Their inclusion does not guarantee they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. Healthcare providers may prescribe other medications, including non-stimulant options, or recommend non-pharmacological treatment based on the patient’s unique health circumstances and needs. Read more
Both
Highlights
- Xanax is mainly FDA-approved for generalized anxiety disorder and panic disorder. Klonopin is FDA-approved for panic disorder and seizure disorders, with common off-label uses for certain sleep issues and movement disorders.
- Xanax is more suitable for acute, sudden anxiety or panic attacks. Klonopin is more commonly used off-label for ongoing management of chronic anxiety or seizure disorders due to a slower onset and a longer-lasting effect.
- Both Klonopin and Xanax carry a high risk of dependence, withdrawal symptoms, and addiction, especially with prolonged use or at higher doses. Tapering under medical supervision is essential when discontinuing either medication.
- The “better” choice between Klonopin and Xanax depends on an individual’s specific symptoms, medical history, and response to treatment, and must always be determined by a healthcare professional.
What Are Klonopin and Xanax?
Klonopin and Xanax are both prescription medications in a group of drugs called
Both Xanax and Klonopin are classified as Schedule IV controlled substances in the U.S. This means they carry a risk of dependence, misuse, and addiction if not taken carefully.
Klonopin
Klonopin is the brand name for the generic medication
Xanax
Xanax is the brand name for the generic medication
Approved and Off-Label Uses
Both Klonopin and Xanax are effective treatments, but because they work differently, healthcare providers use them for different situations.
Klonopin
Klonopin is approved by the FDA for treating panic disorder, making it a helpful option for people who need sustained relief from panic attacks. It is also FDA-approved to treat seizure disorders, including Lennox-Gastaut syndrome, akinetic seizures, and myoclonic seizures, and may be combined with other medicines to treat absence seizures.
Beyond its approved uses, Klonopin is often prescribed off-label to help with insomnia, particularly when anxiety is a factor. It can also be used for certain movement disorders such as
Xanax
Xanax is best known for its effects on anxiety. It is FDA-approved for the short-term treatment of generalized anxiety disorder (GAD) and for panic disorder because it is useful for managing acute attacks.
In addition to these approved uses, sometimes doctors prescribe Xanax off-label for the short-term relief of insomnia, or as an add-on to antidepressant therapy in cases where anxiety is a major part of depression.
Use | Xanax | Klonopin |
Generalized Anxiety Disorder | FDA-approved | Off-label |
Panic Disorder | FDA-approved | FDA-approved |
Seizure Disorder | Not used | FDA-approved |
Insomnia | Off-label | Off-label |
How They Work: Onset, Duration, and Effectiveness
The biggest difference between Klonopin and Xanax is how quickly they start working, how long their effects last, and their overall effectiveness for specific conditions.
Onset of Action
- Xanax is known for its rapid onset of action. It starts working in about 15-30 minutes*, which makes it particularly effective for managing sudden anxiety attacks or panic attacks.
- Klonopin has a slower onset of action compared to Xanax. Its onset of action is usually within 30-60 minutes* after you take it. This makes Klonopin a good option for conditions that require extended control of symptoms.
*The time it takes for Xanax or Klonopin to take effect varies among individuals. Do not exceed the prescribed dosage.
Duration and Half-Life
- Xanax is a short-acting benzodiazepine. Its elimination half-life, which is the time it takes for half of the medication to be eliminated from the body, typically ranges from 6 to 20 hours. This shorter duration of action means its effects wear off faster.
- Klonopin is considered a long-acting benzodiazepine with a half-life ranging from approximately 20 to 50 hours. This means its effects last longer, often allowing for once or twice-daily dosing.
Effectiveness
- Given its fast onset and shorter duration of action, Xanax is often preferred for “as-needed” use to quickly give relief from severe anxiety or the sudden onset of a panic attack.
Clinical studies[2] support its efficacy in reducing the intensity of panic attacks and acute anxiety symptoms. - Klonopin’s slower onset and longer duration, compared to Xanax, make it more suitable for preventing panic attacks or controlling seizure activity over extended periods.
Research[9] has shown clonazepam to be effective in maintaining remission from panic disorder symptoms.
Feature | Xanax | Klonopin |
Onset time | 15-30 minutes | 1-4 hours |
Half-life | 6-20 hours | 20-50 hours |
Duration | Short-acting | Long-acting |
Used for | Acute anxiety, sudden panic attacks | Chronic conditions, ongoing management |
Dosage and Administration
The starting dose for both medications varies based on the condition being treated, age, medical history, and individual response. If an increase in dosage is needed, for both medications, it must be gradual to minimize side effects.
Klonopin can provide more stable, prolonged symptoms control with less frequent dosing, often once or twice daily.
- Klonopin for Panic Disorder: For adults, the initial dose is typically 0.25 mg taken up to twice daily. The dose may be increased over time for improved symptom control.
- Klonopin for Seizure Disorders: For seizure control in adults, initial doses are often 0.5 mg three times daily, gradually increasing every three days until seizures are controlled.
