Prescription

Klonopin vs Xanax: Which medication may be better for me?

by

Ros Lederman

Medically reviewed by

Lloyd Sederer, MD

April 18, 2022

Many people are familiar with medications used to treat conditions like anxiety—such as selective serotonin reuptake inhibitors (SSRIs). These take time to work and often are prescribed for many months. But some people seek and can benefit from a faster-acting solution for anxiety or sleep difficulties. 

Klonopin and Xanax, which are not SSRIs, are options to consider when discussing your treatment with your prescribing doctor, nurse practitioner, or Minded psychiatry provider.

Read on to learn more about Klonopin and Xanax, including:

  • Klonopin uses vs Xanax uses
  • Klonopin vs Xanax dosage information
  • Klonopin side effects vs Xanax side effects
  • How long it takes for Klonopin vs Xanax to work
  • Klonopin vs Xanax for anxiety
  • Klonopin vs Xanax for panic disorder
  • Klonopin vs Xanax for social anxiety
  • Klonopin vs Xanax for depression
  • Klonopin vs Xanax for sleep

Minded Medication Guides, such as this and others, including those for Hydroxyzine vs Xanax and Ativan vs Xanax, are intended as educational aids only. They are not intended as medical advice for individual conditions or treatment. They are not a substitute for a medical exam, nor do they replace the need for services provided by medical professionals. Talk to your doctor, nurse, or pharmacist before taking any prescription medication or following any treatment regimen.

Klonopin vs Xanax: an overview

Both Klonopin and Xanax are benzodiazepines. Benzodiazepines are a class of medication used to treat common mental health problems like anxiety, insomnia, and panic disorder (as well as seizures). Benzodiazepine medications are thought to work largely in the same way; they differ, however, in how quickly one, rather than another, begins to work—as well as the duration of the effects after taking a dose.

Benzodiazepines slow down selected areas of your brain’s activity by attaching on to gamma-aminobutyric (GABA) neuroreceptors in your brain. GABA is a type of neurotransmitter (small molecules in your brain) that relays messages from one nerve to another. By slowing down your brain’s activity at GABA receptors, benzodiazepines can help you feel calm and/or drowsy. 

When considering Klonopin vs Xanax—or even Xanax vs Klonopin vs Ativan (another common benzodiazepine)—keep in mind that benzodiazepines are typically prescribed for short-term use (usually several weeks, sometimes months). You may also have heard that taking benzodiazepines comes with a risk of developing a physical or psychological dependence on or addiction to them. The Drug Enforcement Administration (DEA) has classified benzodiazepines as controlled substances, because of the greater risk of abuse or dependence in people who have a past history of a substance use disorder, as well as not taking them as prescribed. 

Note: Minded does prescribe controlled medications with limitations related to government regulations and Minded protocols. This includes requiring proof of a prior prescription in state monitoring systems that we have access to. We do not prescribe controlled medications in every state where we operate. We only prescribe schedule II medications (things like Ritalin®, Adderall®, and medications with methlyphenidate or amphetamine in their name) in some states. Please ask our team if you have questions about what we prescribe in your location.

We also limit controlled medication doses and do not combine with opioids or when taking multiple controlled medications. Additionally, our providers always use their clinical judgement in deciding the appropriateness of any medication prescribed. Read more about Minded's responsible approach to prescribing controlled medications online.

Klonopin vs Xanax: a closer look at Klonopin

Klonopin is the brand name of the generic drug clonazepam. It is used to treat panic disorder with or without agoraphobia (an anxiety disorder where a person fears and avoids places or situations that could cause them to panic).

Like many other medications, Klonopin is sometimes prescribed for “off-label” use. This means taking a medication for a condition that it has not been specifically approved by the FDA to treat. It is a common and acceptable medical practice. Benzodiazepines (such as Klonopin) are used “off-label” to treat sleep problems. 

