By Irfana
B.Sc (Psychiatry Ward)
29 April 2022 -
Medically reviewed by
Sumayya
D. Pharm
Clonazepam Vs Lorazepam
Table of Contents

Clonazepam

Clonazepam is a drug that is used to treat and prevent seizures. An anticonvulsant or antiepileptic medicine is what this medication is called. It's also used to help people who are having panic attacks. Clonazepam relieves anxiety by calming the brain and nerves. It belongs to the benzodiazepine family of medicines.

Klonopin is the brand name for clonazepam oral tablets and is a prescription medicine only. Buy clonazepam online from a certified online pharmacy.

Clonazepam is available as an oral tablet and an oral dissolving tablet. (Browne, T.R., 1978)

Lorazepam

Lorazepam belongs to the benzodiazepine class of medicines, which have a calming effect on the brain and nerves. Anxiety is treated using this drug. This medication works by amplifying the impact of a natural substance in the body (GABA). You can purchase Lorazepam online from a trusted online pharmacy but it is always recommended to consult your healthcare provider before consuming this medication.

Lorazepam is a prescription drug and has been approved by the Food and Drug Administration (FDA) to

How It Works

Clonazepam

Clonazepam works by boosting gamma-aminobutyric acid activity (GABA). This is a molecule that transmits messages throughout the neural system of a person. A person's body may be aroused if they don't have enough GABA. They may get panic episodes or seizures as a result of this. When a person takes this medication, their body produces more GABA. They will experience fewer panic attacks and seizures as a result of this. (Basit H, Kahwaji CI)

Lorazepam

It works by boosting the amounts of a relaxing chemical in your brain called gamma-amino-butyric acid (GABA). This may help you feel calmer, ease anxiety, or stop a seizure or fit, depending on your health condition.  (Ghiasi, N., Bhansali, R.K. and Marwaha, R., 2021)

Mechanism Of Action

Clonazepam:

Clonazepam is a 1,4-benzodiazepine with anticonvulsant properties that can be used to treat some kinds of myoclonus. Its primary mechanism of action is to help GABAergic transmission in the brain by acting directly on benzodiazepine receptors. GABA receptors are found on the cell bodies of dorsal raphe neurons, and GABA inhibits raphe cell activity, which benzodiazepines enhance. Clonazepam does not affect 5-HT production. However, it does reduce 5-HT use in the brain and prevents 5-HIAA from leaving the brain. It's unclear if Clonazepam's effects on 5-HT function are responsible for its antimyoclonic properties, which are only detected at high doses. Furthermore, Clonazepam's effects are the polar opposite of those anticipated by 5-HTP's therapeutic effects in human myoclonic diseases. (Basit H, Kahwaji CI)

Lorazepam:

Lorazepam interacts with benzodiazepine receptors on postsynaptic GABA-A ligand-gated chloride channel neuron benzodiazepine receptors at various places throughout the central nervous system (CNS). It increases the conductance of chloride ions into the cell by enhancing the inhibitory effects of GABA. The cellular plasma membrane is hyperpolarized and stabilized due to the shift in chloride ions. Its inhibitory action in the amygdala aids anxiety disorders, while its inhibitory activity in the cerebral cortex aids seizures.  (Ghiasi, N., Bhansali, R.K. and Marwaha, R., 2021)

How To Take

Clonazepam

It's important to take Clonazepam precisely as prescribed by the doctor.

Typically, you'll begin with a low dose and gradually raise it over 2 to 4 weeks until your doctor determines that the dose is appropriate.

A doctor may prescribe you whether you should take Clonazepam in one dose or break it into three doses throughout the day. If you're not sure how to take it, consult a doctor or pharmacist.  