Because of its short duration, Xanax often needs to be taken two to four times daily to maintain consistent therapeutic effects. This frequent dosing can sometimes lead to symptoms in between doses as the medication wears off.
- Xanax for Generalized Anxiety Disorder: For adults, an initial dose of 0.25 mg to 0.5 mg taken up to three times daily is common.
- Xanax for Panic Disorder: For panic disorder, treatment usually starts with a lower dose, such as 0.5 mg up to three times daily. The dose may be increased over time for improved symptom control. In some cases, doctors may prescribe
Xanax XR[10] (extended-release), which can be taken once daily and may provide steadier symptom relief throughout the day, similar to clonazepam.
Side Effects and Risks
Like all medications, Klonopin and Xanax come with potential side effects and risks. While many common side effects are similar between the two, there are some differences.
Common Side Effects
- Drowsiness or sedation
- Dizziness or lightheadedness
- Fatigue
- Blurred vision
- Muscle weakness
- Impaired coordination (ataxia)
- Memory problems (amnesia)
- Confusion
- Slurred speech
- Gastrointestinal upset (e.g., nausea, constipation)
Serious Risks and Boxed Warnings
Both Klonopin and Xanax carry significant warnings due to their risk of abuse and potential for harm. These include:
- Dependence and Withdrawal: Both medications can lead to physical dependence, even with therapeutic use. Stopping them suddenly can cause withdrawal symptoms, including seizures, tremors, and severe anxiety.
- Addiction Potential: There is a significant risk of addiction, especially with long-term use, higher doses, or in people with a history of substance abuse.
- Breathing Problems: When combined with other central nervous system (CNS) depressants, particularly opioids, there is a serious risk of profound sedation, respiratory depression (slowed or stopped breathing), coma, and death.
- Overdose Risk: Overdose can occur with benzodiazepines alone but is more likely and dangerous when these medications are combined with alcohol, opioids, or other sedatives. Symptoms can include severe drowsiness, confusion, impaired coordination, slowed reflexes, and loss of consciousness.
Differences in Side Effect Profiles
While many side effects of Xanax and Klonopin overlap, some subtle differences exist due to their varying durations of action.
Klonopin lasts longer in the body, which means its calming effects can carry through much of the day. This can sometimes make people feel more tired during daily activities, but it also provides steadier relief with fewer ups and downs between doses.
Xanax, on the other hand, works quickly but wears off faster, which may cause anxiety symptoms to return between doses. Because of its quick peak, Xanax can also bring on stronger feelings of sleepiness or dizziness shortly after taking it.
Common side effects, their incidence in panic disorder treatment (%), if determined, and notes
Side Effect | ||
Drowsiness | Often persist throughout the day | 77%, May cause more drowsiness right after taking |
Dizziness | 8%, Сommon | Can be more intense after taking |
Memory problems | 4%, Persists after taking | 22%, May fluctuate |
Coordination problems | 6%, May persist | 18%, May come on quickly |
Dependence / Withdrawal | Risk with long-term use | Risk with long-term use; withdrawal is often more intense |
Rebound anxiety | Less likely due to longer duration | More likely to due short duration |
Dependence, Withdrawal, and Addiction Potential
Physical dependence can develop with both clonazepam (Klonopin) and alprazolam (Xanax), even when taken as prescribed. The body adapts to the presence of the medication and requires it to function normally. The longer you take the medication and the higher the dose, the greater the risk of developing dependence.
Because Xanax wears off quickly, withdrawal symptoms can start fast and feel intense. Sometimes, this can happen between scheduled doses. With Klonopin, withdrawal symptoms may appear more slowly but can last longer. They may also feel less intense at the very beginning compared to Xanax.
Signs of Misuse or Addiction
Recognizing the signs of misuse or addiction is crucial for intervention. These may include:
- Experiencing strong cravings for the medication
- Continuing to use the medication despite negative consequences (e.g., job loss, relationship problems)
- Neglecting responsibilities
- Needing higher doses over time to achieve the same effect (tolerance)
- Experiencing withdrawal symptoms if the medication is stopped or the dose is reduced
- Taking more than prescribed
It is not recommended to stop Klonopin or Xanax abruptly because it can lead to severe and potentially life-threatening withdrawal symptoms, including seizures. Gradually reducing the dose over time is the safest and most effective way for safely stopping benzodiazepines. Your healthcare provider can create a personalized tapering schedule, but it often takes several weeks to months to fully stop, depending on dose and duration of treatment. Get personalized tapering guidance with the convenience of online care from MEDvidi.
Special Considerations
Who Should Avoid Klonopin and Xanax
Klonopin and Xanax should generally be avoided by individuals with the following conditions or risk factors:
- Pregnancy and Breastfeeding: There is an increased risk of birth defects, or withdrawal in a newborn infant.
- Liver Disease: If you have severe liver disease, your body can’t process and get rid of the medication as well as it normally would, increasing the risk of side effects.
