizure disorders, among other things. It is an anticonvulsant and antiepileptic medication. Doctors may also prescribe clonazepam for panic disorder.

Xanax and clonazepam both affect the CNS and have the potential for misuse, with some people becoming dependent on them.

What do people use them for?

Xanax is a useful medication for people who experience panic attacks. The drug helps relieve the symptoms and reduce the frequency of attacks.

Some doctors prescribe Xanax for depression, but there is limited evidence to suggest that it is effective unless the person also has anxiety.

Clonazepam is also a benzodiazepine. Doctors use it to treat seizure disorders in both adults and children. It can help address chemical imbalances in the brain and reduce the number of panic attacks.

Taking clonazepam increases a person’s levels of gamma-aminobutyric acid (GABA), which is a chemical that sends signals around the CNS.

A lack of GABA activity can cause people to become excitable and may lead to panic attacks or seizures. Having more GABA activity in the body helps reduce instances of panic attacks and seizures.

How do they differ?

At first glance, Xanax and clonazepam are very similar. Both medications are benzodiazepines, CNS depressants, and ways of treating anxiety or panic attacks.

Both are short acting drugs, but clonazepam stays in the body for longer than Xanax. The half-life of Xanax is 6–25 hours, while for clonazepam, it is 22–54 hours.

Clonazepam can also treat seizures, whereas Xanax does not. Both drugs have their different off-label uses, which the sections below will look at in more detail.

Dosage comparison

Dosages usually differ depending on the individual and the condition that a doctor is trying to treat.

Clonazepam dosage

For panic and anxiety, the dosage for adults is 0.25 milligrams (mg) twice per day.

A doctor can increase the dosage in increments of 0.125 mg to 0.25 mg every 3 days until the panic is under control. However, the maximum dosage does not usually exceed 4 mg per day.

For seizures, the dosage for adults is 0.5 mg three times per day. A doctor can increase the dosage in increments of 0.5 mg to 1 mg until the seizures are under control. The maximum dosage should not exceed 20 mg per day.

Xanax dosage

For anxiety disorders, the dosage for adults typically starts at 0.25 mg to 0.5 mg three times per day. A doctor may incrementally increase the dosage to maximize the effect. However, the maximum dosage does not usually exceed 4 mg per day.

For panic disorders, the required dose of Xanax may exceed 4 mg per day.

Controlled trials involving 1,700 people found that Xanax worked for panic disorder when participants received 1–10 mg per day.

Changing dosage

Whether prescribing clonazepam or Xanax, a doctor will usually start at the lowest possible dosage, regularly reassess the dosage, and consider reducing it, for example, if panic attacks stop.

If a doctor advises reducing the dosage, they must ensure that a person does this slowly. If a person stops taking either drug abruptly, it could result in withdrawal symptoms.

Both Xanax and clonazepam typically begin taking effect after a few hours or days of starting the medication.

A dose of Xanax will affect a person for a few hours. A dose of clonazepam can last around three times longer.

Benzodiazepine dependence

Long-term use of benzodiazepines can lead to dependence on these drugs. Dependence can begin after using the drugs for as little as 1 month.

As Xanax remains in the body for less time than clonazepam, it may carry a higher risk of overuse or misuse, which may lead to dependence.

It is critical that a person does not stop taking either drug suddenly. Doing so can lead to adverse effects, such as life threatening seizures, as well as withdrawal symptoms.

A doctor or pharmacist should carefully monitor how a person uses benzodiazepines to manage the risk of dependence.

Forms comparison

Clonazepam comes in the form of an oral tablet that a person swallows. There is also a version that dissolves in the mouth.

Xanax is available in immediate-release and extended-release oral tablets, as well as an oral solution.

Side effects

These drugs can have a number of adverse effects. The sections below will look at these in more detail.

Clonazepam

Some of the more common side effects of clonazepam include:

drowsiness
shaky movements and unsteady gait
dizziness
depression
fatigue
memory problems
constipation or diarrhea
nausea

If any of these side effects develop, a person should talk to their doctor.

