Anti Anxiety

What are the Differences between Alprazolam, Etizolam, Clonazepam and Diazepam?

25 Jan 2023

Alprazolam, Etizolam, Clonazepam, and Diazepam are all Benzodiazepines. These are in a family of drugs known as central nervous system depressants, along with alcohol and barbiturates. The drugs of this category work similarly in your brain and body. As they are similar, is there a difference between benzodiazepine options? How do you know which benzodiazepine is appropriate for your needs? There are some essential differences between each prescription drug. Working with your doctor to determine the best one for you is vital.


What are Benzodiazepines?

Benzodiazepines (also called Benzos) are drugs that may treat many conditions. Doctors often prescribe Benzodiazepines to treat anxiety, seizures, and insomnia. Benzodiazepines change the activity of the neurons that trigger stress and produce anxiety reactions. A benzodiazepine enhances the effect of a neurotransmitter known as gamma-aminobutyric acid, or GABA, that suppresses the activity of nerves. Doctors prescribe benzodiazepines for:

  • Anxiety disorder
  • Panic disorder
  • Depression
  • Seizures (convulsions)
  • Insomnia or trouble sleeping
  • General anaesthesia
  • Sedation before surgery or diagnostic procedures
  • Muscle relaxation
  • Alcohol withdrawal and drug-associated agitation
  • Nausea and vomiting due to chemotherapy


Types of Benzodiazepines

Benzodiazepines are of different types, each with a different length of action. For example, short-acting benzodiazepines bind to the brain rapidly, have a short half-life, and are quickly metabolised out of the body.

  • Short-actingAlprazolam, Diazepam, Etizolam
  • Intermediate-acting: Chlordiazepoxide, Lorazepam
  • Long-acting: Clonazepam, Oxazepam, Prazepam, Temazepam 

How Alprazolam, Etizolam, Clonazepam, and Diazepam Differ?

There are several aspects in which benzodiazepines are different from each other:


Onset of Action


Diazepam (Valium) begins working quickly. It has an onset of action as short as 20 to 30 minutes. The quick onset of action may be ideal for people who require fast relief. For instance, Clorazepate sometimes treats partial seizures. Since seizures can come on suddenly, immediate relief is essential. Panic disorders also need quick relief.  


Alprazolam has an intermediate onset of action, along with Oxazepam, Lorazepam and Clonazepam. Alprazolam may take 1-2 hours before you feel its full effect. Benzodiazepines that take a long time to work may still be helpful if you have time to prepare. They may effectively treat insomnia by taking it before winding down for the night.


Duration of Action

The duration of action means the length of time a drug works. Benzodiazepines fall into different categories, like short-acting, intermediate-acting, and long-acting benzodiazepines.


Benzodiazepines with a short duration of action are helpful for people who face trouble falling asleep but usually stay asleep through the night. In addition, short-acting benzodiazepines may be available in extended-release forms. Extended-release tablets are formulated to release a hefty dosage of the drug over time, extending the length of time they are effective. 


Benzos that last for long periods are helpful for short-term therapeutic use. For example, suppose you have an anxiety disorder. You may take long-acting benzos consistently for several days or weeks to relieve symptoms. Then you may taper off the medication.

Length of half-life

Some benzodiazepines act on the brain and body for longer than others. The half-life of each medicine is a helpful way to know how long a drug's effects last. Short-acting benzodiazepines have a shorter half-life. It means that the drugs are processed and leave the body more quickly. Short-acting drugs also have an increased risk of withdrawal symptoms. This is because the body has less time to adapt to working without the medication once you stop using it.


Long-acting benzodiazepines have a longer half-life. It means that the drugs are processed by the body more slowly and take longer to leave the body. As a result, you are more likely to experience a hangover effect when taking these drugs. But you are less likely to experience withdrawal problems.


Generally, short-acting benzodiazepines are often used as sleeping pills and long-acting benzodiazepines for anxiety. But this is not always the case. For example, some anxiety-related drugs also help you sleep if you take them at night. And lower doses of sleeping pills can help you stay calm if you take them during the day.


Potency (strength)

Benzodiazepines may have different levels of potency. This refers to the strength of each drug's chemical reaction in the body. Take a lower dosage of a high-potency benzodiazepine. It may cause similar effects to a higher dosage of a low-potency benzodiazepine.


Metabolism (breakdown in the body)

Your body breaks down benzodiazepines in many ways. The process is known as your body metabolising the drug. Some benzodiazepine drugs, such as diazepam, produce other benzodiazepine chemicals when metabolising them. These additional chemicals stay in the body, prolonging the drug's overall effect.



Benzodiazepines are a group of depressant drugs. They're generally prescribed for anxiety or occasionally sleeping problems. They have a similar mode of action, but still, they differ in some respects.