Table of ContentsView AllTable of ContentsUnderstanding AnxietyWhat Is Klonopin?What Is Xanax?DosingBeers' CriteriaAlternative Treatment OptionsSide EffectsWhen to Avoid Klonopin or XanaxInteractionsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Understanding Anxiety
What Is Klonopin?
What Is Xanax?
Dosing
Beers' Criteria
Alternative Treatment Options
Side Effects
When to Avoid Klonopin or Xanax
Interactions
Frequently Asked Questions
When an individual presents with a diagnosable case of ananxiety disorder, a healthcare provider will often recommendtherapyor a prescription drug regime to help the distressed person feel more confident and comfortable in their day-to-day life.
Therefore, if a prescription medication route is chosen, some commonly prescribed medications for anxiety includeKlonopin (clonazepam)andXanax (alprazolam). Klonopin and Xanax are Food and Drug Administration (FDA)-approved medications that are classified asbenzodiazepines.
Benzodiazepinesare a class of medications that are used for anxiety,muscle spasms, and/orseizures, depending on the specific medication.
Nonetheless, while these drugs are deemed generally similar, safe, and practical, they carry some notable differences that potential users should be aware of.
This article will offer an in-depth comparison between Klonopin and Xanax, examining their specific uses, active ingredients, dosing guidelines, potential side effects, and more.
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Feelings of anxiety can cause mental symptoms like persistent fear and dread, in addition to physical symptoms such as sweating and a fast heartbeat.
Moreover, regarding their prevalence, anxiety disorders are the most common mental health condition among adults in the United States, affecting nearly 20% of adults annually.
There are various types of anxiety disorders, including:
Not all feelings of anxiety are necessarily linked to a disorder; however, if you feel that anxiety consistently affects your ability to maneuver throughout the day successfully, it may be wise to consult a healthcare provider,
Klonopin contains the active ingredient clonazepam. It is FDA-approved to:
Some healthcare providers prescribe medications off-label. This means prescribing a drug that is not FDA-approved for a particular use.
Sometimes, healthcare providers prescribe Klonopin off-label for conditions such as:
How Does Klonopin Work?
The exact way Klonopin works has yet to be understood entirely. However, it is thought to work on a receptor that binds a neurotransmitter (chemical messenger) typically in thecentral nervous system (CNS)calledgamma-aminobutyric acid (GABA), enhancing its activity.
Klonopin causes a slowing down of the CNS, which causes relaxation and sleepiness and can also help prevent seizures.
It is available in brand and generic forms as oral and orally disintegrating tablets (tablets that dissolve in a person’s mouth.
Xanax contains the active ingredient alprazolam. It is FDA-approved to:
Sometimes, healthcare providers prescribe Xanax off-label for conditions such as:
How Does Xanax Work?
Like Klonopin, Xanax is thought to work on a receptor that binds a neurotransmitter typically in the CNS called GABA.
Xanax is available in both brand and generic formulations:
Boxed Warning
The warning states:
Valium vs. Xanax: Which Is Better for Anxiety?
Dosing Comparison
With benzodiazepines, the healthcare provider will prescribe the lowest effective dose and monitor the individual closely.
When stopping a benzodiazepine, the dosage will be gradually tapered to lower the risk of withdrawal reactions.
Dosage is individualized, and the healthcare provider will determine the best dosage based on various factors. We will provide some general dosing guidelines here.
Klonopin
General dosing guidelines are as follows. However, some individuals may be prescribed one dose at bedtime rather than two daily doses.
For oral dosage forms (tablets or disintegrating tablets):
Seizures:
Panic disorder:
Xanax
The recommended starting dose for GAD is 0.25 or 0.5 mg thrice daily.
The healthcare provider may gradually increase the dosage to a maximum recommended total daily dose of 4 mg given in divided doses.
Anxiety:
For oral dosage forms (solution, tablets, or orally disintegrating tablets):
For oral dosage form (ER tablets):
The American Geriatrics Society publishes lists of medications that may be potentially dangerous in older adults. The list is called the Beers' Criteria for Potentially Inappropriate Medication (PIM) Use in Older Adults, and it helps healthcare providers make prescribing decisions.
The updated 2023 guidelines strongly recommend avoiding benzodiazepines in older adults (65 and older). This is because of the risks of these medications, such as abuse, misuse, addiction, severe sedation, impairment, falls, fractures, car crashes, breathing problems, coma, and death.
