Unfortunately, a substantial portion of the population struggles with anxiety disorders, panic attacks, and insomnia. Anxiety is considered the most widespread mental illness that affects the U.S. population, and according to a report, nearly 40 million Americans aged 18 and older deal with it annually. Despite their treatability, only 36.9 percent of people who struggle with it will get the treatment they need.
However, those who reach out to a doctor for help could receive it in the form of chemical relief. Benzodiazepines are commonly prescribed medications to treat all of the above, as well as seizures or other off-label reasons.
Two such drugs, known as Klonopin and Ativan, are highly sought medications for their relaxing properties. When used as prescribed, these medications can be highly effective. However, when abused, it can lead to adverse side effects and deadly withdrawal symptoms.
Are Klonopin and Ativan the Same Thing?
Klonopin (clonazepam) and Ativan (lorazepam) are benzodiazepines used to manage anxiety disorders. However, Ativan is also prescribed to treat panic attacks, insomnia, and alcohol withdrawal. Klonopin is more commonly used to treat seizure disorders and slow down an over-excited nervous system.
As you’d expect with all medications, both drugs can produce side effects even when used responsibly. The following are possible side effects of Ativan and include:
- Muscle weakness
- Blurred vision
- Sleep issues such as insomnia
- Loss of coordination or balance
- Inability to concentrate
- Amnesia or forgetfulness
- Changes in appetite
- Skin rash
Benzodiazepines all contain similar side effects because they fall into the same class of drugs, although some may differ. The following are possible side effects of Klonopin and include:
- Loss of orientation
- Sleep disturbances
- Slurred speech similar to alcohol intoxication
- Problems with memory or thinking
- Sore gums
- Dry mouth
- Loss of appetite
- Runny nose
- Blurred vision
Both Klonopin and Ativan interact with cold or allergy medications, alcohol, sleeping pills, narcotics, anti-anxiety medications, muscle relaxers, medicine for seizures, MAO inhibitors, barbiturates, medications that treat psychiatric disorders, or antidepressants. You should always consult with your primary care physician before trying new medications.
What Drugs Interact With Ativan?
Benzodiazepine drugs like Ativan can be dangerous when used with other medications. For example, opioids are depressants like Ativan, and mixing the two can be fatal. According to the National Institute on Drug Abuse (NIDA), in 2019, 16 percent of overdose deaths involved opioids and benzodiazepines.
The same study shows that 136 people die each day after overdosing on opioids. Between 1996 and 2013, the number of people who filled a benzodiazepine prescription rose by 67 percent, from 8.1 million to 13.5 million, leading to a substantial increase in emergency department visits for a drug-related emergency.
Ativan produces increased central nervous system (CNS) effects when used with other CNS depressants. These include barbiturates, antipsychotics, alcohol, anxiolytics, sedative/hypnotics, narcotic analgesics, antidepressants, sedative antihistamines, anesthetics, and anticonvulsants.
What Drugs Interact with Klonopin?
Since it belongs to the same class of depressants, combining Klonopin with alcohol, opioids, other benzos, and barbiturates is a recipe for disaster. Other drugs that interact with Klonopin include nonbarbiturate hypnotics, anticonvulsant drugs, anti-anxiety agents, phenothiazines, butyrophenone and thioxanthene, antipsychotic agents, tricyclic antidepressants, and monoamine oxidase inhibitors.
You must always speak to your healthcare provider about medications you take, including non-prescription and prescription medications, herbal supplements, and vitamins. Using Klonopin or Ativan with other medicines could lead to adverse side effects or affect how well they work.
You shouldn’t start or stop other medications without approval from your treating physician. Always keep a list of the medicines you take to show to your doctor and pharmacy when you start a new medicine.
What Are the Main Differences Between Ativan and Klonopin?
Klonopin is the brand name of clonazepam, which, as was mentioned above, is used to treat seizures and panic disorders. Klonopin remains in the body for an extended period with a half-life of 30 to 40 hours, meaning a person can experience the lingering effects of the drug for quite some time after it’s ingested.