- History of Substance Misuse: Benzodiazepines may not be a good option for people with a history of alcohol or drug abuse due to the high potential for dependence while taking the medication.
- Certain Mental Health Conditions: Benzodiazepines may worsen symptoms in people with certain severe mental health conditions, such as psychosis or depression.
- Acute Narrow-Angle Glaucoma: People with acute narrow-angle glaucoma shouldn’t take benzodiazepines.
- Severe Respiratory Conditions: Patients with severe chronic obstructive pulmonary disease (COPD) or sleep apnea are at increased risk of respiratory depression.
Drug Interactions
Both Klonopin and Xanax can have dangerous interactions with other substances, primarily those that also affect the central nervous system, including:
- Prescription pain medications
- Muscle relaxants
- Sleep medications
- Certain antihistamines
- Mood stabilizers
- Alcohol
- Certain antifungal medications
- tricyclic antidepressants
Use in Special Populations
- Older Adults: Older adults are more sensitive to the effects of benzodiazepines and are at a higher risk of falls, confusion, and memory issues.
- Children: Klonopin may be used for seizures in children. Xanax is generally not recommended for people under 18 years old.
People With Chronic Illness: People with kidney, liver, or breathing problems may need dose adjustments and require close monitoring.
Always disclose all conditions and medications to your prescriber before starting a benzodiazepine.
Klonopin vs Xanax: Which Is Better for You?
There isn’t a universally “better” choice. The most appropriate medication will depend on your symptoms, health history, and how your body responds to the medication. Here is a recap of the key differences to consider:
- Onset: Xanax provides relief for acute symptoms, while Klonopin has a more gradual and slower onset.
- Duration: Klonopin lasts longer with less frequent dosing, while Xanax wears off quicker.
- Common Uses: Xanax is often prescribed for acute anxiety and panic disorder. Klonopin is used for control of panic disorder and seizure disorders. It is frequently used off-label for chronic anxiety and certain movement and sleep issues.
- Dosing Convenience: Klonopin’s longer duration of action typically allows for once or twice-daily dosing. Xanax generally requires more frequent administration throughout the day.
- Abuse Potential: Both medications have a high potential for dependence and addiction, but Xanax’s fast effects may make it more addictive for some.
Your healthcare provider will weigh these factors, along with your symptoms, full medical history, and other medications you are currently taking, to determine whether Klonopin or Xanax is the right choice for you.
At-a-Glance Comparison Table
Feature | Klonopin | Xanax |
Onset | Slower (1-4 hours) | Faster (15-30 minutes) |
Duration of Effects | Long acting | Short acting |
Primary Use | Panic disorder, seizures | Anxiety, panic disorder |
Abuse risk | High | High |
In Conclusion
Klonopin and Xanax are both effective medications for anxiety and panic disorder, but they work in different ways and fit different needs. Xanax acts quicker, making it useful for sudden episodes, while Klonopin lasts longer, providing steadier relief and support for ongoing symptoms. Both carry risks of dependence, withdrawal, and side effects, so the choice should always be made by a healthcare provider, based on your health history and treatment goals.
For personalized recommendations, sign up at MEDvidi today for an online appointment with one of our providers in 24 hours.
FAQs About Klonopin and Xanax
Which medication is stronger, Klonopin or Xanax?
Both are potent benzodiazepines, but Xanax (alprazolam) is generally considered more suitable for rapid anxiety relief due to its quick onset and higher potency per milligram, while the effects of Klonopin (clonazepam) last longer.
Does Klonopin make you sleepy like Xanax?
Yes, both can cause drowsiness, but Klonopin’s effects often last long, whereas Xanax tends to act more quickly and strongly in the short term.
Does Klonopin take longer to work than Xanax?
Yes, usually, the onset of action of Klonopin is 30–60 minutes (peak effect achieved in 1–4 hours), while the onset of action of Xanax is 15–30 minutes. Note that these timeframes may vary among individuals.
Which is better for sleep, clonazepam or alprazolam?
Neither is ideal as a long-term sleep aid. If prescribed by your healthcare provider, clonazepam may be more useful for sleep maintenance due to its longer duration, while alprazolam may help with falling asleep. However, note that there are medications and other treatments available specifically for sleep issues, and they are more likely to be the first-line choice.
Is Klonopin safer than Xanax?
Neither is inherently “safer,” but Klonopin’s longer half-life makes it less prone to rebound anxiety and withdrawal between doses compared to Xanax. The fast onset of Xanax may contribute to a higher potential for misuse in some individuals.
Can you switch from Xanax to Klonopin?
Yes, switching is possible, but must always be done under the supervision of your healthcare provider. They will gradually reduce the dosage of one medication while slowly starting the other to minimize withdrawal symptoms.
Can Klonopin replace Xanax?
In many cases, yes. Klonopin can be prescribed instead of Xanax for anxiety or panic, especially if longer-lasting coverage is needed. Your healthcare provider can help decide if switching to Klonopin is right for you.
Is Klonopin easier to get off than Xanax?
Generally, yes. Stopping Xanax can be more