Klonopin dosages

Klonopin is available in both regular tablets and orally disintegrating tablets (wafers):

Klonopin tablet

  • 0.5 mg
  • 1 mg
  • 2 mg

Klonopin orally disintegrating tablet

  • 0.125 mg
  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg

When prescribed for panic disorder, a typical starting dose of Klonopin is 0.25 mg, taken twice per day. If this dose is not sufficient to ease your symptoms, your doctor or prescribing nurse may increase your dose every few days, up to the maximum recommended daily dose of 4 mg per day.

Klonopin is taken daily (at regularly scheduled times) or on an “as-needed” basis. Your prescribing doctor, nurse practitioner, or Minded psychiatry provider will provide you with instructions on how often and when to take this medication, as well as the maximum amount that can be taken in a day. 

While you can take Klonopin with or without food, if you find that taking it without food upsets your stomach, you may want to try taking it with food.

Oral disintegrating Klonopin tablets should be kept in their original packaging—not removed and put in a pillbox. Once opened, they should be taken immediately rather than stored to be taken later. Unlike regular tablets, oral disintegrating tablets dissolve in your mouth in seconds and do not need to be taken with a liquid.

Whether you are taking the regular tablet or the oral disintegrating tablet, if you miss a dose of Klonopin, you can either: take the missed dose as soon as you remember to, or—if it is closer to when you would take your next dose, just go ahead and take the next dose. 

How long does it take for Klonopin to work?

In general, Klonopin is relatively fast-acting compared with other types of medications for anxiety or depression (such as selective serotonin reuptake inhibitors, or SSRIs). Klonopin reaches peak concentrations between 1 and 4 hours after taking it. When taking Klonopin for sleep or anxiety or insomnia, you may start to notice your symptoms begin to improve within hours or days of first taking it. 

Klonopin side effects

common side effects of klonopin

Common side effects of Klonopin include:

  • Depression
  • Difficulty with walking and coordination
  • Dizziness
  • Drowsiness
  • Fatigue
  • Memory problems

Side effects like these usually decrease over the first few weeks of taking Klonopin.

Let your prescribing doctor, nurse practitioner, or Minded psychiatry provider know if you experience these or any other side effects.

Rare or serious side effects of Klonopin include:

  • Difficulty speaking
  • Extreme tiredness or dizziness
  • Feelings of depression or decreased interest in day-to-day life
  • Headaches
  • Impaired memory
  • Increased heart rate
  • Irritability
  • Passing out (fainting)
  • Restlessness
  • Severe allergic reaction and facial swelling, which can occur even with the first dose
  • Shortness of breath
  • Thoughts of self-harm or suicide

In some cases, people who take benzodiazepines to help with sleep problems may engage in activities—such as eating, driving, or making phone calls—while they are asleep or not fully awake. There is no memory of having done these activities once a person awakens.

It is important to seek immediate medical attention if you experience these or any other serious side effects of Klonopin.

Warnings

Klonopin has an FDA “Black Box” warning. This means that the FDA has identified certain serious safety risks that could occur from taking this medication. While these are serious safety warnings, their actual risk may be low.

The Black Box warning for Klonopin (clonazepam) states that:

  • Taking benzodiazepines (such as Klonopin) along with opioids can lead to serious—and potentially fatal—interactions
  • Benzodiazepine use comes with a risk of abuse, misuse, and/or addiction
  • Continued use of benzodiazepines may lead to physical dependence on these medications and/or withdrawal if the medication is discontinued abruptly 

Always let your prescribing doctor, nurse practitioner, or Minded psychiatry provider know about any and all other medications and supplements you are taking to see if Klonopin may have any negative interactions with them.

Klonopin and pregnancy

Discuss your treatment plan with your prescribing doctor or nurse practitioner if you are pregnant or planning to become pregnant. Taking Klonopin during pregnancy may harm your baby. Klonopin can also pass to your baby through your breast milk.

