Clonazepam (Klonopin)

Possible Benefits. Useful for generalized anxiety disorder, panic disorder. Works quickly, reduces anticipatory anxiety. Controlled trials suggest it may be helpful for social phobia. Longer acting than alprazolam.

Possible Disadvantages. See benzodiazepines-possible disadvantages, above. Some patients develop depression while taking Klonopin. Best to avoid taking this drug during the first three months of pregnancy. Frequent use in later pregnancy can cause symptoms in the newborn. Avoid breast-feeding on this drug. Alcohol will increase the drug's depressant effects on the brain and can result in excessive drowsiness or intoxication.

Possible Side Effects. See benzodiazepines-side effects, above. Drowsiness occurs for 50% of patients, typically in the first two weeks. Fatigue, unsteadiness.

Dosages Recommended by Investigators. Twice a day, .25 to 2 mg.

Lorazepam (Ativan)

Possible Benefits. Used for generalized anxiety, panic disorder. Few side effects.

Possible Disadvantages. See benzodiazepines-possible disadvantages, above. Do not take if planning to get pregnant, while pregnant or while breast-feeding. Use alcohol with caution.

Possible Side Effects. See benzodiazepines-side effects, above. Drowsiness, dizziness, blurred vision, tachycardia, weakness, disinhibition (where they act inappropriately grandiose or out-of-control).

Dosages Recommended by Investigators. Start with a .5 mg tablet per night on the first night. Increase to .5 mg twice a day. Can be increased .5 mg every two or three days or more. Dosing is usually three times a day. Maximum dose is 10 mg per day.

Diazepam (Valium)

Possible Benefits. Used for generalized anxiety disorder, panic disorder and sometimes for a condition called night terrors, that occurs in children.

Possible Disadvantages. See benzodiazepines-possible disadvantages, above. Avoid use during pregnancy and breast-feeding. Alcohol increases this drugs absorption and it depressant effects on the brain. Be cautious, and never drink alcohol if driving a car or operating dangerous equipment.

Possible Side Effects. See benzodiazepines-side effects, above. Drowsiness, fatigue, dizziness, blurred vision, tachycardia, loss of muscle coordination.

Dosages Recommended by Investigators. Between 5 and 20 mg daily. Valium is a long-acting benzodiazepine, so one or two doses can last the whole day. It is also fast-acting, so you can feel some relief within thirty minutes. You can divide the dose and take it in the morning and evening, or take it all at once.

Chlordiazepoxide (Librium)

Possible Benefits. Used for generalized anxiety.

Possible Disadvantages. See benzodiazepines-possible disadvantages, above. Do not take if planning to get pregnant, if pregnant or breast-feeding. Use caution when drinking alcohol.

Possible Side Effects. See benzodiazepines-side effects, above. Postural hypotension, drowsiness, blurred vision, tachycardia, lack of muscle coordination, nausea.

Dosages Recommended by Investigators. Start with 5 to 25 mg two to four times per day and increase to average of 200 mg, as needed.

Oxazepam (Serax)

Possible Benefits. Used for generalized anxiety.

Possible Disadvantages. See benzodiazepines-possible disadvantages, above. May reduce blood pressure. Do not take if planning to get pregnant, if you are pregnant or if you are breast-feeding. Intensifies effects of alcohol.

Possible Side Effects. See benzodiazepines-side effects, above. Drowsiness, dizziness, postural hypotension, tachycardia.

Dosages Recommended by Investigators. The usual dose is 10 to 30 mg, three to four times per day.

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