Mental Health Clonazepam vs Lorazepam

[cbtodacb]

Hey guys,

I'm just keen to here of the different experiences people have had with these two drugs and which they prefer.

Also, any information on tolerance to either would be great.

I am a clonazepam user, I am prescribed 6mg daily. I am a bit worried about tolerance but don't know if it is all in my head and just simply part of my major GAD and paranoia.

Cheers.

 

[NeighborhoodThreat]

Clonazepam is longer-acting but takes considerably longer to kick in than lorazepam (Ativan) does. Lorazepam is better suited for treating panic since it kicks in quicker but its duration is also shorter. Tolerance with shorter-acting benzos tends to rise higher than with longer-acting benzos so if you're already taking 6mg of clonazepam per day you already have a decent tolerance. Are you considering adding lorazepam to your medications or are you considering replacing your clonazepam with lorazepam?

Both of these drugs are cross-tolerant with each other. If you're worried about tolerance I would not switch to lorazepam. We don't really encourage drug comparison (drug A vs. drug B) type threads because they really only result in speculation. Some people react better to lorazepam and some people react better to clonazepam. This is really something you should discuss with your doctor. You're already on a high dose of clonazepam, I wouldn't be so quick to add more benzos as it will eventually raise your tolerance even higher. IME, 1mg lorazepam is equal to around 0.5mg clonazepam so your 6mg clonazepam converts to 12mg lorazepam. This conversion chart shows the same.

Again, your reaction may (and probably will) differ from mine and others who post here. It is also important to note that dose conversions for benzos aren't always as simple as the charts make them out to be. If you've been taking that dose of clonaz for a long time it's even more important to discuss any dosage changes with your doctor.

 

[cbtodacb]

Thanks heaps for the feedback mate.

I had ADHD too, so I was thinking of asking my doc about throwing an ADHD drug into the mix?

Also, what are your thoughts on Imipramine and Nardil?

Cheers mate.

 

[calebtrask]

I found clonazepam more sedating than lorazepam, and anecdotally most people I've talked to about it felt the same. If you're feeling too tired on clonazepam, that might be something to take into account if you're considering switching. The biggest difference between the two (besides short-acting vs long-acting) for me was that 6mg/day of lorazepam gave me serious memory gaps, moreso than I've experienced on any other benzo. I imagine this was probably just a unique reaction that I had to the drug, but it was enough to get me to stop taking it.

As far as an ADHD drug, I've been on both methylphenidate and amphetamine in addition to a benzo and had no problems with it. Stimulants on their own don't worsen my anxiety or OCD symptoms (in fact I tend to find them somewhat calming), but they have been known to exacerbate anxiety and especially tics in some people.

Imipramine, like most antidepressants, can be used to treat anxiety and shouldn't have a serious interaction with anything you'd be taking. Here's a study comparing it to sertraline for treatment of depression and panic disorder. Nardil, on the other hand, is an MAOI and there is a general taboo prescribing an MAOI with a stimulant because they are contraindicated, so you may have difficulty finding a doctor who's willing to combine the two. Personally, I'm currently on an MAOI (tranylcypromine) and amphetamine to treat ADHD and haven't had any adverse side effects to the combination.