However, certain benzodiazepines may be appropriate in specific individuals if the healthcare provider weighs the risks and benefits and determines that the benefits outweigh the risks.
If you are 65 and older, talk to your healthcare provider about the benefits and risks before taking a benzodiazepine medicine.
In addition to medication (which may also include an antidepressant) for anxiety, you can try other things to help with anxiety symptoms.
Alternative options include:
Vistaril (Hydroxyzine) vs. Xanax (Alprazolam) for Anxiety
Side Effects & Safety
In addition to the boxed warnings described above, there are some side effects to be aware of when taking a benzodiazepine such as Klonopin or Xanax.
Common Side Effects
Common side effects of both medications include but are not limited to:
Severe Side Effects
Serious side effects and their symptoms can include, but are not limited to, the following:
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening, or you think you have a medical emergency.
Who Should Avoid Klonopin or Xanax?
You should not take Klonopin if you:
You should not take Xanax if you:
Interactions: Klonopin vs. Xanax
Tell your healthcare provider about all of the medicines you take, including:
While taking Klonopin or Xanax, do not start any new medications without approval from your healthcare provider.
Some interactions that apply to both Klonopin and Xanax include:
This is not a full list of drug interactions. Other drug interactions may occur with Klonopin or Xanax. Consult your healthcare provider for more information about drug interactions and how they may affect you.
Summary
Klonopin (clonazepam) and Xanax (alprazolam) are two FDA-approved medications for treating adult anxiety disorders.
Klonopin can also be used to prevent seizures in adults and children. Both drugs are benzodiazepines and controlled substances. Therefore, these benzodiazepines have the potential for abuse and dependence and, thus, are not always safe for everyone.
Consult your healthcare provider for more information about these medications.
Frequently Asked QuestionsStore Klonopin or Xanax at room temperature (between 68 and 77 degrees F), away from direct light, heat, and moisture. Do not store it in the bathroom.Because these medications have a high risk of misuse (which can cause addiction, overdose, and death), store your medicine where no one can get to it and keep track of your pills so you know if any are missing.You can talk to your healthcare provider and ask for a referral to a mental health professional. If you are in immediate danger, you should call 911.If you are in suicidal crisis or emotional distress, call or text 988 for the Suicide & Crisis Lifeline. You can also find other resources at theNational Institute of Mental HealthorAnxiety & Depression Association of America.
Store Klonopin or Xanax at room temperature (between 68 and 77 degrees F), away from direct light, heat, and moisture. Do not store it in the bathroom.Because these medications have a high risk of misuse (which can cause addiction, overdose, and death), store your medicine where no one can get to it and keep track of your pills so you know if any are missing.
Store Klonopin or Xanax at room temperature (between 68 and 77 degrees F), away from direct light, heat, and moisture. Do not store it in the bathroom.
Because these medications have a high risk of misuse (which can cause addiction, overdose, and death), store your medicine where no one can get to it and keep track of your pills so you know if any are missing.
You can talk to your healthcare provider and ask for a referral to a mental health professional. If you are in immediate danger, you should call 911.If you are in suicidal crisis or emotional distress, call or text 988 for the Suicide & Crisis Lifeline. You can also find other resources at theNational Institute of Mental HealthorAnxiety & Depression Association of America.
You can talk to your healthcare provider and ask for a referral to a mental health professional. If you are in immediate danger, you should call 911.
If you are in suicidal crisis or emotional distress, call or text 988 for the Suicide & Crisis Lifeline. You can also find other resources at theNational Institute of Mental HealthorAnxiety & Depression Association of America.