Usual Dose For;

  • Epilepsy in Adults: 1mg given at night is the initial dose (increasing to 4mg to 8mg over 2 to 4 weeks)
  • Epilepsy in Children:The dosage is determined by their age. It will be gradually raised over the next 2 to 4 weeks.
  • Adults with involuntary musclespasms: Should start with 1mg given at night (increasing to 4mg to 8mg over 2 to 4 weeks)
  • Panic Disorder: 1mg to 2mg each day.
  • Restless Legs Syndrome: 5mg to 2mg each day.

A doctor may prescribe a lesser dose if the patient is over 65 or have kidney, liver, or severe breathing problems. (Basit H, Kahwaji CI)

Lorazepam

Always take Lorazepam as prescribed by the doctor. 

Lorazepam tablets are available in strengths of 0.5mg, 1mg, and 2.5mg. Each 1ml of the liquid contains 1mg of lorazepam.

Usual Dosage For;

  • Anxiety: 1 to 4 mg per day; your doctor will advise you on how often to take it.
  • Sleep Problem: 1mg to 2mg before bedtime (Lorazepam starts to work in 20-30 mins)
  • A Pre-Med for Adults: 2 to 3 mg the night before the surgery, then 2 to 4 mg 1 to 2 hours before the procedure
  • A Pre-Med for Children Aged 1Month to 11Years: The child's weight will determine the dosage.
  • A Pre-Med for Children Aged 12 to 17Years and Above: 1 to 4 mg the night before or 1 hour before the operation.

A doctor may prescribe a lesser dose if the patient is over 65 years old or have liver or kidney problems.  (Ghiasi, N., Bhansali, R.K. and Marwaha, R., 2021)

Common Side-Effects

Common side-effects of Clonazepam 

  • drowsiness,
  • dizziness,
  • weakness,
  • unsteadiness,
  • depression,
  • loss of orientation,
  • headache,
  • sleep disturbances (Basit H, Kahwaji CI)

Some common side-effects of Lorazepam

Difference And Similarities Between Clonazepam And Lorazepam

Particular

Clonazepam

Lorazepam

Drug Class

Benzodiazepine

Benzodiazepine

Brand Name

Klonopin

Ativan

Form of Drug

Oral Tablet

Oral Tablet and injection

Standard Dosage

0.25 mg twice per day, depending upon doctor's prescription

1 mg twice per day, depending upon doctor's prescription

Medication Prescribed for

Panic disorder: Adults 18years and older     

Seizures: Adults or children 10 years and older

Anxiety: Adults or children 12 years and older

 

Which Is More Effective Clonazepam or Lorazepam

Both Clonazepam and Lorazepam are effective drugs for treatment. Depending on the condition being treated, their effectiveness can vary because they have been studied for different purposes. 

In multicenter research, the active components of clonazepam and Lorazepam were equally effective in treating anxiety disorders. There were no significant differences between these medicines when it came to anxiety and sleep improvement. Clonazepam has fewer negative effects in the study. 

Another study evaluated the effects of clonazepam and Lorazepam in treating status epilepticus, a form of a severe seizure. Clonazepam is a more effective alternative to Lorazepam for status epilepticus, even though Lorazepam is more extensively utilized. Clonazepam is sometimes used for treatment, off-label.

Warning: Clonazepam And Lorazepam

Taking Benzodiazepines and opioids together can cause a greater risk of respiratory depression, coma, and death.

They have the potential to be abused and become addicted. As a result, they usually are only recommended for short-term use.

Both the drug should be avoided on the elderly or those who may be at risk of falls. Patients on these drugs should be monitored regularly with liver disease, as both affect the liver.

Clonazepam and Lorazepam should be avoided during pregnancy or if planning pregnancy. It should also be kept away a while, breastfeeding.

Conclusion

Both Clonazepam and Lorazepam are benzodiazepines with an intermediate action; as a result, their effects may endure longer than those of comparable medications. Both medications can treat anxiety disorder, which binds to GABA receptors in the brain. 

While both these medications function in similar ways, the way they are administered differs, like in dosage, form in which they are available, and for whom it is suitable.

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