Klonopin and alcohol

As with many medications for depression, anxiety, and insomnia, you should not drink alcohol while taking Klonopin. Alcohol can increase the negative side effects of medications like Klonopin—such as sedation—and decrease their benefits as well. Because alcohol can impair judgment and memory, drinking may also increase your risk of unintentionally overdosing on Klonopin by taking a higher dose than what is prescribed.

Symptoms of a Klonopin overdose include:

  • Confusion
  • Coma
  • Decreased coordination
  • Slowed reflexes
  • Death

A Klonopin overdose can be fatal. Seek medical attention right away if you are experiencing symptoms of an overdose.

Klonopin withdrawal symptoms

Klonopin can cause withdrawal symptoms if you suddenly stop taking it. If you need to go off of Klonopin, discuss how to do so safely with your doctor or prescribing nurse. Together, you can develop a plan to carefully taper down your dose to avoid withdrawal symptoms.

Symptoms of withdrawal from Klonopin include:

  • Changes in blood pressure
  • Dizziness
  • Irritability
  • Nausea
  • Rapid heart rate
  • Seizures
  • Tremors

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Klonopin vs Xanax: A closer look at Xanax

Xanax is the brand name of the generic medication alprazolam. It is used to treat panic disorder (with or without agoraphobia) as well as generalized anxiety disorder (GAD). 

Like Klonopin (and other benzodiazepines), Xanax is sometimes also prescribed “off-label” to treat sleep problems.

Xanx dosages

Xanax is available in multiple forms and doses:

Xanax tablet

  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg

Xanax XR (extended release) tablet

  • 0.5 mg
  • 1 mg
  • 2 mg
  • 3 mg

The dose of Xanax that you take will depend on the condition you are taking it to treat. 

For generalized anxiety disorder, a typical starting dose of Xanax is 0.25 to 0.5 mg taken 3 times a day. If this dose is not enough to provide symptom relief, your prescribing doctor, nurse practitioner, or Minded psychiatry provider may increase the dose every few days up to the maximum recommended daily dose of 4 mg (taken in divided doses).

For panic disorder, a typical starting dose of Xanax is 0.5 mg, also taken 3 times per day. This dose may be gradually increased by your prescribing doctor or nurse up to the maximum recommended dose of 10 mg daily, 3 times per day.

Because elderly people may be more prone to experience side effects of Xanax, a lower starting dose of 0.25 mg (taken 2 or 3 times a day) is recommended.

Like Klonopin, Xanax may be taken at regularly scheduled times each day or on an “as-needed” basis. Your prescribing doctor,  nurse practitioner, or Minded psychiatry provider will instruct you on when and how often to take this medication—as well as the maximum amount that can be taken in a day. 

You can take Xanax with or without food—though if you get an upset stomach from taking it without food, you may want to take it with food.    

If you miss a dose of Xanax, you will want to:

  • Take the missed dose as soon as you remember

Or, if it is closer to when you would take your next dose:

  • Take the next dose

How long does it take for Xanax to work?

Xanax is also is relatively fast-acting compared to other types of medications (like SSRIs). Peak blood levels of Xanax usually are reached within 1 or 2 hours of taking the medication. And anxiety or insomnia symptoms may begin to noticeably improve within hours or days of first taking Xanax. 

Xanax side effects

common side effects of xanax

Common side effects of Xanax include:

  • Difficulty saying words (dysarthria)
  • Low blood pressure (hypotension)
  • Reduced sex drive
  • Trouble with coordination

Side effects such as these tend to decrease over the first couple of weeks of taking Xanax. 

Let your prescribing doctor, nurse practitioner, or Minded psychiatry provider know if you experience these or any other side effects.

