Benzodiazepines are a class of prescription medication frequently used to treat anxiety, insomnia, and seizures. They work by boosting the effects of GABA, a neurotransmitter in your brain.
Lorazepam (Ativan) and clonazepam (Klonopin) are two common benzodiazepines that doctors prescribe to treat anxiety disorders and seizures.
How are lorazepam and clonazepam similar? How are they different? This article explores the uses, dosages, and side effects of lorazepam vs. clonazepam so you can better understand these anxiety medications.
What are lorazepam and clonazepam?
Lorazepam (Ativan) and clonazepam (Klonopin) are both benzodiazepines, a class of medications often prescribed for anxiety.
Lorazepam (Ativan)
Lorazepam is a benzodiazepine approved to treat anxiety, insomnia, and some types of seizures. It’s available as an oral tablet and as an injectable solution.
Clonazepam (Klonopin)
Clonazepam is a benzodiazepine approved to treat panic disorder and seizures. It’s available as an oral tablet.
How they work
Both lorazepam and clonazepam enhance the effects of gamma-aminobutyric acid (GABA) in your brain. GABA is an inhibitory neurotransmitter, which means it works by decreasing neuronal excitability. By boosting GABA activity, these medications can reduce feelings of anxiety and promote relaxation.
Klonopin vs. Ativan: Key Differences
Although lorazepam and clonazepam are similar medications, there are a few key differences to note.
Half-Life and Duration of Action
Clonazepam stays in your system longer than lorazepam. Clonazepam has a half-life of 30 to 40 hours, while lorazepam’s half-life is around 20 hours. This means the effects of clonazepam will last longer than the effects of lorazepam.
Approved Uses
Clonazepam is approved to treat panic disorder and certain types of seizures. Lorazepam is approved to treat anxiety, insomnia, and some types of seizures.
Side Effects
While both medications can cause side effects, one study found that clonazepam may have fewer side effects than lorazepam. Drowsiness, for example, was reported less often in people taking clonazepam (7%) compared to those taking lorazepam (almost 16%).
Dosage and Administration
The correct dosage of either lorazepam or clonazepam depends on your individual needs and the condition being treated. Never take more or less than your doctor prescribes. Here are a few things to keep in mind about each drug:
Lorazepam Dosage
- Because lorazepam has a shorter half-life than clonazepam, it’s usually administered several times per day.
Clonazepam Dosage
- Clonazepam’s longer half-life means it’s typically taken once or twice a day.
Important Considerations
Benzodiazepines should always be taken exactly as prescribed by a doctor, and you should never change the dose without consulting your healthcare provider first. If you feel you need a higher dose, be sure to discuss this with your doctor.
Effects and Side Effects
Lorazepam and clonazepam can cause similar side effects, though the severity and likelihood of experiencing them can vary from person to person.
Common Side Effects (applies to both)
- Dizziness, drowsiness, and impaired coordination
- Fatigue, weakness, and lightheadedness
- Memory problems and confusion
Less Common Side Effects (applies to both)
- Depression
- Blurred vision
- Gastrointestinal disturbances
Serious Side Effects (seek immediate medical attention)
- Severe allergic reactions (rash, itching, swelling)
- Difficulty breathing
- Suicidal thoughts or behaviors
This isn’t an exhaustive list, so it’s important to discuss potential side effects with your doctor or pharmacist before starting either medication. Also, it’s important to let your doctor know right away if you experience any unusual or bothersome symptoms while taking lorazepam or clonazepam.
Withdrawal and Dependence
Like other benzodiazepines, both lorazepam and clonazepam can lead to dependence, both physical and psychological, especially if used for a long time. Because of this potential, the Drug Enforcement Administration (DEA) has classified both drugs as Schedule IV controlled substances, meaning they have a recognized potential for being misused.
If you suddenly stop taking either lorazepam or clonazepam, you may experience withdrawal symptoms, such as anxiety, insomnia, tremors, seizures, and even hallucinations.
For this reason, it’s important to always follow your doctor’s instructions about when and how to stop taking these medications. Usually, your doctor will have you gradually reduce your dose to minimize any withdrawal symptoms.
Warnings and precautions
If your doctor prescribes lorazepam or clonazepam, there are a few things you should know.
- Older adults are at a higher risk of side effects.
- You may need a lower dose if you have liver disease.
- These drugs can cause problems during pregnancy and breastfeeding.
- These drugs interact with many other drugs, especially opioids and other sedatives.
- You should never drink alcohol while taking a benzodiazepine.
Cost and coverage
Lorazepam and clonazepam are usually covered by insurance plans. Generic versions of both medications are available, which lowers the cost. You may also be able to save money with prescription discount programs like SingleCare.
Frequently Asked Questions
Is lorazepam stronger than clonazepam?
“Stronger” is tricky because it depends on what you mean. Lorazepam tends to have a faster onset of action, meaning you feel its effects sooner. Clonazepam, on the other hand, has a longer half-life, so its effects last longer. The potency can also vary depending on the individual and the specific dose.
Why is clonazepam sometimes preferred?
Clonazepam is often preferred for managing anxiety and panic disorders because of its longer duration of action. The extended half-life means you don’t need to take it as frequently, leading to more consistent relief and potentially fewer withdrawal symptoms if you stop taking it.
What is the safest benzo for anxiety?
There’s no single “safest” benzodiazepine. The best choice depends on individual factors like your medical history, other medications you’re taking, and the specific type of anxiety you’re experiencing. Shorter-acting benzos like lorazepam might be preferred for occasional use, while longer-acting ones like clonazepam could be better for chronic conditions. Always discuss the risks and benefits with your doctor.
Why do doctors sometimes not like lorazepam?
While effective, lorazepam’s shorter half-life can lead to more frequent dosing and a higher risk of dependence and withdrawal symptoms compared to longer-acting benzodiazepines. It’s also associated with a slightly higher potential for abuse. Doctors might prefer other options if a longer-term solution is needed or if there are concerns about addiction.
In Closing
The best choice between lorazepam and clonazepam hinges on your unique needs, medical background, and the condition requiring treatment. To determine the most appropriate medication for you, talk with your doctor or another qualified healthcare provider.
Whenever possible, short-term use is recommended to minimize the risk of dependence and other adverse effects.