Prozac vs. Klonopin for Panic Disorder: Important Differences and Potential Risks.

Key takeaways

Prozac (fluoxetine) and Klonopin (clonazepam) are both prescription medications, but they belong to different drug classes and treat different conditions. Prozac is an SSRI (selective serotonin reuptake inhibitor) used to treat depression, OCD, bulimia, panic disorder, and depression from bipolar 1 disorder. It works by increasing serotonin levels in the brain. Klonopin, on the other hand, is a benzodiazepine used to treat seizures and panic disorder. It calms the brain by reducing signaling in brain cells. Prozac is typically taken once daily, while Klonopin is taken up to two to three times a day. Prozac can take up to 2 months to show full effects, whereas Klonopin works within a few hours. Prozac is not a controlled substance, but Klonopin is a Schedule IV controlled substance due to its potential for misuse and dependence. Common side effects of Prozac include headaches and difficulty sleeping, while Klonopin often causes drowsiness and dizziness.

Fluoxetine

(Prozac)

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Clonazepam

(Klonopin)

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Summary for Prozac

Prescription only

Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI). It's used to treat several mental health conditions, including depression and panic disorder. The immediate-release pill and liquid are taken by mouth, typically once or twice daily. The delayed-release capsule is taken weekly, but it's approved only for depression. Some common side effects of fluoxetine (Prozac) include headaches, difficulty sleeping, and tiredness. Don't suddenly stop this medication if you've been taking it for a while; doing so can lead to symptoms of withdrawal.

Indications for Prozac

Pros and Cons for Prozac

Pros

Good choice for treating depression, OCD, and panic disorder
Less likely to make you sleepy compared to some other antidepressants, such as paroxetine (Paxil)
Taken by mouth, typically once daily (IR capsules and liquid) or once weekly (DR capsules, for depression only)
Can be taken with or without food

Cons

Can take up to 2 months for you to feel the full effects of the medication
Can raise the risk of suicidal thoughts and/or behavior in those age 24 or younger
Can interact with other medications, especially those affecting serotonin levels
Can cause withdrawal symptoms if you suddenly stop taking it

Common Side Effects for Prozac

Difficulty falling asleep (up to 33%)
Nausea (up to 29%)
Headache (21%)
Weakness (up to 21%)
Diarrhea (up to 18%)
Low appetite (up to 17%)
Drowsiness (up to 17%)
Anxiety (up to 15%)
Nervousness (up to 14%)
Tremor (up to 13%)
Dry mouth (up to 12%)
Throat pain (up to 11%)
Yawning (up to 11%)
Low sex drive (up to 11%)

Warnings for Prozac

Worsening depression, suicidal thoughts and behavior
Anxiety and trouble sleeping
Serotonin syndrome
Severe allergic reactions
Not for use alone in bipolar disorder
Risk of bleeding
Glaucoma
Low blood sodium levels
Life-threatening abnormal heart rhythm (QT prolongation)

Summary for Klonopin

Prescription only

Clonazepam (Klonopin) is a benzodiazepine. It's approved to treat seizures in adults and children, and panic disorder in adults only. Clonazepam (Klonopin) is taken by mouth, typically two or three times a day. It's also available as orally disintegrating tablets (ODTs) for people who have trouble swallowing. Some common side effects of this medication include drowsiness, dizziness, and poor movement control. Before stopping clonazepam (Klonopin), speak with your prescriber to come up with a plan to lower your dose slowly over time to avoid withdrawal symptoms.

Indications for Klonopin

Pros and Cons for Klonopin

Pros

Taken by mouth
Less likely to cause rebound anxiety (in people with panic disorders) when stopping compared to some other benzodiazepines
Available as a lower-cost generic
Available as orally disintegrating tablet (ODT)

Cons

Taken 2 to 3 times daily
Can be habit-forming, so isn't typically used for long-term treatment
Can cause memory problems, drowsiness, dizziness, and confusion
Might not work as well for seizure control over time

Common Side Effects for Klonopin

Seizures:

Drowsiness (50%)
Poor movement control, clumsiness (30%)
Behavior problems (25%)

Panic Disorder:

Drowsiness (up to 50%)
Dizziness (up to 12%)
Runny nose, sore throat, and other symptoms of a respiratory infection (up to 10%)
Extreme tiredness (up to 9%)
Poor movement control, clumsiness (up to 9%)
Depression (up to 8%)