Glen asked
I'm currently taking 0.5mg of Klonopin twice per day and have been prescribed Tranxene 3.75mg once per day. How do these doses compare in effectiveness and how long does the Tranxene last?
Answer
Klonopin (Clonazepam) and Tranxene (Clorazepate) are both in the benzodiazepine class of drugs, and work the same way. There are fairly significant differences between the two drugs however.
Klonopin has a rapid onset of action and has an intermediate duration of action. Clonazepam's onset of action is 20—60 minutes and persists for up to 6—8 hours in children and up to 12 hours in adults. After it is metabolized by the body, the by-products have no chemical activity (inactive metabolites). Depending on the use, it is usually dosed 2-3 times daily.
Tranxene has an intermediate onset of action and a long duration of action. The onset of action is typically 1-2 hours and depending on the person, can persists for up to 12 hours. Tranxene is still commonly dosed 1-4 times daily depending on the activity level of the drug. Unlike Klonopin, Tranxene has active metabolites (when the drug is broken down, the byproducts are active in the body). This property makes it LESS likely to suffer withdrawal effects from the drug versus other benzodiazepines. It TYPICALLY, is a safer choice long term as it is most likely easier to stop it when necessary. However, due to the long duration of action of the drug and the buildup of metabolites, it may cause prolonged sedation in some people.
In terms of comparable efficacy, it is tough to say. Both drugs work the same way, it is just their kinetic profile which is different. Both drugs are commonly used for anxiety and seizure control. If you are using both for anxiety, the Tranxene dose appears to be a little on the low side.
The common dose for anxiety for Tranzene is 15-60mg per day. The common dose for anxiety for Klonopine is 0.5-4 mg per day. Again, every person is different and you doctor may be seeing how you respond to the Tranxene.