Ativan is the brand name for lorazepam and is used to treat seizures and anxiety. In some cases, it’s used as an injectable for anesthesia before specific procedures. Ativan has a much shorter half-life of around 20 hours in the body, meaning the effects will dissipate much sooner than Klonopin.
Conditions Treated by Ativan and Klonopin
We’ve established that these drugs are approved by the Food and Drug Administration (FDA) to treat seizures. Klonopin can also treat akinetic and myoclonic seizures that result from Lennox-Gastaut syndrome. Ativan is used for more severe types of seizures known as epilepticus.
Klonopin is used to treat symptoms of recurring panic attacks and anxiety, while Ativan is used to treat anxiety that’s caused by depression. Both drugs have other off-label uses at the discretion of the treating physician. This could be for other anxiety disorders like social phobia.
Ativan is FDA approved to treat insomnia, while some doctors will use Klonopin off-label to treat sleep issues. Other off-label uses for Ativan and Klonopin include treating agitation and alcohol withdrawal.
Is Ativan or Klonopin More Effective?
Both drugs are effective in treating the disorders mentioned above. Since they’ve been studied for other purposes, the effectiveness can vary depending on the condition that’s being treated. Both drugs are highly effective in treating anxiety disorders, and there were no significant differences found between the two when treating sleep disorders. However, the only difference was that clonazepam was found to have fewer side effects.
Both drugs were used to treat specific seizures, and although lorazepam is approved for treating epilepticus, clonazepam was found to be a useful alternative. Clonazepam is commonly used off-label for this type of seizure treatment.
Warnings of Ativan and Klonopin
Using benzodiazepines for longer than intended or in higher doses than prescribed should be avoided. It can cause a greater risk of respiratory depression, coma, and death if you take too much. Benzodiazepines are Schedule IV drugs by the DEA, meaning there is potential for abuse and dependence. With that said, you should only use it in the short-term unless instructed otherwise.
Ativan and Klonopin should never be prescribed to the elderly or others at significant risk of falling. Since both drugs affect our liver, they must be monitored in individuals with liver disease. Both drugs are listed in Pregnancy Category D, meaning they should never be used during pregnancy. If you’re planning to get pregnant and use one of these drugs, you should consult with a doctor to weigh your options. If you’re breastfeeding, you should be monitored by medical professionals or avoid the pills altogether.
Benzodiazepine Withdrawal Syndrome
Despite the effectiveness of treating these conditions, benzodiazepines can produce fatal withdrawal symptoms upon abrupt cessation. Even when used in therapeutic doses, physical dependence that leads to withdrawal can occur. Benzodiazepine use has become widespread in the past decade among all age groups, from teens to the elderly. Nearly 500,000 people in the United States abused sedative drugs in 2016.
Withdrawing from benzodiazepines like Ativan and Klonopin can be challenging and sometimes dangerous. You should expect a return of anxiety and feeling on-edge for several weeks after you stop. You might even feel hypersensitive to everything around you. Insomnia is also prevalent, as well as hand tremors and headaches.
Ativan and Klonopin withdrawal can be managed with a gradual dose reduction, leading to milder symptoms that come and go in waves. However, if you’ve been using the drugs for longer than six months, abrupt cessation can lead to delirium and grand mal seizures. It’s in your health’s best interest to involve a doctor or addiction specialist in your withdrawal process.
Withdrawal can occur as soon as a month after use, even in small or therapeutic doses. Of those who used benzos for more than six months, about 40 percent experience moderate to severe symptoms when they stopped suddenly. The other 60 percent experience mild symptoms. Withdrawal symptoms will depend on if you’ve taken more than one benzo, your current dose, how long you’ve taken it, other substance abuse issues, and whether you’re quitting more than one substance at a time.
If you’ve been using Klonopin or Ativan and you’re ready to stop, you should seek immediate medical help and check into medical detox. If you’re ready to stop, it’s not worth risking your life.