Medicine

Difference Between Clonazepam and Lorazepam

Main difference

The main difference between clonazepam and lorazepam is that clonazepam is used to treat seizure disorders and lorazepam is used to treat anxiety disorder.

Clonazepam versus lorazepam

Clonazepam has hydrogen at carbon number 3 of the diazepine ring, while lorazepam has a hydroxyl group attached to carbon number 3 of the diazepine ring. Clonazepam has a nitro group attached as R7 of a benzene ring, on the other hand, lorazepam has a chloride group attached as R7 of a benzene ring. Clonazepam is a long-acting benzodiazepine with a duration of action of 1 to 3 days, while lorazepam is an intermediate-acting benzodiazepine with a duration of action of 11 to 20 hours. Clonazepam has more selective anticonvulsant activity, while lorazepam has less selective anticonvulsant activity. Clonazepam at non-sedating doses causes muscle relaxation, whereas lorazepam does not cause muscle relaxation at non-sedating doses. Clonazepam is not used as an anesthetic adjuvant, while lorazepam is used as an anesthetic adjuvant. Clonazepam antagonizes the effects of pentylenetetrazol at unusual doses; on the other hand, lorazepam does not antagonize the effects of pentylenetetrazol. Tolerance to clonazepam develops in patients after 1-6 months of treatment and after which the patient shows no response to any dose while on lorazepam, tolerance soon develops.

Comparison chart

Clonazepam Lorazepam
Clonazepam is a long-acting benzodiazepine that facilitates GABAergic transmission. Lorazepam is an intermediate-acting benzodiazepine that facilitates GABAergic transmission.
Receptors on which the drug acts
Clonazepam acts on GABA receptors. Lorazepam also acts on GABA receptors.
Action mode
Clonazepam acts as an agonist at GABA receptors. Lorazepam acts as an agonist at GABA receptors.
therapeutic uses
Anticonvulsant, Antiepileptic Anxiety, status epilepticus
Effect on the respiratory system
Clonazepam causes respiratory depression when administered intravenously. Lorazepam causes respiratory depression when administered intravenously.
Effect on the cardiovascular system
Clonazepam causes cardiovascular depression when administered intravenously. Cardiovascular depression of lorazepam when administered intravenously.
Available dosage forms
oral, parenteral oral, parenteral
Contraindications
Angle-closure glaucoma, Wide-angle glaucoma, Porphyria Benzodiazepine hypersensitive patients, Acute narrow-angle glaucoma
Adverse effects
Dizziness, tiredness, loss of coordination, increased saliva Fatigue, amnesia, memory impairment, confusion, depression
What is clonazepam?

Clonazepam is the benzodiazepine that is used to treat different types of seizures. The different types of seizures include myotonic or atonic seizures. Clonazepam is also used to treat photosensitive epilepsy and absence seizures. Tolerance is the problem in clonazepam use as tolerance develops when clonazepam is used to treat seizures. Clonazepam works by enhancing the response of gamma-aminobutyric acid receptors. Clonazepam use is also classified as drug abuse. Clonazepam can be used alone or in combination with other medications to treat Lennox-Gastaut syndrome. Clonazepam is given orally for seizure disorders. Clonazepam decreases generalized seizures produced by stimulation of the amygdala but does not eliminate the unusual discharge at the site of stimulation. Clonazepam causes drowsiness and lethargy. Clonazepam also causes muscle intoxication and ataxia. Clonazepam metabolism occurs primarily by reduction of the nitro group. Clonazepam has a half-life of 1 day.

Example

Examples of famous brands that contain clonazepam is Klonopin.

What is lorazepam?

Lorazepam is the benzodiazepine, which is used to treat anxiety disorders and to produce a calming effect. Lorazepam acts both on the brain and on the nerves, which is why it is used in anesthesia as an adjuvant. Lorazepam is also used to treat insomnia and anterograde amnesia. Lorazepam shows some narcotic effects. Lorazepam is rapidly absorbed when administered orally. In case of renal or hepatic insufficiency, the dose of lorazepam is adjusted. Lorazepam can also be used as a replacement for some medications, such as lorazepam, it can be used to treat agitation when haloperidol is not available. When administered with alcohol ,narcotics, psychoactive substances acts synergistically so it should not be prescribed with narcotics or psychoactive agents. Lorazepam also has the problem of tolerance and dependency. Lorazepam metabolism occurs primarily by conjugation with glucuronic acid. The half-life of lorazepam is approximately 14 hours.

Example

Examples of famous brands that contain lorazepam are Ativan.

Key differences

  1. Clonazepam is a long-acting benzodiazepine, while lorazepam is an intermediate-acting benzodiazepine.
  2. Clonazepam is used to treat seizures. On the other hand, lorazepam is used to treat anxiety.
  3. Clonazepam has a half-life of 1 day, on the other hand, the half-life of lorazepam is about 14 hours.
  4. Clonazepam is useful in the treatment of absence seizures and myoclonic seizures in children, while lorazepam is useful in the treatment of status epilepticus in both children and adults.

Final Thoughts

The conclusion from the above discussion is that both clonazepam and lorazepam are benzodiazepine agonists, differing slightly in their therapeutic uses. Both find their role in changing neuronal transmission at GABA receptors.

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