Rare or serious side effects of Xanax include:

  • Difficulty speaking
  • Extreme tiredness or dizziness
  • Feelings of depression or decreased interest in day-to-day life
  • Headaches
  • Impaired memory
  • Increased heart rate
  • Irritability
  • Passing out (fainting)
  • Restlessness
  • Severe allergic reaction and facial swelling, which can occur even on the first dose
  • Shortness of breath
  • Thoughts of self-harm or suicide

Sometimes people who are taking benzodiazepines (such as Xanax) to help them sleep engage in activities (such as eating, making phone calls, or driving) while they are either asleep or not fully awake. They do not remember having done these activities once awake.

Seek medical attention immediately if you experience these or any other serious side effects while taking Xanax.

Warnings

Like Klonopin and other benzodiazepines, Xanax comes with an FDA “Black Box” warning. 

The Black Box warning for Xanax states:

  • Taking benzodiazepines (such as Xanax) along with opioids can lead to serious—and potentially fatal—interactions
  • Benzodiazepine use comes with a risk of abuse, misuse, and/or addiction
  • Continued use of benzodiazepines may lead to physical dependence on these medications and/or withdrawal if the medication is discontinued abruptly 

Let your healthcare professional know about any and all other medications and supplements you are taking to determine if Xanax may have any troublesome interactions with them.

Xanax and pregnancy

If you are planning on becoming pregnant and/or breastfeeding, discuss your treatment plan with your prescribing doctor, nurse practitioner, or Minded psychiatry provider. As with Klonopin, taking Xanax during pregnancy may harm your baby. Xanax can also be passed to your baby through your breast milk.

Xanax and alcohol

You also should not drink alcohol while you are taking Xanax. Not only can alcohol decrease the benefits of medications like Xanax, but it also can increase side effects, such as sedation. And because alcohol can impair both memory and judgment, it may increase your risk of unintentionally overdosing on Xanax by taking a higher dose of the medication than what was prescribed.

Symptoms of a Xanax overdose include:

  • Confusion
  • Coma
  • Decreased coordination
  • Slowed reflexes
  • Death

A Xanax overdose can be fatal. Seek medical attention right away if you are experiencing symptoms of an overdose.

Xanax withdrawal symptoms

As with Klonopin, suddenly stopping taking Xanax can cause withdrawal symptoms. If you need to go off of Xanax, your prescribing doctor, nurse practitioner, or Minded psychiatry provider can work with you to develop a plan to do so carefully and gradually in order to avoid withdrawal symptoms. 

Symptoms of withdrawal from Xanax include:

  • Anxiety
  • Changes in blood pressure
  • Difficulty sleeping
  • Dizziness
  • Irritability
  • Nausea
  • Rapid heart rate
  • Seizures
  • Tremors

What's the difference between Klonopin and Xanax?

Xanax vs Klonopin for anxiety

Both Xanax and Klonopin have been found to be effective in treating anxiety, according to a 2016 study published in Clinical Psychopharmacology and Neuroscience. However, the study also found that fewer people reported experiencing negative side effects from Klonopin compared to Xanax (26.7% vs 48.4%).

Klonopin vs Xanax for panic disorder

Clinical trials have found both Klonopin and Xanax to be effective treatments for panic disorder. 

Based on three clinical trials, Xanax was found to be more effective than a placebo, as measured by both the number of patients who reported zero panic attacks (up to 83% of patients) as well as an overall improvement in symptoms. 

In one clinical trial, 74% of patients taking Klonopin reported being free of panic attacks (compared to 56% of patients who were given a placebo). In a second clinical trial, 62% of patients were panic attack-free (compared to 37% of placebo patients).

Xanax vs Klonopin for social anxiety

Few head-to-head studies of Xanax vs Klonopin for social anxiety are available. That being said, according to a 2013 article in the International Journal of Neuropsychopharmacology, Klonopin was found to be effective in treating social anxiety.

Xanax or Klonopin for depression

Some studies indicate that taking benzodiazepines along with antidepressant medications (such as selective serotonin reuptake inhibitors, or SSRIs) may be more effective in treating depression than antidepressants alone.

