Overview
Lorazepam and Clonazepam both are Benzodiazepine drugs, commonly prescribed for anxiety, seizure, and insomnia disorders. These two drugs are more frequently used to manage numerous psychological or other disorders regularly.
However, their pharmacological uses and their exact method of working are somewhat similar as they are from the same class of drugs. However, Lorazepam and Clonazepam differ regarding the dosage, dosing, usage, and adverse effects.
In this blog, we will compare both drugs on certain parameters that are sure to assist you in deciding on the better drug.
Comparison Between Lorazepam and Clonazepam
Lorazepam
Lorazepam is an approved medication for the short-term management of anxiety symptoms that contribute to anxiety disorders, insomnia caused by insomnia, anesthesia premedication in adults, and status epilepticus. It is sold under various brand names like Ativan etc. The indication of using Lorazepam depends on the patient’s health condition and clinical monitoring. It is a Schedule IV controlled substance drug, which indicates its potential for misuse and abuse.
Mechanism of Action
Lorazepam is a generic medicine that works by enhancing the activity and effects of GABA (Gamma-aminobutyric acid) neurotransmitter. In addition, enhanced GABA chemical aids through its calming effects in the Central Nervous System (CNS). It helps to regulate the abnormal excitability of the neurons in the brain through their hyper-polarization.
Clonazepam
Clonazepam is a highly potent Benzodiazepine that is known for its long-acting tranquilizing effects. It is a generic variant for brand-name drugs like Klonopin and Rivotril. It is a Schedule IV controlled substance drug, which indicates its potential for drug abuse and misuse. Furthermore, it can lead the patient to physical dependence if taken wrongly.
Mechanism of Action
Generic Clonazepam boosts and enhances the soothing effects of GABA (Gamma-aminobutyric acid) brain chemicals. It controls the abnormal activity of neurons that contribute to several disorders like seizure disorders, panic disorders, etc. Improved GABA exerts its calming effects in the Central Nervous System to make the neurons calm. Thus, reduces the symptoms of associated illnesses.
Uses
Lorazepam
The Food and Drug Administration approves Lorazepam for various conditions like:
Primary Use of Lorazepam
- Anxiety disorders
- Anxiety-related insomnia
- Anesthesia premedication in adults to relieve anxiety or to induce sedation or amnesia
- Status epilepticus
Off-label Uses of Lorazepam
- Rapid tranquilization of the agitated patient
- Vertigo
- Insomnia
- Combined or breakthrough Chemotherapy (associated anticipatory nausea and vomiting)
- Panic disorder
- Alcohol withdrawal delirium and syndrome
- Delirium
- Psychogenic catatonia
Clonazepam
Clonazepam is an FDA-approved drug for the treatment of seizure and panic disorders. Its indication includes:
Primary Uses of Clonazepam
- Seizure Disorders
- Panic Disorder
- Acute Mania
- Tardive dyskinesia
Other Uses of Clonazepam
- Akathisia
- Restless leg syndrome
- Bruxism
Dosage and Dosing
Lorazepam
It is available for oral administration in various forms like tablets, extended-release capsules, solutions, and concentrate solutions.
- Tablets: 0.5mg, 1mg and 2.5mg
- Extended-release capsules: 1mg, 2mg, and 3mg
- Concentrate solutions: 2mg/ml
- Solution: 2mg/ml and 4mg/ml
Dosing
- For Anxiety Disorders: The starting initial dosage is 2mg to 3mg, twice or thrice a day. It can be taken orally, with or without food. The maximum daily limit is 10mg which should not be exceeded.
- For Insomnia Caused by Stress or Anxiety: 0.5mg to 2mg taken at bedtime, is the recommended dosage for patients aged 65 or younger. While, for patients aged above 65 the suggested dosage is 0.5mg to 1mg.
Clonazepam
Clonazepam is available for oral administration in the form of immediate-release tablets orally disintegrated tablets (ODT) or dispersible tablets.
- Tablets: 0.5mg, 1mg, and 2mg
- ODT or Dispersible Tablets: 0.125mg , 0.25mg, 0.5mg, 1mg, and 2mg
Dosing
- For Seizure Disorders: 0.5mg, thrice a day is the recommended dosage for adults, geriatric patients, and adolescents with a body weight of more than 30kg. This dose can be increased by a doctor, to 1mg every 3 days until seizures are under control. The maximum daily limit is 20mg. For pediatric patients (weight below 30) the recommended dose is 0.01 to 0.03mg per kg in a day, divided into 2 or 3 doses.
- Panic Disorders: 0.25mg, taken twice or thrice in a day is the starting dose, which can be increased to 0.5 mg two times a day. The maximum daily limit is 1 to 4 mg.
Side Effects
Besides their effectiveness, these drugs also can cause some mild to severe side effects. However, most of the adverse effects are temporary and disappear automatically with time. But, few of them may require immediate medical attention.
A few of the known side effects of Lorazepam and Clonazepam are listed below:
Lorazepam
- Seizures
- Amnesia
- Syncope
- Blood dyscrasias
- Constipation
- Diplopia
- Tachycardia
- Hypotension
- Fatigue
- Irritability
- Menstrual irregularities
- Ataxia
- Dysarthria
- Jaundice
- Behavioral changes
- Sedation
- Dizziness
- Asthenia
- Respiratory depression
- Constipation
Clonazepam
- Lethargy
- Hallucination
- Fatigue
- Short-term memory loss
- Irritability
- Behavioral disturbance
- Impaired balance
- Dysphoria
- Blurred vision
- Worsening of depression
- Sedation
- Drowsiness
- Personality changes
- Thrombocytopenia
- Impaired coordination
- Confusion
- Ataxia
- Increased frequency of seizures
- Dizziness
Precautions
- Lorazepam and Clonazepam are both classified as prescription medications, which implies that getting these medicines necessarily involves obtaining a recommendation from a doctor.
- To ensure that these drugs are safe for the patients, one should be knowledgeable about the side effects of these drugs and the possible interactions. Thus, it is required to consult a doctor to get the correct advice.
- One should avoid alcohol and smoking if they have been prescribed to use Lorazepam and Clonazepam. It may result in overdose and withdrawal symptoms in the patient.
- Do not self-administer doses higher than indicated or make changes to dosage and frequency, as modifications must be made under the direction of a doctor. Moreover, strictly follow the dosage guide exactly as prescribed by the doctor.
- Some of these drugs may pose unwanted effects if taken during pregnancy and breastfeeding, as they will influence the newborn.