Some rarer and more severe side effects of clonazepam include:

depressed mood or suicidal thoughts
seizures, especially if a person stops taking the drug suddenly
hallucinations
mood and behavioral changes
sweating
abnormal eye movements
anxiety
difficulty speaking
insomnia
excessive bleeding and bruising, from reduced platelets in the blood
menstrual problems
difficulty urinating

If any of these side effects develop, a person needs immediate medical attention.

Xanax

Some of the more common side effects of Xanax include:

drowsiness and fatigue
lightheadedness
headaches
nausea
dry mouth
irritability
becoming talkative
forgetfulness or difficulty concentrating
difficulty passing urine
constipation
joint pain
changes in appetite
changes in weight
sexual dysfunction

If any of these side effects develop, a person should make an appointment to see their doctor.

Some rarer and more severe side effects of Xanax include:

yellowing of the skin or eyes
difficulty speaking
poor coordination and balance
seizures
mood changes
hallucinations
confusion or memory problems
depression or suicidal thoughts
a severe rash

If any of these side effects develop, a person needs immediate medical attention.

As both Xanax and clonazepam may cause drowsiness and poor coordination, people taking these drugs should be cautious about driving and operating machinery.

With either drug, a severe allergic reaction is unlikely. However, if a person develops any symptoms of a reaction — such as a rash, difficulty breathing, itching, or swelling — they need emergency help.

Interactions

People taking Xanax or clonazepam should not mix them with alcohol or opioid medication. Doing so can cause dangerous side effects that could be fatal.

Other CNS depressants can also interact with Xanax or clonazepam and change the way they work. Such changes can also lead to severe side effects.

Some other CNS depressants include:

cannabis
antihistamines
sedatives and sleeping pills
tranquilizers
mood stabilizers
muscle relaxants
seizure medications
pain medications

Before starting to take a new medication, a person should tell their doctor or pharmacist about any other drugs that they are taking or planning to take.

Off-label uses

Off-label uses are uses that are not indicated on the Food and Drug Administration (FDA)-approved packaging but for which a doctor might still prescribe the drug.

Some off-label uses for Xanax include the following:

irritable bowel syndrome
essential tremor
ringing in the ears
depression
agoraphobia, or a fear of open spaces
premenstrual syndrome

Some off-label uses for clonazepam include the following:

burning mouth syndrome
essential tremor
depression
multiple sclerosis
periodic limb movement disorder
restless legs syndrome
ringing in the ears
Tourette’s syndrome
vertigo
West syndrome

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Which is the best one to use?

Although clonazepam and Xanax are similar types of drug, there are times when one might be better to use than the other.

Xanax is not a seizure medication. Therefore, a person trying to control and treat seizures may find clonazepam more useful.

People with anxiety disorders should make an appointment with their doctor to discuss the various treatment options and the pros and cons of each.

The doctor will ask about the person’s symptoms and medical history. They will consider any current medication the individual is taking before advising which prescription is most suitable.

Some people’s bodies react badly to particular medications, or the drug may be ineffective. If this is the case, a person should talk to their doctor, who can make an alternative recommendation.

Epilepsy
Mental Health
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Pharmacy / Pharmacist
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How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Alprazolam. (2020).https://www.nlm.nih.gov/medlineplus/druginfo/meds/a684001.html
Anxiety disorders. (2018).http://nimh.nih.gov/health/publications/anxiety-disorders/index.shtml?rf=53414
Brett, J., et al. (2015). Management of benzodiazepine misuse and dependence.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/
Clonazepam. (2017).https://www.ncbi.nlm.nih.gov/books/NBK548030/
FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. (2020).https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class
Klonopin tablets (clonazepam). (2013). https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/017533s053,020813s009lbl.pdf
Xanax: Alprazolam tablets, USP. (2016).https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf
Xanax overview. (n.d.).https://www.recallreport.org/dangerous-drugs-products/xanax/

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Medically reviewed by Alan Carter, Pharm.D. — Written by Bethany Cadman — Updated on December 22, 2023

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What do people use them for?

How do they differ?

Dosage comparison

Clonazepam dosage

Xanax dosage

Changing dosage

Benzodiazepine dependence

Forms comparison

Side effects

Clonazepam

Xanax

Interactions

Off-label uses

Which is the best one to use?

How we reviewed this article:

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