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22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Anxiety.DailyMed.Label: Klonopin- clonazepam tablet.DailyMed.Label: Xanax- alprazolam tablet.United States Drug Enforcement Administration (DEA).Benzodiazepines.Anxiety & Depression Association of America.Anxiety disorders - facts & statistics.UpToDate.Generalized anxiety disorder in adults: management.Trenkwalder C, Hening WA, Montagna P, et al.Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice.Mov Disord. 2008;23(16):2267-2302. doi:10.1002/mds.22254Khouzam HR.Identification and management of tardive dyskinesia: a case series and literature review.Postgrad Med. 2015;127(7):726-737. doi:10.1080/00325481.2015.1074031Huynh NT, Rompré PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ.Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size.Int J Prosthodont. 2006;19(5):435-441.Minkel J, Krystal AD.Optimizing the pharmacologic treatment of insomnia: current status and future horizons.Sleep Med Clin. 2013;8(3):333-350. doi:10.1016/j.jsmc.2013.06.002United States Drug Enforcement Administration (DEA).Drug scheduling.MedlinePlus.Clonazepam.DailyMed.Label: clonazepam tablet.American Academy of Child & Adolescent Psychiatry.Psychiatric medication for children and adolescents: part II - types of medication.UpToDate.Pharmacotherapy for insomnia in adults.DailyMed.Label: Xanax XR- alprazolam tablet, extended release.DailyMed.Label: alprazolam tablet, orally disintegrating.DailyMed.Label: alprazolam solution, concentrate.MedlinePlus.Alprazolam.By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel.American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults.J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372Centers for Disease Control and Prevention (CDC).How much physical activity do adults need?Anxiety & Depression Association of America.Tips and strategies to manage anxiety and stress.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Anxiety.DailyMed.Label: Klonopin- clonazepam tablet.DailyMed.Label: Xanax- alprazolam tablet.United States Drug Enforcement Administration (DEA).Benzodiazepines.Anxiety & Depression Association of America.Anxiety disorders - facts & statistics.UpToDate.Generalized anxiety disorder in adults: management.Trenkwalder C, Hening WA, Montagna P, et al.Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice.Mov Disord. 2008;23(16):2267-2302. doi:10.1002/mds.22254Khouzam HR.Identification and management of tardive dyskinesia: a case series and literature review.Postgrad Med. 2015;127(7):726-737. doi:10.1080/00325481.2015.1074031Huynh NT, Rompré PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ.Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size.Int J Prosthodont. 2006;19(5):435-441.Minkel J, Krystal AD.Optimizing the pharmacologic treatment of insomnia: current status and future horizons.Sleep Med Clin. 2013;8(3):333-350. doi:10.1016/j.jsmc.2013.06.002United States Drug Enforcement Administration (DEA).Drug scheduling.MedlinePlus.Clonazepam.DailyMed.Label: clonazepam tablet.American Academy of Child & Adolescent Psychiatry.Psychiatric medication for children and adolescents: part II - types of medication.UpToDate.Pharmacotherapy for insomnia in adults.DailyMed.Label: Xanax XR- alprazolam tablet, extended release.DailyMed.Label: alprazolam tablet, orally disintegrating.DailyMed.Label: alprazolam solution, concentrate.MedlinePlus.Alprazolam.By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel.American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults.J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372Centers for Disease Control and Prevention (CDC).How much physical activity do adults need?Anxiety & Depression Association of America.Tips and strategies to manage anxiety and stress.
MedlinePlus.Anxiety.
DailyMed.Label: Klonopin- clonazepam tablet.
DailyMed.Label: Xanax- alprazolam tablet.
United States Drug Enforcement Administration (DEA).Benzodiazepines.
Anxiety & Depression Association of America.Anxiety disorders - facts & statistics.
UpToDate.Generalized anxiety disorder in adults: management.
Trenkwalder C, Hening WA, Montagna P, et al.Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice.Mov Disord. 2008;23(16):2267-2302. doi:10.1002/mds.22254
Khouzam HR.Identification and management of tardive dyskinesia: a case series and literature review.Postgrad Med. 2015;127(7):726-737. doi:10.1080/00325481.2015.1074031
Huynh NT, Rompré PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ.Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size.Int J Prosthodont. 2006;19(5):435-441.
Minkel J, Krystal AD.Optimizing the pharmacologic treatment of insomnia: current status and future horizons.Sleep Med Clin. 2013;8(3):333-350. doi:10.1016/j.jsmc.2013.06.002
United States Drug Enforcement Administration (DEA).Drug scheduling.
MedlinePlus.Clonazepam.
DailyMed.Label: clonazepam tablet.
American Academy of Child & Adolescent Psychiatry.Psychiatric medication for children and adolescents: part II - types of medication.
UpToDate.Pharmacotherapy for insomnia in adults.
DailyMed.Label: Xanax XR- alprazolam tablet, extended release.
DailyMed.Label: alprazolam tablet, orally disintegrating.
DailyMed.Label: alprazolam solution, concentrate.
MedlinePlus.Alprazolam.
By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel.American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults.J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372
Centers for Disease Control and Prevention (CDC).How much physical activity do adults need?
Anxiety & Depression Association of America.Tips and strategies to manage anxiety and stress.
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