However, both Xanax and Klonopin—and benzodiazepines in general—also may worsen symptoms of depression. Let your prescribing doctor or nurse practitioner know if you are experiencing new or worsening signs of depression while taking either of these medications.

Xanax or Klonopin for sleep?

Because they are benzodiazepines, both Klonopin and Xanax have a sedative effect and may sometimes be prescribed to help with difficulty sleeping. If fast relief is important to you, Xanax may start working slightly faster than Klonopin (within 1 to 2 hours compared to 1 to 4 hours for Klonopin), something to consider when discussing treatment options with your prescribing doctor, nurse, or Minded psychiatry provider.

Klonopin vs Xanax dosage

As with many medications, Klonopin and Xanax are usually first prescribed at a low starting dose that can be gradually increased by the prescribing doctor or nurse, up to a maximum recommended daily dose if symptom relief is not achieved.

While Klonopin is typically prescribed to be taken in 2 doses per day, Xanax is usually prescribed to be taken in 3 doses per day

Both Klonopin and Xanax can be taken daily at regularly scheduled times or on an “as-needed” basis, depending on the instructions provided by your prescribing doctor or nurse. Both medications can be taken with or without food—though if taking it without food causes an upset stomach, you may want to take it with food.

Klonopin vs Xanax side effects

xanax vs klonopin side effects

While Klonopin and Xanax have possible side effects in common, each may come with its own more common side effects.

Common Klonopin side effects:

  • Depression
  • Dizziness
  • Drowsiness
  • Fatigue
  • Memory problems

Common Xanax side effects:

  • Difficulty saying words (dysarthria)
  • Low blood pressure (hypotension)
  • Reduced sex drive

Common side effects of both Klonopin and Xanax:

  • Difficulty with walking/coordination

Can you take Xanax and Klonopin together?

Because Xanax and Klonopin are both benzodiazepines, these medications should not be taken together. They can cause similar side effects—including drowsiness—and taking them together can potentially dangerously increase this or other effects.   

In order to prevent dangerous interactions, always let your doctor know about all medications and supplements you are taking and always take your medications as they are prescribed.

Switching from Xanax to Klonopin (or switching from Klonopin to Xanax)

In general, benzodiazepines (such as Xanax and Klonopin) are prescribed for short-term use. You should not stay on one medication if it is not working for you after an adequate trial.

You and your prescribing doctor, nurse practitioner, or Minded psychiatry provider may consider switching you from Xanax to Klonopin (or vice versa) if:

  • You have been on one of these medications at the right dose (as determined by you and your doctor or prescribing nurse) long enough to see little or no symptom improvement
  • You are experiencing side effects that are difficult to tolerate

In order to avoid withdrawal symptoms, do not stop either medication without discussing a safe way to do so with your healthcare professional.

Klonopin vs Xanax withdrawal

Both Klonopin and Xanax can cause withdrawal symptoms if stopped abruptly. If you need to go off of either of these medications, it is important to work with your prescribing doctor, nurse practitioner, or Minded psychiatry provider to develop a plan to do so gradually to avoid withdrawal symptoms.

Final thoughts on Klonopin vs Xanax

Klonopin and Xanax are both medications to consider for your anxiety or insomnia treatment plan. While they are both benzodiazepines with many similarities, they also have differences that give each medication its own pros and cons.

Klonopin is approved to treat panic disorder. It also is used “off-label” to treat sleep problems. Xanax is approved to treat panic disorder and generalized anxiety disorder (GAD) and is used “off-label” to treat sleep problems as well.

While both Klonopin and Xanax have been found effective in treating anxiety, more people may experience negative side effects from Xanax.

On the other hand, while both medications may help with insomnia or sleep difficulties, Xanax may start to work more quickly than Klonopin.

Your prescribing doctor, nurse practitioner, or the psychiatry providers at Minded can help you determine which medication, if any, may be the better fit for your needs.


Drugs
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