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

Key takeaways

Sertraline (Zoloft) and clonazepam (Klonopin) are both prescription medications, but they belong to different drug classes and treat different conditions. Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression and various anxiety disorders, while clonazepam (Klonopin) is a benzodiazepine used to treat seizures and panic disorder. You typically take sertraline (Zoloft) once a day, whereas clonazepam (Klonopin) is usually taken two to three times daily. Sertraline (Zoloft) is not a controlled substance, but clonazepam (Klonopin) is a Schedule IV controlled substance due to its potential for misuse and dependence. Common side effects of sertraline (Zoloft) include nausea and diarrhea, while clonazepam (Klonopin) often causes drowsiness and dizziness. Additionally, sertraline (Zoloft) can take up to two months to show full benefits, whereas clonazepam (Klonopin) typically works within a few hours. Both medications have generic forms available.

Sertraline

(Zoloft)

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Clonazepam

(Klonopin)

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Summary for Zoloft

Prescription only

Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI). It's used to treat different mental health conditions, including depression and certain types of anxiety disorder, such as panic disorder. It's typically taken by mouth once per day. This medication is available as both a tablet and liquid. Common side effects of sertraline (Zoloft) include nausea, diarrhea, and dry mouth. It's best to avoid alcohol while taking sertraline (Zoloft) because this combination can worsen side effects of sertraline (Zoloft).

Indications for Zoloft

Pros and Cons for Zoloft

Pros

Taken by mouth once daily
A possible option during pregnancy and breastfeeding
Fewer interactions compared to other SSRIs
Less likely to cause weight gain compared to paroxetine (Paxil)
Available as a generic

Cons

Can take up to 2 months before you feel the full benefits
More likely to cause diarrhea compared to other SSRIs
Might make it more difficult for you to fall asleep
Can cause withdrawal symptoms if you suddenly stop taking it
The liquid form contains alcohol

Common Side Effects for Zoloft

Nausea (26%)
Diarrhea (20%)
Difficulty sleeping (20%)
Dry mouth (14%)
Sleepiness (12%)

Warnings for Zoloft

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

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%)