Benzodiazepine drugs like alprazolam and clonazepam have shown significant benefits when treating conditions like anxiety. However, despite their ability to manage these conditions, they’re extremely potent, meaning they’re prone to abuse. While most of those who take these won’t experience adverse effects or misuse the medications, others will. Since benzodiazepines are extremely dangerous during withdrawal, people are urged to seek treatment to ensure safety during detox.
While clonazepam and alprazolam are classified as benzodiazepines and fall under the same class of drugs known as central nervous system (CNS) depressants, they both possess unique characteristics, which we’ll discuss below.
Benzodiazepine Misuse Statistics
Alprazolam, more commonly referred to by its brand name, Xanax, is an extremely popular anti-anxiety medication. It was created by Upjohn but is now owned and manufactured by Pfizer and surpassed Valium as the most popular drug to treat anxiety disorders. Every year, doctors write more than 50 million prescriptions for the medication, and it is consistently the most prescribed drug in any class. With that number of prescriptions each year, it’s inevitable that some will be diverted for misuse by those without a prescription or by those who lie to doctors about their symptoms.
Clonazepam, more commonly referred to by its brand name Klonopin, is another benzodiazepine dispensed liberally to manage panic disorders and seizures. Clonazepam was patented in 1964 by the Hoffman La Roche company during a period when benzodiazepines were taking over barbiturates. It was available to the public for the first time in 1975 and marketed as a drug that treated epileptic seizures. Although it’s not as sought out as Xanax, doctors wrote 14,758,212 prescriptions for the drug to a total of 2,498,126 patients. It’s an astonishing figure despite it being more than 35 million less than Xanax.
According to one study, 30.6 million adults, equating to 12.6 percent, admitted to past-year benzodiazepine use. The figures state that 25.3 million, or 10.4 percent used the drugs as prescribed. However, 5.3 million, or 2.2 percent, reported misusing benzodiazepines like clonazepam and alprazolam. Misuse accounted for a staggering 17.2 percent of overall benzodiazepine use. Adults between the ages of 50 and 64 had the highest rate of taking benzos as prescribed, while 18 through 25 had the highest rate of misuse. Benzodiazepine abuse was strongly associated with misuse, abuse, or dependence on opioids.
These drugs are commonly prescribed, but what’s the difference in potency, addictiveness, and how addiction is treated between clonazepam and alprazolam? We’ll discuss that below.
What Is Clonazepam?
Clonazepam, also known as Klonopin, is a benzodiazepine drug primarily used to prevent and control seizures. It’s also known as an anticonvulsant or antiepileptic drug, differentiating it from Xanax. While it’s also used to treat panic attacks, it’s more often used for the treatment of seizures. The medication works by calming your nerves and brain. These medications help those unable to produce enough gamma-Aminobutyric acid (GABA) to control these issues naturally. An overactive nervous system can lead to the problems mentioned above.
Despite its ability to prevent seizures and relieve anxiety attacks, many people use these drugs for reasons not mentioned. Clonazepam produces side effects like euphoria that cause individuals to misuse the medication. After a few weeks, a small dose won’t cut it, and users increase their amount to achieve the same euphoria they encountered when they began using it. Unfortunately, this puts them on the fast track to addiction.
What Is Alprazolam?
Unlike clonazepam, Xanax is not an anticonvulsant, and it’s primarily used to treat anxiety and panic disorders. Alprazolam has an incredibly short half-life, which is the amount of time it takes for the amount of a drug’s active substance in your system to be reduced by half. For that reason, it’s the ideal choice for a panic attack since they come on quickly and disappear shortly after they occur. Although the half-life differs between the two, they both produce similar side effects, such as euphoria, drowsiness, and dizziness. When used as prescribed, these effects are minimal. However, when abused, these are amplified and can be dangerous. A Xanax overdose can be fatal.
Primary Differences Between Clonazepam and Alprazolam
Both clonazepam and alprazolam are extremely addictive. Due to the short half-life of Xanax and how quickly it hits the user, many people seek it out over clonazepam. However, clonazepam is considered more addictive because it produces greater sensations of euphoria. At a glance, the two are incredibly similar – they’re both CNS depressants, and both have the capability of treating panic attacks and anxiety.
Despite its longer half-life, clonazepam is considered a short-acting drug, although it remains in your body for much longer and affects you differently than alprazolam. The half-life of clonazepam is 22 to 54 hours, whereas alprazolam is six to 25 hours, depending on several factors, such as metabolism, weight, and drug use history. As was mentioned above, clonazepam is used to treat seizures, while Xanax is not.
Below, we’ll look at the differences between doses.
When clonazepam is prescribed for anxiety and panic, the standard dose in adults is 0.25 milligrams twice a day. However, this is dependent on many factors. Doctors could prescribe more or less. Medical experts typically increase the dosage in 0.125-milligram increments or 0.25 milligrams every three days until your panic is controlled. The maximum dosage should never exceed four milligrams per day.
When the drug is prescribed for seizure disorders, the typical adult dose is 0.5 milligrams three times per day. Doctors will increase the dosage in 0.5 milligrams to 1-milligram increments until your seizures are under control. Doctors will not prescribe more than 20 milligrams in a day. In extreme cases, doctors will consider barbiturates if you’re not responding to benzodiazepines.
The standard dosage of alprazolam for adults is 0.25 milligrams to 0.5 milligrams three times daily. Doctors will adjust the dose as they see fit, but it should never exceed four milligrams per day. For panic disorders, patients might need up to four milligrams a day. Alprazolam is absorbed quicker than clonazepam, and peak concentrations occur within one to two hours after it’s been taken. However, there’s no proof that one is stronger than the other.
How Is Benzodiazepine Addiction Treated?
Now that we’ve established that alprazolam is more likely to lead to dependence than clonazepam because it remains in your system for a shorter period and they’re equally as potent, how is benzodiazepine addiction treated? The first thing to note is you must never abruptly stop taking either drug – doing so can be extremely dangerous or even fatal. Benzodiazepine withdrawal can lead to life-threatening seizures, as well as other severe symptoms. The only way to manage withdrawal and dependence is by seeking addiction treatment.
To reiterate what was said above, never stop taking clonazepam or alprazolam without notifying your doctor. Depending on how much you were taking, they could either taper your dose until it’s safe to stop or send you to medical detox. If they opt for the latter based on your situation, you will head to an on-site facility for up to seven days or more. Medical experts will watch over you 24 hours per day to ensure you’re safe and will provide medication to keep you comfortable. The primary objective of detox is to remove all traces of clonazepam or alprazolam from your system and avoid severe withdrawal symptoms. While the process will be uncomfortable despite their assistance, it’ll be much better than attempting to do so yourself.
Once you’ve safely removed the drug(s) from your system, doctors will recommend you enter the next stage of treatment. Detox is vital for your safety, but it does not treat the underlying reasons why you began abusing clonazepam or alprazolam in the first place. It’ll be in your best interest to follow their advice.
You will undergo therapy, learn more about addiction and help you get to the root of your problems. They will also help you find alternative methods for treating panic disorders or anxiety that don’t require potent drugs. Addiction treatment might be on-site or on an outpatient basis – this is determined by the severity of your benzodiazepine addiction and if you’ve been through treatment before.
While these drugs are similar on the surface, there are differences, as we’ve described above. If you become dependent on either one, it’s important that you seek help right away.